A little boy of 7 years old was brought to Saveetha Dental College and Hospital by his parents with a complaint of a swelling in the jaw. He had been taken to a nearby hospital, Chennai at the age of 3 since the parents noticed a small swelling at the right lower jaw, but he refused to co-operate for any investigative procedures as he was very young. Hence the swelling was left undiagnosed for 4 years. He was brought to our institution at the age of 7 years as the swelling was slowly increasing in size.

The parents were very apprehensive as they had thought it could be a cancer of the jaw. The initial work up by the surgeons revealed a large lesion with multiple hard structures at a single site within the lower jaw. During the surgery, the operating surgeon noticed a well-defined bag like mass which was removed in its entirety. The specimen weighed about 200gms.

The specimen was radiographed which revealed multiple tiny radiopaque structures. On further evaluation by the oral pathologists, and to their utmost surprise the bag revealed 526 tooth like structures. In the pathologists’ own words “it was reminiscent of pearls in an oyster”. It took 5 hours of meticulate searching to remove all the minute teeth from the opened bag like specimen. “This pandora box of miniature teeth is a jewel on our crown” said the postgraduates. The tooth sizes varied from 1mm to 15mm and each resembled a tooth with crown covered by enamel and a root like structure.

This is the first ever case to be documented world wide, where so many minute teeth were found in a single individual. This rare lesion is termed as “compound odontome”. The expertise and the competence of the team of oral surgeons and oral pathologists in Saveetha Dental College and Hospitals in dealing with such a rare case are to be applauded. The surgeons’ discretion in removing the lesion in total without exploring it on the operating table (akin to opening a bag of worms) avoided a major mishap and saved the patient from being under general anaesthesia for a longer duration and the attendant complications. Saveetha has always been the benchmark of excellence and abides by all health care schemes and is readily accessible to all strata of patients.

Clinical Photograph: 7 year old boy with swelling in right side of lower jaw

Faculty & Postgraduates Counting the teeth

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**For furthur details kindly communicate to: dir.acad.sac@saveetha.com**

OPG: Reveals Mixed Radiolucent -Radioopaque structure in the right side of the lower jaw