Immediate Implant Placement Following Surgical Removal of a Complex Odontoma of the Mandible: A Case Report

Abstract

Background: Complex odontomas are benign developmental odontogenic lesions composed of disorganised dental hard tissues. Although often asymptomatic, they may present with pain, swelling, or infection, or may interfere with normal tooth eruption. Immediate implant placement following surgical removal of a complex odontoma has been infrequently reported, and evidence regarding its clinical outcomes remains limited. Case Presentation: A 45-year-old female presented with intermittent pain and swelling in the left posterior mandibular region following an unsuccessful extraction attempt of the mandibular left first molar two years earlier. Clinical examination and cone beam computed tomography (CBCT) revealed a well-defined radiopaque lesion with a surrounding radiolucent rim, consistent with a complex odontoma. Based on the available bone volume and comprehensive treatment planning, surgical enucleation of the lesion followed by immediate implant placement was undertaken. Treatment and Results: A full-thickness mucoperiosteal flap was elevated, and the buccal cortical plate was carefully removed to facilitate complete surgical excision of the odontoma. Following debridement of the surgical site, a 3.5 × 10 mm dental implant was placed, achieving adequate primary stability. The residual peri-implant defect was augmented using a bone graft (xenograft) secured with the patient’s own PRF to support bone regeneration. Postoperative healing was uneventful, with satisfactory clinical recovery and radiographic evidence of appropriate implant positioning during follow-up. Conclusion: This case demonstrates that immediate implant placement following complete surgical removal of a complex odontoma may represent a predictable treatment option in carefully selected patients with adequate bone support. Comprehensive preoperative CBCT assessment, meticulous surgical technique, and appropriate case selection are essential for achieving favourable clinical outcomes. Nevertheless, additional studies with larger patient cohorts and long-term follow-up are required to validate the long-term success of this treatment approach.