Hamartomas in the opercula of four unerupted primary molars

Abstract

Odontogenic lesions in the opercula may result in delayed eruption of primary molars. CASE REPORTS This case presents a rare occurrence of delayed eruption of four primary molars causing interference with normal function. The lesions were surgically excised to expose the underlying first deciduous molars. Histopathological analysis of the excised tissue revealed hamartomatous lesions. These lesions appeared histologically identical to those of an odontogenic giant cell fibroma, consisting of odontogenic epithelial islands with scattered giant cells and histiocytes in a surrounding dense fibrous connective tissue stroma. Occasional dyskeratotic cells were also noted with an intermixed mild, chronic inflammatory cell infiltrate. CONCLUSION Eruption cysts are traditionally left untreated to resolve spontaneously with the eruption of the underlying teeth. However, lesions that stay unresolved or interfere with function should be surgically excised and sent for hist- ological analysis. The presence of hamartomas in the oper- culum should be considered as a differential diagnosis in persistent unerupted deciduous and permanent teeth.