Background: The clinical presentation, radiographic features, and histopathological findings of a case of ameloblastic fibro-odontoma are described. The clinical and radiographic presentations of this case are typical of this benign odontogenic tumor. The patient was young and asymptomatic with the exception of the clinical absence of the permanent mandibular left first molar. Treatment consisted of simple enucleation with removal of the primary mandibular left second molar.

Methods: A panoramic image and cone beam computed tomography (CBCT) scan were acquired in order to determine the reason for clinical absence of the permanent mandibular left first molar. The CBCT image proved to be a valuable supplement to the conventional radiographic examination as it provided information not apparent on the 2-dimensional panoramic image. Both the extent of the lesion and its effects on adjacent structures were better delineated with CBCT. Additionally, the presence of calcifications, an important radiographic characteristic of this particular lesion, were visible on CBCT versus the panoramic image.

Conclusions: This case report demonstrates that the CBCT scan provided important management and treatment planning information that was not apparent in the panoramic image.

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