Hundreds of teeth extracted from a teen

 

Case brief

Dentists were left stunned after a 17year old male patient from Buldhana presented with 232 teeth after suffering from a rare condition. Doctors at J J Hospital spent 6 hours with the boy in surgery removing all his extra teeth leaving him now with 28 teeth. The boy, Ashiq Gavai, from a village in Buldhana district in the Amravati region. His family noticed a facial swelling on the right side of his mandible, however, local doctors were unable to identify the issue.

A few weeks later the boy started complaining of severe pain, his family were also panicked and rushed him to the city of Mumbai for a thorough head and neck examination where he was later diagnosed with ‘composite odontoma’.  This is a very rare condition and literature available shows that it has previously be seen in the maxilla where 25 teeth were extracted.  However, in Gavais case, the tumour was deep in the mandible, and 232 teeth needed to be removed, said Dr Sunanda Dhiware, head of the dental unit at J.J. Hospital.

Treatment

Composite odontoma is classified as a benign tumour, however, it is not a life-threatening condition.  It can cause difficulties in eating, swallowing and can cause debilitating facial swellings. At the hospital, the operation was carried out by 2 surgeons and 2 assistants where they attempted to remove all of the tumour cells intraorally. “While a few teeth were loose, others were in clumps which made it difficult to count. The tumour was an abnormal growth of the second molar which did not come out. It was also pressing on the wisdom tooth which we had to remove” Dhiware said.

Ashiq now has a much healthier dentition and a normal 28 teeth however doctors did fear that during the operation due to the nature of the tumour the mandible may have fractured needing screws and jaw plates, but this was not the case and Ashiq’s jaw remains intact.

Follow up

The surgeons attempted to remove all of the abnormal tumour cells, however, there is always a chance that the condition could reoccur due to residual cells being left in situ, regular follow-ups are vital in the long term.