Surgical Management of Pediatric Odontogenic Tumors: Clinical, Radiographic, and Histopathological Outcomes

Abstract

Background:
Pediatric odontogenic tumors are uncommon lesions that may present with variable clinical and radiographic features, making accurate diagnosis and selection of an appropriate surgical approach important for achieving favorable outcomes while minimizing morbidity.
Aim:
The present study aimed to evaluate the clinical, radiographic, histopathological, and postoperative outcomes of surgically managed pediatric odontogenic tumors and to assess the relationship between surgical approach, radiographic characteristics, and tumor recurrence.
Materials and Methods:
A total of 30 pediatric patients with histopathologically diagnosed odontogenic tumors were evaluated. Demographic characteristics, anatomical site, clinical presentation, radiographic features, histopathological diagnosis, surgical procedure, early postoperative complications, treatment response, and recurrence were assessed. Descriptive statistics were expressed as mean ± standard deviation or frequency and percentage. Associations between categorical variables were evaluated using the chi-square test or Fisher’s exact test, with statistical significance established at p < 0.05.
Results:
The study population had a mean age of 12.7 ± 3.1 years, with males comprising 60.0% of the participants. The mandible was involved in 76.7% of cases, with the posterior mandible being the most frequently affected site (53.3%). Painless swelling was the predominant clinical presentation (66.7%). Radiographically, unilocular radiolucency was most common (60.0%), while 83.3% of lesions had well-defined borders and 63.3% demonstrated cortical expansion. Unicystic ameloblastoma was the most frequent histopathological diagnosis (26.7%), followed by adenomatoid odontogenic tumor (20.0%) and odontoma (16.7%). Enucleation with curettage was the most commonly performed surgical procedure (43.3%), followed by enucleation alone (23.3%). Primary bone healing without complications occurred in 83.3% of cases. Overall, complete clinical and radiographic resolution was achieved in 90.0% of patients, while recurrence occurred in 3.3% of cases. Recurrence was not significantly associated with conservative versus radical/segmental surgery (p = 0.540). However, cortical expansion (p = 0.001) and root resorption/displacement (p = 0.036) were significantly associated with recurrence.
Conclusion:
Pediatric odontogenic tumors in this study showed a predominance of mandibular involvement and commonly presented as painless swelling with well-defined, predominantly unilocular radiolucent lesions. Conservative surgical management was frequently used and was associated with favorable healing and treatment outcomes. Although overall recurrence was low, selected radiographic features, particularly cortical expansion and root resorption or displacement, were associated with recurrence and may be useful in postoperative risk assessment and follow-up planning.