Conservative Management of an Anterior Maxillary Calcifying Epithelial Odontogenic Tumor With Customized Titanium Mesh-Guided Bone Regeneration and Implant Rehabilitation

Calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is a rare benign odontogenic neoplasm with a recognized risk of local recurrence. Management of anterior maxillary lesions is particularly challenging due to aesthetic and functional implications. We report the case of a 26-year-old woman who presented with a missing maxillary right canine. Cone beam computed tomography (CBCT) revealed a 2.2 × 1.5 × 1.2 cm, well-defined mixed lesion associated with an impacted tooth 13 with internal calcifications. Incisional biopsy suggested CEOT. Following a multidisciplinary discussion, a conservative surgical approach was selected. Enucleation with curettage and extraction of tooth #13 were performed. Histopathology confirmed CEOT. Complete bone healing was observed at eight months. Secondary reconstruction using guided bone regeneration with a customized titanium mesh was performed, followed by implant placement and prosthetic rehabilitation. At the 30-month follow-up, no evidence of recurrence or implant-related complications was observed. In effect, in selected anterior maxillary CEOTs, conservative surgery followed by staged reconstruction and implant rehabilitation may achieve satisfactory oncologic, functional, and aesthetic outcomes.