Unusual Mandibular Presentations of Adenomatoid Odontogenic Tumor: Two Case Reports and Surgical Management

Abstract Adenomatoid odontogenic tumour is a benign odontogenic tumour typically found in the anterior maxilla of adolescent females, often associated with impacted canines. Mandibular presentations are rare and can be challenging to diagnose, as they may mimic other odontogenic pathologies. This report details two unusual cases of mandibular AOT in females aged 20 and 12 years. Case 1 involved a large, expansive lesion requiring surgical enucleation and reconstruction due to extensive bony loss. Case 2 was an incidental discovery during orthodontic evaluation, managed conservatively with enucleation and extraction of the associated impacted canine. Histopathological examination in both cases confirmed AOT, revealing characteristic features such as duct-like structures, rosette formations, and calcifications. These cases highlight the importance of considering AOT in the differential diagnosis of mandibular radiolucencies, especially in young female patients. Early diagnosis, comprehensive radiological assessment (including CBCT), and histopathological confirmation are crucial for appropriate conservative surgical management, which typically yields excellent prognoses with minimal recurrence.