Sialolithiasis or complex odontoma?

We present a case of a 53-year old woman admitted for treatment in the clinic after detection of radiopacity in the left half of the mandible. The patient was operated on with a tentative diagnosis of complex odontoma. No pathological lesion was found intraoperatively after trepanation of the mandibular bone. Additional clinical examination and contrast media sialography of the left submandibular salivary gland in PA and lateral oblique view were instrumental in making the correct diagnosis and administering the proper treatment. This case demonstrates that difficulties may arise in differentiating between a sialolith and a complex odontoma.