An unerupted tooth is one that cannot erupt in the dental arch. Depending on the location, radiographic density may be confused with mineralized bone alterations. A 70-year-old female patient with melanoderma visited the outpatient clinic for stomatologic evaluation, prior to placement of a total prosthesis. In the intra-oral examination, we observed a nodule located in the alveolar ridge of the maxilla, well delimited, hardened, and normochromic, suggesting an included tooth. No changes were seen in the periapical radiograph, but the panoramic radiograph indicated a complex odontoma. To clarify the diagnosis, occlusal radiography was performed, evidencing the presence of an included tooth. The proposed treatment was extraction. Computed tomography analysis confirmed the presence of the included tooth, placed horizontally, with the crown facing distally, located in the tuberosity of the left maxilla. It is concluded that imaging tests help to clarify the diagnosis and therapeutic approach of bone alterations.