Dental Pathology Quiz
120 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What type of odontogenic tumor is composed of mesenchyme and/or odontogenic ectomesenchyme with or without odontogenic epithelium?

  • Malignant Odontogenic Tumor
  • Benign Odontogenic Tumor
  • Odontogenic Fibroma (correct)
  • Odontogenic Carcinoma

    • What is the term for a benign odontogenic tumor that is composed of epithelial cells and resembles an ameloblastoma?

  • Squamous Odontogenic Tumor
  • Adenomatoid Odontogenic Tumor (correct)
  • Ameloblastoma, Unicystic Type
  • Calcifying Epithelial Odontogenic Tumor

    • What is the term for a malignant odontogenic tumor that arises from an ameloblastoma?

  • Clear Cell Odontogenic Carcinoma
  • Ameloblastic Carcinoma, Primary Type
  • Metastasizing (Malignant) Ameloblastoma (correct)
  • Ameloblastic Carcinoma, Secondary Type

    • What type of odontogenic tumor is characterized by the presence of ghost cells?

    <p>Ghost Cell Odontogenic Carcinoma</p> Signup and view all the answers

    What is the term for a benign odontogenic tumor that is composed of a mixture of epithelial and mesenchymal cells?

    <p>Ameloblastic Fibroma</p> Signup and view all the answers

    What is the term for a type of odontogenic carcinoma that arises from a keratocystic odontogenic tumor?

    <p>Primary Intraosseous Squamous Carcinoma Derived from Keratocystic Odontogenic Tumor</p> Signup and view all the answers

    Which of the following is an example of an odontogenic sarcoma?

    <p>Ameloblastic Fibrosarcoma</p> Signup and view all the answers

    What is the term for a type of benign odontogenic tumor that is composed of epithelial cells and resembles an ameloblastoma?

    <p>Calcifying Epithelial Odontogenic Tumor</p> Signup and view all the answers

    Which of the following tumors is classified as a benign epithelial odontogenic tumor?

    <p>Adenomatoid odontogenic tumor</p> Signup and view all the answers

    What is the classification of Odontoma?

    <p>Benign mixed epithelial &amp; mesenchymal odontogenic tumor</p> Signup and view all the answers

    Which of the following is a malignant Odontogenic Tumor?

    <p>Ameloblastic carcinoma</p> Signup and view all the answers

    What type of tumor is Ameloblastoma, unicystic?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What is the classification of Odontogenic myxoma?

    <p>Benign mesenchymal odontogenic tumor</p> Signup and view all the answers

    Which of the following tumors is classified as a benign mixed epithelial & mesenchymal odontogenic tumor?

    <p>Odontoma</p> Signup and view all the answers

    What type of tumor is Ameloblastic carcinoma?

    <p>Malignant Odontogenic Tumor</p> Signup and view all the answers

    Which of the following is NOT a malignant Odontogenic Tumor?

    <p>Odontogenic fibroma</p> Signup and view all the answers

    What is the average age of incidence for Cementoblastoma?

    <p>25 years</p> Signup and view all the answers

    What is the typical shape of the radiopaque mass in a Cementoblastoma?

    <p>Irregular</p> Signup and view all the answers

    What is the characteristic feature of the pain associated with Cementoblastoma?

    <p>Low-grade intermittent pain</p> Signup and view all the answers

    What is the composition of the mineralized trabeculae in Cementoblastoma?

    <p>Cementum or cementum-like tissue</p> Signup and view all the answers

    What is the typical site of predilection for Cementoblastoma?

    <p>Mandible</p> Signup and view all the answers

    What is the treatment for Cementoblastoma?

    <p>Excision with extraction of the associated tooth</p> Signup and view all the answers

    What is the characteristic feature of the cells lining the mineralized trabeculae?

    <p>Prominent cementoblast cells</p> Signup and view all the answers

    What is the prognosis for Cementoblastoma?

    <p>Good prognosis without recurrence</p> Signup and view all the answers

    What is the most characteristic histopathologic feature of COC?

    <p>Ghost cells</p> Signup and view all the answers

    What type of calcification is seen in COC?

    <p>Both A and C</p> Signup and view all the answers

    What is the definition of an odontoma?

    <p>A non-neoplastic developmental malformation</p> Signup and view all the answers

    What is the most common type of odontogenic tumors?

    <p>Odontoma</p> Signup and view all the answers

    What are the possible causes of an odontoma?

    <p>All of the above</p> Signup and view all the answers

    What is unique about the cells in an odontoma?

    <p>They are fully differentiated and functional</p> Signup and view all the answers

    What is the main difference between compound and complex odontoma?

    <p>Pattern of dental tissues</p> Signup and view all the answers

    What is the composition of a compound odontoma?

    <p>Multiple small tooth-like structures</p> Signup and view all the answers

    What is the percentage of the Extrafollicular type of AOT that is not related to an unerupted tooth?

    <p>24%</p> Signup and view all the answers

    What is the location of the Peripheral (extraosseous) type of AOT?

    <p>In the gingiva</p> Signup and view all the answers

    What is the characteristic of the radiolucency in the Follicular type of AOT?

    <p>Well defined unilocular</p> Signup and view all the answers

    What is the distinguishing feature of the Extrafollicular type of AOT?

    <p>Contains faint calcifications</p> Signup and view all the answers

    What is the composition of the tumor in AOT?

    <p>Spindle shaped epithelial cells and little fibrous CT stroma</p> Signup and view all the answers

    What is the characteristic of the duct-like structures in AOT?

    <p>Consist of a central space surrounded by a single layer of columnar cells</p> Signup and view all the answers

    What is the nature of the eosinophilic material in the duct-like structures of AOT?

    <p>It is a type of basement membrane-like material</p> Signup and view all the answers

    What is the characteristic of the rings of columnar epithelial cells in AOT?

    <p>They give rise to tubular structures with two rows of cells</p> Signup and view all the answers

    What is the definition of Odontogenic Tumors?

    <p>A group of neoplasm and tumors-like malformations derived from epithelial and/or ectomesenchymal elements.</p> Signup and view all the answers

    According to the WHO Classification of Odontogenic Tumors / 2005, what type of tumor is Ameloblastoma?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What is the characteristic of the tumor in Odontoma?

    <p>It is a type of benign tumor composed of epithelial and mesenchymal cells.</p> Signup and view all the answers

    What is the classification of Ameloblastic fibroma?

    <p>Benign mixed epithelial and mesenchymal odontogenic tumor</p> Signup and view all the answers

    What is the characteristic of the odontogenic epithelium in Odontogenic tumors?

    <p>It is derived from epithelial elements.</p> Signup and view all the answers

    What is the classification of Calcifying epithelial odontogenic tumor?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What is the origin of Odontogenic Tumors?

    <p>From odontogenic tissues.</p> Signup and view all the answers

    Which of the following is an example of a benign odontogenic tumor?

    <p>Ameloblastoma</p> Signup and view all the answers

    What is the characteristic of the adenomatoid odontogenic tumor?

    <p>It is a benign tumor with a well-encapsulated fibrous capsule</p> Signup and view all the answers

    What is the origin of the Calcifying Epithelial Odontogenic Tumor?

    <p>Stratum intermedium of the enamel organ or Reduced Enamel Epithelium</p> Signup and view all the answers

    What is the average age of incidence for Calcifying Epithelial Odontogenic Tumor?

    <p>40 years</p> Signup and view all the answers

    What is the most common site of predilection for Calcifying Epithelial Odontogenic Tumor?

    <p>Central (intra-osseous) mandible</p> Signup and view all the answers

    What is the treatment for adenomatoid odontogenic tumor?

    <p>Simple enucleation</p> Signup and view all the answers

    What is the characteristic of the Calcifying Epithelial Odontogenic Tumor?

    <p>It is a benign but locally invasive tumor</p> Signup and view all the answers

    What is the prognosis for adenomatoid odontogenic tumor?

    <p>Good</p> Signup and view all the answers

    What can be seen in the adenomatoid odontogenic tumor?

    <p>Small foci of calcifications</p> Signup and view all the answers

    What is the characteristic histopathologic feature of COC?

    <p>Presence of ghost cells</p> Signup and view all the answers

    What type of calcification is seen in COC?

    <p>Both dentinoid and dystrophic calcification</p> Signup and view all the answers

    What is the characteristic of the tumor in Ameloblastic Fibroma?

    <p>It is composed of epithelial and ectomesenchymal tissues</p> Signup and view all the answers

    What is the definition of an odontoma?

    <p>A non-neoplastic developmental malformation</p> Signup and view all the answers

    In which decades of life is Ameloblastic Fibroma more commonly seen?

    <p>1st and 2nd decades</p> Signup and view all the answers

    What is the most common type of odontogenic tumors?

    <p>Odontoma</p> Signup and view all the answers

    What are the possible causes of an odontoma?

    <p>Both local trauma or infection, and genetic or inherited mutations</p> Signup and view all the answers

    What is the sex incidence of Ameloblastic Fibroma?

    <p>Male &gt; female</p> Signup and view all the answers

    What is the typical site of predilection for Ameloblastic Fibroma?

    <p>Mandibular premolar-molar area</p> Signup and view all the answers

    What is unique about the cells in an odontoma?

    <p>They are fully differentiated</p> Signup and view all the answers

    What is the characteristic of the radiolucent area in Ameloblastic Fibroma?

    <p>It is a well-defined unilocular radiolucent area</p> Signup and view all the answers

    What is the main difference between compound and complex odontoma?

    <p>Pattern of formation of dental tissues</p> Signup and view all the answers

    What is the composition of a compound odontoma?

    <p>Multiple small tooth-like structures</p> Signup and view all the answers

    What is the characteristic of the mesenchymal tissue in Ameloblastic Fibroma?

    <p>It is composed of immature dental papilla</p> Signup and view all the answers

    What is the characteristic of the epithelial components in Ameloblastic Fibroma?

    <p>They are present in two distinct patterns</p> Signup and view all the answers

    What is the characteristic of the tumor border in Ameloblastic Fibroma?

    <p>It is well-defined but not encapsulated</p> Signup and view all the answers

    What is the origin of Cementoblastoma?

    <p>Periodontal ligament and cementoblast</p> Signup and view all the answers

    What is the average age of incidence for Cementoblastoma?

    <p>25 years</p> Signup and view all the answers

    What is the typical site of predilection for Cementoblastoma?

    <p>Mandible, especially lower first permanent molar</p> Signup and view all the answers

    What is the characteristic feature of the pain associated with Cementoblastoma?

    <p>Low grade intermittent pain</p> Signup and view all the answers

    What is the typical radiographic appearance of Cementoblastoma?

    <p>Well-demarcated radiopaque mass with a thin radiolucent rim</p> Signup and view all the answers

    What is the composition of the mineralized trabeculae in Cementoblastoma?

    <p>Cementum-like tissue</p> Signup and view all the answers

    What is the treatment for Cementoblastoma?

    <p>Excision with extraction of the associated tooth</p> Signup and view all the answers

    What is the prognosis for Cementoblastoma?

    <p>Good prognosis with no recurrence</p> Signup and view all the answers

    What is the definition of Odontogenic Tumors?

    <p>A group of neoplasm &amp; tumors-like malformations derived from epithelial and/or ectomesenchymal elements</p> Signup and view all the answers

    What is the origin of Odontogenic Tumors?

    <p>From odontogenic tissues</p> Signup and view all the answers

    According to the WHO Classification of Odontogenic Tumors / 2005, what type of tumor is Ameloblastoma?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What type of tumor is Squamous odontogenic tumor?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What type of tumor is Adenomatoid odontogenic tumor?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What type of tumor is Keratinizing cystic odontogenic tumor?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What type of tumor is Ameloblastic fibroma?

    <p>Benign mixed epithelial &amp; mesenchymal odontogenic tumor</p> Signup and view all the answers

    What type of tumor is Calcifying epithelial odontogenic tumor?

    <p>Benign epithelial odontogenic tumor</p> Signup and view all the answers

    What is the characteristic of the granular cells in Granular Cell Ameloblastoma?

    <p>They are cuboidal or rounded cells with eosinophilic granules</p> Signup and view all the answers

    What is the average age of incidence for unicystic ameloblastoma?

    <p>23 years</p> Signup and view all the answers

    What is the result of squamous metaplasia in Acanthomatous Ameloblastoma?

    <p>Production of keratin in form of keratin pearls</p> Signup and view all the answers

    What is the characteristic of Basaloid Ameloblastoma?

    <p>It shows close similarity to basal cell carcinoma</p> Signup and view all the answers

    Where is the site of predilection for unicystic ameloblastoma?

    <p>Lower posterior area</p> Signup and view all the answers

    What is the characteristic radiographic feature of unicystic ameloblastoma?

    <p>Well-defined unilocular radiolucency</p> Signup and view all the answers

    What is the result of hyalinization of the stroma in Desmoplastic Ameloblastoma?

    <p>The stroma remains eosinophilic and never calcifies</p> Signup and view all the answers

    What is the histopathological feature of luminal unicystic ameloblastoma?

    <p>Fibrous cyst wall with a lining of ameloblastic epithelium</p> Signup and view all the answers

    What is the recurrence rate of conventional ameloblastoma with curettage?

    <p>50% to 90%</p> Signup and view all the answers

    What is the treatment for unicystic ameloblastoma?

    <p>Enucleation without a safety margin</p> Signup and view all the answers

    What is the characteristic of Unicystic Ameloblastoma?

    <p>It is a benign tumor composed of a central large cystic cavity</p> Signup and view all the answers

    What is the effect of marginal resection on the recurrence rate of conventional ameloblastoma?

    <p>It reduces the recurrence rate to 15%</p> Signup and view all the answers

    What is the characteristic of the basal layer of ameloblastic epithelium in unicystic ameloblastoma?

    <p>Hyperchromatic nuclei and vacuolated cytoplasm</p> Signup and view all the answers

    What is the histopathological variant of unicystic ameloblastoma characterized by one or more nodules of ameloblastoma projecting into the lumen of the cyst?

    <p>Intra-luminal ameloblastoma</p> Signup and view all the answers

    What is the origin of Unicystic Ameloblastoma?

    <p>It develops de-novo as a neoplasm</p> Signup and view all the answers

    What is the recurrence rate of unicystic ameloblastoma after enucleation?

    <p>10-20%</p> Signup and view all the answers

    What is the percentage of the Extrafollicular type of AOT that is not related to an unerupted tooth?

    <p>24%</p> Signup and view all the answers

    Where is the Peripheral (extraosseous) type of AOT typically located?

    <p>In the gingiva</p> Signup and view all the answers

    What is the characteristic of the radiolucency in the Follicular type of AOT?

    <p>It is well-defined and unilocular, and involves the crown of an unerupted tooth</p> Signup and view all the answers

    What is the distinguishing feature of the Extrafollicular type of AOT?

    <p>It contains faint calcifications and patchy radiopacities</p> Signup and view all the answers

    What is the composition of the tumor in AOT?

    <p>Spindle shaped epithelial cells that form sheets, islands, and whorled masses in a little fibrous stroma</p> Signup and view all the answers

    What is the characteristic of the duct-like structures in AOT?

    <p>They consist of a central space surrounded by a single layer of columnar cells</p> Signup and view all the answers

    What is the nature of the eosinophilic material in the duct-like structures of AOT?

    <p>It is a type of basement membrane-like material</p> Signup and view all the answers

    What is the characteristic of the rings of columnar epithelial cells in AOT?

    <p>They give rise to all of the above</p> Signup and view all the answers

    What is the origin of odontogenic fibroma?

    <p>Periodontal ligament, dental papilla, or dental follicles</p> Signup and view all the answers

    What is the age incidence of odontogenic fibroma?

    <p>40 years</p> Signup and view all the answers

    What is the sex incidence of odontogenic fibroma?

    <p>Female &gt; male</p> Signup and view all the answers

    What is the site predilection of odontogenic fibroma?

    <p>Anterior maxilla</p> Signup and view all the answers

    What is the radiographic feature of odontogenic fibroma?

    <p>Well-defined unilocular radiolucency</p> Signup and view all the answers

    What is the composition of odontogenic fibroma?

    <p>Fibrous tissue containing strands and islands of inactive odontogenic epithelium</p> Signup and view all the answers

    What is the treatment for odontogenic fibroma?

    <p>Enucleation and curettage</p> Signup and view all the answers

    What is the characteristic of central odontogenic fibroma?

    <p>It has a loose stroma with fine collagen fibrils</p> Signup and view all the answers

    Study Notes

    Odontogenic Tumors

    • Odontogenic tumors can be classified into benign and malignant types
    • Benign odontogenic tumors include:
      • Mesenchymal origin: odontogenic fibroma, odontogenic myxoma/myxofibroma, cementoblastoma
      • Mixed (epithelial-mesenchymal) origin: ameloblastic fibroma, primordial odontogenic tumor, odontoma (complex type), odontoma (compound type), dentinogenic ghost cell tumor
      • Epithelial origin: ameloblastoma, ameloblastoma (unicystic type), ameloblastoma (extraosseous/peripheral type), metastasizing (malignant) ameloblastoma, squamous odontogenic tumor, calcifying epithelial odontogenic tumor, adenomatoid odontogenic tumor

    Malignant Odontogenic Tumors

    • Malignant odontogenic tumors include:
      • Odontogenic carcinomas:
        • Metastasizing (malignant) ameloblastoma
        • Ameloblastic carcinoma – primary type
        • Ameloblastic carcinoma – secondary type (intraosseous)
        • Ameloblastic carcinoma – secondary type (peripheral)
        • Primary intraosseous squamous cell carcinoma – solid type
        • Primary intraosseous squamous carcinoma derived from keratocystic odontogenic tumor
        • Primary intraosseous squamous cell carcinoma derived from odontogenic cysts
        • Clear cell odontogenic carcinoma
        • Ghost cell odontogenic carcinoma
      • Odontogenic sarcomas:
        • Ameloblastic fibrosarcoma
        • Ameloblastic fibro-dentino and fibro-odontosarcoma

    WHO Classification of Odontogenic Tumors (2017)

    • Benign odontogenic tumors:
      • Epithelial origin: ameloblastoma, ameloblastoma (unicystic type), ameloblastoma (extraosseous/peripheral type), metastasizing (malignant) ameloblastoma, squamous odontogenic tumor, calcifying epithelial odontogenic tumor, adenomatoid odontogenic tumor
      • Mixed (epithelial-mesenchymal) origin: ameloblastic fibroma, primordial odontogenic tumor, odontoma (complex type), odontoma (compound type), dentinogenic ghost cell tumor
      • Mesenchymal origin: odontogenic fibroma, odontogenic myxoma/myxofibroma, cementoblastoma
    • Malignant odontogenic tumors:
      • Ameloblastic carcinoma
      • Primary intraosseous carcinoma, NOS
      • Sclerosing odontogenic carcinoma
      • Clear cell odontogenic carcinoma
      • Ghost cell odontogenic carcinoma
      • Odontogenic carcinosarcoma
      • Odontogenic sarcomas

    Adenomatoid Odontogenic Tumor (AOT)

    • AOT is a benign epithelial odontogenic tumor
    • Types of AOT:
      • Follicular type: well-defined unilocular radiolucency involves the crown of an unerupted tooth
      • Extrafollicular type: well-defined unilocular radiolucency usually located between the roots of erupted teeth
      • Peripheral type: rare, situated in gingiva
    • Histopathological features:
      • The tumor may be solid or cystic
      • Made of spindle-shaped epithelial cells that form sheets, islands, and whorled masses of cells in a little fibrous connective tissue stroma
      • Rings of columnar epithelial cells give rise to tubular structure, convoluted bands, and duct-like structures
      • Ghost cells are present and may undergo calcification

    Odontoma

    • Definition: a non-neoplastic developmental malformation (hamartoma) that contains fully formed enamel, dentine, cementum, and pulp
    • Etiology:
      • Unknown origin
      • Local trauma or infection
      • Genetic (inherited or mutation)
    • Types of odontomas:
      • Compound odontoma: a malformation in which all dental tissues are represented in a more orderly pattern than in the complex odontoma
      • Complex odontoma: a malformation in which all dental tissues are represented in a more disorderly pattern than in the compound odontoma

    Cementoblastoma (True Cementoma)

    • Definition: a rare benign ectomesenchymal odontogenic tumor of cementoblast origin, related to a vital tooth
    • Origin: periodontal ligament and cementoblast
    • Clinical features:
      • Age incidence: average age is 25 years
      • Sex incidence: male > female
      • Site predilection: mandible > maxilla (especially lower first permanent molar)
      • Symptom and signs: o It forms an irregular or rounded mass attached to the apical ⅓ of the roots o Slow growing with bony expansion o Pain is diagnostic feature, usually of low-grade intermittent pain and becomes more intense when the area is palpated o The associated tooth is vital
    • Radiographic features:
      • Typically appears as a well-demarcated radiopaque mass with a thin radiolucent rim attached to the root of the lower tooth
      • Resorption of the related root is common
    • Histopathological features:
      • It consists of sheets and thick trabeculae of mineralized material (cementum or cementum-like tissue) with prominent basophilic reversal lines and cells lying in lacunae

    Odontogenic Tumors

    • Odontogenic tumors are a group of neoplasms and tumors-like malformations derived from epithelial and/or ectomesenchymal elements that are part of the tooth-forming apparatus.

    Classification of Odontogenic Tumors (WHO, 2005)

    • Benign odontogenic tumors:
    • Odontogenic epithelium with mature, fibrous stroma without odontogenic ectomesenchyme:
      • Ameloblastoma (solid/multicystic, extraosseous/peripheral, desmoplastic, and unicystic types)
      • Squamous odontogenic tumor
      • Calcifying epithelial odontogenic tumor
      • Adenomatoid odontogenic tumor
      • Keratinizing cystic odontogenic tumor
    • Odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation:
      • Ameloblastic fibroma
      • Ameloblastic fibro-odontoma
      • Ameloblastic fibro-dentinoma
      • Odontoma (complex and compound types)
      • Odontoameloblastoma
      • Calcifying cystic odontogenic tumor
      • Dentinogenic ghost cell tumor

    Adenomatoid Odontogenic Tumor

    • Well-encapsulated tumor with fibrous CT capsule
    • Lobules of polyhedral-shaped epithelial cells
    • Sheets of spindle-shaped epithelial cells
    • Duct-like structure of columnar epithelial cells with eosinophilic band
    • Convoluted tubules of columnar epithelial cells
    • Areas of calcification
    • Treatment: simple enucleation
    • Prognosis: good prognosis (benign tumor with no recurrence rate due to encapsulation)

    Calcifying Epithelial Odontogenic Tumor (CEOT/Pindborg's Tumor)

    • Definition: benign, locally invasive epithelial neoplasm characterized by development of intra-epithelial amyloid-like material that may become calcified and liberated into surrounding stroma
    • Origin: stratum intermedium of the enamel organ or reduced enamel epithelium, dental lamina, and its remnants (epithelial rests of Serres)
    • Clinical features: average age incidence of 40 years, no sex predilection, and central (intra-osseous) mandible > maxilla
    • Treatment: not mentioned

    Ameloblastic Fibroma

    • Definition: rare, benign mixed odontogenic tumor in which both epithelial and ectomesenchymal tissues are neoplastic
    • Origin: dental papilla, dental follicle, or periodontal ligament
    • Clinical features: average age incidence in the 1st and 2nd decades, male > female, mandibular premolar-molar area, painless, slowly growing swelling
    • Radiographic features: well-defined unilocular (mainly) or multilocular radiolucent area, may be surrounded by sclerotic border, and often associated with unerupted tooth
    • Histopathological features:
    • Well-circumscribed, may or may not be encapsulated
    • Highly cellular mesenchymal tissue resembling primitive dental papilla, mixed with proliferated odontogenic epithelium
    • Epithelial components: show one of two patterns
      • Long anastomosing cords, strands, usually only two cells in thickness, composed of cuboidal or columnar cells
      • Small discrete islands resembling enamel organ (peripheral columnar cells with reverse polarity resembling ameloblasts surround a central mass of loosely arranged star-shaped cells resembling stellate reticulum)
    • Mesenchymal components: plump stellate and ovoid cells in a loose matrix resemble immature dental papilla with little collagen fibers
    • Juxta-epithelial hyalinization (cell-free zone) around epithelial islands

    Odontoma

    • Definition: non-neoplastic developmental malformation (hamartoma) that contains fully formed enamel, dentine, cementum, and pulp
    • Etiology: unknown origin, local trauma or infection, and genetic (inherited or mutation)
    • Both epithelial and mesenchymal cells exhibit complete differentiation, resulting in the formation of functional ameloblasts and odontoblasts that form enamel and dentine
    • Types of odontomas:
    • Compound odontoma: malformation in which all dental tissues are represented in a more orderly pattern than in the complex odontoma, composed of multiple small tooth-like structures
    • Complex odontoma: malformation in which all dental tissues are represented in a more disorderly pattern than in the compound odontoma

    Cementoblastoma (True Cementoma)

    • Definition: rare, benign ectomesenchymal odontogenic tumor of cementoblast origin, related to a vital tooth
    • Origin: periodontal ligament and cementoblast
    • Clinical features: average age incidence of 25 years, male > female, mandible > maxilla (especially lower first permanent molar), slow-growing with bony expansion, and pain is a diagnostic feature
    • Radiographic features: well-demarcated radiopaque mass with a thin radiolucent rim attached to the root of the lower tooth, resorption of the related root is common
    • Histopathological features:
    • Sheets and thick trabeculae of mineralized material (cementum or cementum-like tissue) with prominent basophilic reversal lines and cells lying in lacunae
    • Mineralized trabeculae lined by prominent cementoblast cells
    • Cellular fibrovascular tissue between mineralized trabeculae
    • Periphery composed of uncalcified matrix
    • Multinucleated cementoclasts seen
    • Treatment: excision with extraction of the associated tooth
    • Prognosis: good prognosis, no recurrence

    Odontogenic Tumors

    • Definition: A group of neoplasms and tumors-like malformations (hamartomas) derived from epithelial and/or ectomesenchymal elements that are parts of the tooth forming-apparatus.
    • Origin: Odontogenic tissues.

    Classification of Odontogenic Tumors (WHO, 2005)

    • Benign Odontogenic Tumors:
      • Odontogenic epithelium with mature, fibrous stroma without odontogenic ectomesenchyme:
        • Ameloblastoma (solid/multicystic, extraosseous/peripheral, desmoplastic, unicystic types)
        • Squamous odontogenic tumor
        • Calcifying epithelial odontogenic tumor
        • Adenomatoid odontogenic tumor
        • Keratinizing cystic odontogenic tumor
      • Odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation:
        • Ameloblastic fibroma
        • Ameloblastic fibro-odontoma
        • Ameloblastic fibro-dentinoma
        • Odontoma (complex, compound types)
        • Odontoameloblastoma
        • Calcifying cystic odontogenic tumor
        • Dentinogenic ghost cell tumor
      • Granular Cell Ameloblastoma: characterized by changing stellate reticulum-like cells to granular cells with eosinophilic granules.

    Ameloblastoma

    • Subtypes:
      • Acanthomatous Ameloblastoma: stellate reticulum-like cells undergo squamous metaplasia, producing keratin in form of keratin pearls.
      • Basaloid Ameloblastoma: stellate reticulum-like cells change to nests of hyperchromatic basaloid cells.
      • Desmoplastic Ameloblastoma: showing compressed follicles due to deposition of large amount of collagen fibers in the stroma.
    • Treatment: The conventional ameloblastoma tends to infiltrate between intact cancellous bone trabeculae at the periphery of the tumor, requiring marginal resection at least 1cm past the margins to reduce the recurrence rate.

    Unicystic Ameloblastoma

    • Definition: A locally invasive tumor consisting of a central large cystic cavity, less aggressive than conventional ameloblastoma.
    • Origin: De-novo as a neoplasm or neoplastic transformation of a pre-existing odontogenic cyst (dentigerous cyst).
    • Clinical Features:
      • Age incidence: common in younger patients (average age 23 years).
      • Sex incidence: male = female.
      • Site predilection: mandible > maxilla, 90% occurs in lower posterior area with unerupted lower wisdoms.
      • Symptoms & signs: asymptomatic, large lesions may cause painless, slowly growing swelling, associated with impacted 3rd molar.
    • Radiographic Features: Appears as a well-defined unilocular radiolucency that surrounds the crown of the unerupted third molar, resembling a dentigerous cyst.
    • Histopathological Features:
      • Three histopathological variants:
        • Luminal Ameloblastoma: tumor tissue is confined to the luminal surface of the cyst.
        • Intra-luminal Ameloblastoma: one or more nodules of ameloblastoma project from the cystic lining into the lumen of the cyst.
        • Mural Ameloblastoma: the fibrous wall of the cyst is infiltrated by follicular or plexiform ameloblastoma.
    • Treatment: usually treated as cysts by enucleation (without safety margin) with recurrence rate 10-20%. Mural variant should be treated aggressively like conventional ameloblastomas.

    Adenomatoid Odontogenic Tumor (AOT)

    • Definition: A benign tumor consisting of spindle-shaped epithelial cells that form sheets, islands, and whorled masses of cells in a little fibrous C.T. stroma.
    • Clinical Features:
      • Age incidence: 40 years.
      • Sex incidence: female > male.
      • Site predilection: commonly in anterior maxilla.
      • Symptoms & signs: small lesions usually asymptomatic, larger lesions associated with localized bony expansion or loosening of adjacent teeth.
    • Radiographic Features: Appears as a well-defined unilocular radiolucency, often with faint (snowflakes) calcifications or patchy radiopacities.
    • Histopathological Features:
      • Tumor composed of:
        • Spindle-shaped epithelial cells forming sheets, islands, and whorled masses.
        • Rings of columnar epithelial cells giving rise to tubular, convoluted bands, and duct-like structures.
      • Eosinophilic material is thought to be a basement membrane-like material, PAS positive.

    Odontogenic Fibroma

    • Definition: A benign, fibroblastic neoplasm containing varying amounts of inactive odontogenic epithelium.
    • Origin: Periodontal ligament, dental papilla, or dental follicles.
    • Clinical Features:
      • Age incidence: 40 years.
      • Sex incidence: female > male.
      • Site predilection: commonly in anterior maxilla.
      • Symptoms & signs: small lesions usually asymptomatic, larger lesions associated with localized bony expansion or loosening of adjacent teeth.
    • Radiographic Features: Appears as a well-defined unilocular radiolucency.
    • Histopathological Features:
      • Composed of:
        • Cellular fibrous tissue containing strands and islands of inactive odontogenic epithelium.
        • Calcifications composed of osteoid or cement-like tissues and dysplastic dentine may be present.
      • Stellate fibroblasts and immature collagen resembling dental papilla.
    • Treatment: Enucleation & curettage.
    • Histological variants: Simple (epithelial-poor type) and WHO (epithelial-rich type)

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Odontogenic Tumors PDF 2023-2024 (University of Tripoli)

    Description

    Identify the different types of odontogenic tumors, including benign and malignant types. Test your knowledge of dental pathology and oral cancer diagnosis.

    More Like This

    Oral Pathology: Odontogenic Tumors
    70 questions

    Oral Pathology: Odontogenic Tumors

    BrighterVitality4568 avatar
    BrighterVitality4568
    Quistes y Tumores Odontogénicos
    10 questions

    Quistes y Tumores Odontogénicos

    DazzlingAluminium avatar
    DazzlingAluminium
    Odontogenic Pathology Quiz
    30 questions

    Odontogenic Pathology Quiz

    LikedNovaculite7231 avatar
    LikedNovaculite7231
    Benign Odontogenic Tumors Quiz
    30 questions

    Benign Odontogenic Tumors Quiz

    PurposefulNephrite7733 avatar
    PurposefulNephrite7733
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser