Odontogenic Tumors Overview

Odontogenic Tumors Overview

• Odontogenic tumors arise from the tissues involved in tooth development.
• Types include epithelial, mesenchymal, and mixed tumors.

Epithelial Odontogenic Tumors

• Major types:
  • Ameloblastoma
  • Calcifying Epithelial Odontogenic Tumor (CEOT)
  • Adenomatoid Odontogenic Tumor
  • Calcifying Odontogenic Cyst
  • Squamous Odontogenic Tumor

Ameloblastoma

• Etiology:
  • Unknown with no single causative factor.
  • Theories suggest origins from enamel organ remnants, surface epithelium, or heterotrophic epithelium.
• Clinical features:
  • Predominantly affects adults aged 35-45.
  • Asymptomatic, with mobile teeth as a common complaint.
  • Slow-growing and often undetectable by palpation.
• Types:
  • Solid
  • Multicystic
  • Unicystic
• Radiographic features:
  • Appears as a soap bubble or multilocular osteolytic lesion in tooth-bearing areas.
  • Margins are typically unencapsulated with potential for tooth resorption.
• Histological features:
  • Presence of polarized ameloblast-like cells and loosely arranged cells similar to stratum reticulum.
  • Subtypes include follicular, cystic, plexiform, acanthomatous, basal, and granular.
• Treatment:
  • Solid/multicystic tumors require surgical excision or resection.
  • Unicystic may be treated with enucleation.

Calcifying Epithelial Odontogenic Tumor (CEOT)

• Etiology:
  • Unknown, believed to arise from dental lamina remnants.
• Clinical features:
  • Occurs in the 2nd to 10th decade with an average age of 40.
  • More prevalent in the mandible than the maxilla, typically in the molar-ramus area.
• Radiographic features:
  • Can appear unilocular or multilocular with a honeycomb or snowflake appearance.
• Histological features:
  • Characterized by polygonal epithelial cells and amyloid deposits, visible under a polarized light.
• Treatment:
  • Enucleation or excision is preferred due to lower recurrence rates (20%).

Adenomatoid Odontogenic Tumor

• Previously known as adenoameloblastoma, classified as a benign hamartoma.
• Clinical features:
  • Common in the second decade of life, with a female predominance.
  • Typically well-circumscribed around the crowns of impacted teeth, particularly in the anterior maxilla and mandible.
• Histological features:
  • Exhibits a lobular pattern, with polyhedral and spindle-shaped cells and rosettes.
• Treatment:
  • Enucleation or excision is effective.

Calcifying Odontogenic Cyst

• Known as "ghost cell tumor," exhibits benign characteristics but has malignant variants.
• Clinical features:
  • Can occur at any age, often in the maxilla.
  • Usually found in the alveolar ridge anterior to the first molar.
• Histological features:
  • Characterized by ghost cells and squamous epithelial lining with ameloblast-like basal cells.
• Treatment:
  • Enucleation, low risk of recurrence.

Squamous Odontogenic Tumor

• Rare tumor primarily affecting young adults.
• Clinical features:
  • More common in the anterior maxilla and posterior mandible.
  • Displays cyst-like properties or mimics periodontal bone loss.
• Histological features:
  • Contains islands of squamous epithelium and foci of keratin or parakeratin.
• Treatment:
  • Typically managed by curettage and extraction of involved teeth.