Oral Pathology: Odontogenic Tumors
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Questions and Answers

What percentage of Adenomatoid odontogenic tumor cases are intraosseous?

  • 100%
  • 80%
  • 95% (correct)
  • 90%

    • What is the common location of Adenomatoid odontogenic tumor?

  • Middle part of maxilla
  • Posterior part of mandible
  • Anterior part of maxilla (correct)
  • Anterior part of mandible

    • What is the characteristic radiographic feature of Adenomatoid odontogenic tumor?

  • Multilocular radiolucency with no radiopacities
  • Well defined unilocular radiolucency with fine radiopacities (correct)
  • Multilocular radiolucency with radiopacities
  • Ill-defined radiolucency with no radiopacities

    • What is the characteristic macroscopic feature of Adenomatoid odontogenic tumor?

    <p>Smooth rounded symmetrical masses</p> Signup and view all the answers

    What type of tissue does adenomatoid odontogenic tumor consist of?

    <p>Both odontogenic epithelium and ectomesenchyme</p> Signup and view all the answers

    What is the characteristic histopathological feature of Adenomatoid odontogenic tumor?

    <p>Duct-like structures with columnar or cuboidal epithelial cells</p> Signup and view all the answers

    What is the composition of epithelial odontogenic tumors?

    <p>Odontogenic epithelium only</p> Signup and view all the answers

    Where do calcifying epithelial odontogenic tumors most commonly occur?

    <p>In the posterior area of the mandible</p> Signup and view all the answers

    What is a characteristic radiographic feature of calcifying epithelial odontogenic tumors?

    <p>Combined radiolucent and radiopaque appearance</p> Signup and view all the answers

    What is a distinct feature of the epithelial cells in calcifying epithelial odontogenic tumors?

    <p>Distinct outline with prominent intercellular bridges</p> Signup and view all the answers

    What is the unique protein secreted by neoplastic cells in calcifying epithelial odontogenic tumors?

    <p>Odontogenic amyloid protein</p> Signup and view all the answers

    What is the characteristic calcification pattern seen in calcifying epithelial odontogenic tumors?

    <p>Liesegang ring calcifications</p> Signup and view all the answers

    What is the characteristic radiographic feature of a cementoblastoma?

    <p>A radiopaque mass fused to the root and surrounded by a thin radiolucent rim</p> Signup and view all the answers

    What is the treatment for a cementoblastoma?

    <p>Surgical extraction of the tooth together with the attached calcified mass</p> Signup and view all the answers

    What is the most common site for ameloblastic fibroma?

    <p>Posterior mandible</p> Signup and view all the answers

    What type of tumor is composed of both odontogenic epithelium and ectomesenchyme?

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

    What is the most common type of mixed odontogenic tumor?

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

    What is the characteristic histopathological feature of a cementoblastoma?

    <p>Calcified cementum like material with reversal lines</p> Signup and view all the answers

    What is the treatment for odontoma?

    <p>Simple local excision</p> Signup and view all the answers

    What is the aim of this lecture?

    <p>To detail the principle radiological and histopathological features of non-ameloblastoma odontogenic tumours, odontomes and cemental disorders</p> Signup and view all the answers

    What should students review before this lecture?

    <p>Relevant teaching from first year</p> Signup and view all the answers

    What is the title of the textbook recommended for reading?

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

    What is the page range recommended for reading in Robinson M et al. Soames’ and Southam’s Oral Pathology?

    <p>149-159</p> Signup and view all the answers

    Who is the author of Odell E.W. Cawson’s Essentials of Oral Pathology and Oral Medicine?

    <p>Odell E.W.</p> Signup and view all the answers

    What is the most common type of odontogenic tumors?

    <p>Compound odontoma</p> Signup and view all the answers

    What is the characteristic radiographic feature of compound odontoma?

    <p>A collection of tooth-like structures</p> Signup and view all the answers

    Where do compound odontomas mainly occur?

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

    What is the characteristic histopathological feature of complex odontoma?

    <p>Mature tubular dentin that encloses clefts or hollow circular structures</p> Signup and view all the answers

    What is the characteristic macroscopic feature of complex odontoma?

    <p>A white bony hard mass</p> Signup and view all the answers

    What is the common association of odontomas?

    <p>Unerupted teeth</p> Signup and view all the answers

    What is the primary goal of this lecture regarding odontogenic tumours?

    <p>To detail the principle radiological and histopathological features</p> Signup and view all the answers

    Which of the following conditions may occasionally occur in addition to odontogenic tumours?

    <p>Cemento-ossifying disorders</p> Signup and view all the answers

    What is the typical treatment for odontomas?

    <p>Simple local excision</p> Signup and view all the answers

    What is the recommended reading material for students to review before this lecture?

    <p>Relevant sections of Robinson M et al. and Odell E.W.</p> Signup and view all the answers

    What is the primary focus of the textbook by Reichart PA and Philipsen HP?

    <p>Odontogenic tumours and allied lesions</p> Signup and view all the answers

    What is the treatment for odontogenic myxoma?

    <p>Complete excision with safety margin</p> Signup and view all the answers

    What is a common clinical feature of odontogenic fibroma?

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

    What is a characteristic radiographic feature of large odontogenic fibromas?

    <p>Multilocular radiolucency</p> Signup and view all the answers

    What is a characteristic histopathological feature of odontogenic fibroma?

    <p>Inactive odontogenic epithelium</p> Signup and view all the answers

    What is a common site for cementoblastoma?

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

    Which type of odontogenic tumor is composed of both odontogenic epithelium and ectomesenchyme?

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

    What is the characteristic radiographic feature of Cementoblastoma?

    <p>A radiopaque mass surrounded by a thin radiolucent rim</p> Signup and view all the answers

    What is the treatment for a Cementoblastoma?

    <p>Surgical extraction of the tooth together with the attached calcified mass</p> Signup and view all the answers

    What is the characteristic histopathological feature of a Cementoblastoma?

    <p>The presence of calcified cementum-like material with reversal lines</p> Signup and view all the answers

    What is the common location of Ameloblastic fibroma?

    <p>Posterior mandible</p> Signup and view all the answers

    What is the characteristic radiographic feature of Ameloblastic fibroma?

    <p>Well-defined unilocular or multilocular radiolucent lesion</p> Signup and view all the answers

    What is the composition of Odontomas?

    <p>Mixed epithelial and mesenchymal tumor-like malformations</p> Signup and view all the answers

    What is the treatment approach for Ameloblastic fibroma?

    <p>Conservative surgical removal</p> Signup and view all the answers

    What is the characteristic histopathological feature of Ameloblastic fibroma?

    <p>Long, narrow cords or small discrete islands of odontogenic cells in a loose matrix</p> Signup and view all the answers

    What is the association of Odontomas with other conditions?

    <p>Gardner's syndrome</p> Signup and view all the answers

    What is the characteristic that distinguishes adenomatoid odontogenic tumor from calcifying epithelial odontogenic tumor?

    <p>Composition of both odontogenic epithelium and ectomesenchyme</p> Signup and view all the answers

    Which of the following is a characteristic clinical feature of calcifying epithelial odontogenic tumor?

    <p>Slowly growing tumor ultimately producing bony expansion</p> Signup and view all the answers

    What is the characteristic radiographic feature of calcifying epithelial odontogenic tumor?

    <p>Circumscribed unilocular or multilocular radiolucency</p> Signup and view all the answers

    What is the characteristic histopathological feature of calcifying epithelial odontogenic tumor?

    <p>Discrete islands of neoplastic epithelial cells with prominent intercellular bridges</p> Signup and view all the answers

    What is the prognosis of calcifying epithelial odontogenic tumor?

    <p>Good prognosis due to benign nature</p> Signup and view all the answers

    What is the primary composition of mesenchymal odontogenic tumors?

    <p>Only odontogenic ectomesenchyme</p> Signup and view all the answers

    What is a characteristic feature of mixed odontogenic tumors?

    <p>Composed of both odontogenic epithelium and ectomesenchyme</p> Signup and view all the answers

    What is the most common type of benign odontogenic tumor?

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

    What is the primary classification of odontogenic tumors based on?

    <p>Histopathological features</p> Signup and view all the answers

    What is the focus of this lecture regarding odontogenic tumors?

    <p>Histopathological features and implications</p> Signup and view all the answers

    What is the classification of Adenomatoid odontogenic tumor?

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

    What is the typical clinical feature of Adenomatoid odontogenic tumor?

    <p>Painless expansion of bone</p> Signup and view all the answers

    What is the characteristic radiographic feature of Adenomatoid odontogenic tumor?

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

    What is the characteristic histopathological feature of Adenomatoid odontogenic tumor?

    <p>Duct-like structures with central space lined by layer of cuboidal epithelial cells</p> Signup and view all the answers

    What is the prognosis of Adenomatoid odontogenic tumor?

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

    How does the treatment of Adenomatoid odontogenic tumor typically involve?

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

    What is the characteristic macroscopic feature of Adenomatoid odontogenic tumor?

    <p>Smooth, rounded, symmetrical masses</p> Signup and view all the answers

    What is the common association of Adenomatoid odontogenic tumor?

    <p>Impacted canine tooth</p> Signup and view all the answers

    What is the growth potential of Adenomatoid odontogenic tumor?

    <p>Limited growth potential</p> Signup and view all the answers

    What is the common location of Adenomatoid odontogenic tumor?

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

    Study Notes

    Odontogenic Tumors

    • Classification:
      • Epithelial: composed of odontogenic epithelium only
      • Mesenchymal: composed of odontogenic ectomesenchyme only (dental papilla-dental follicle)
      • Mixed: composed of both odontogenic epithelium and ectomesenchyme

    Adenomatoid Odontogenic Tumor

    • Definition: a benign epithelial odontogenic tumor that shows duct-like structures
    • Clinical features:
      • 95% of cases are intraosseous, but extraosseous variant has been documented
      • Found in the anterior part of the maxilla
      • Usually asymptomatic, but large lesions may cause painless expansion of bone
    • Radiographic features:
      • Well-defined unilocular radiolucency with fine radiopacities
      • May be associated with an unerupted tooth (mostly canine)
    • Macroscopy:
      • Smooth, rounded, symmetrical masses
      • Easy removal from bone due to tumor's capsule
    • Histopathological features:
      • Well-defined lesion surrounded by thick fibrous capsule
      • Composed of masses, sheets, or strands of spindle cells in scanty fibrous stroma
      • Duct-like structures with central space lined by layer of columnar or cuboidal epithelial cells with polarized nuclei
      • Convoluted tubules may also be seen
      • Foci of calcification may be scattered throughout the tumor

    Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor)

    • Definition: a benign epithelial odontogenic tumor that secretes an amyloid protein that tends to calcify
    • Clinical features:
      • Most lesions appear in the posterior area of the mandible
      • Slowly growing, ultimately producing bony expansion
    • Radiographic features:
      • Circumscribed unilocular or multilocular radiolucency
      • May be associated with an impacted tooth (50-60% of cases)
      • Lesion is mostly radiolucent and radiopaque mixed
    • Histopathology:
      • Tumor has discrete islands or sheets of neoplastic epithelial cells
      • Epithelial cells have a distinct outline and show prominent intercellular bridges
      • Nuclei of the neoplastic cells are pleomorphic, but the mitotic rate is low
      • Neoplastic cells secrete unique odontogenic amyloid protein (eosinophilic hyaline material)
      • Calcification takes place in the form of concentric rings (Liesegang ring calcifications)

    Cementoblastoma (True Cementoma)

    • Definition: a rare, benign odontogenic neoplasm that is intimately associated with roots of teeth
    • Clinical features:
      • Site: mandibular premolar-molar region
      • Associated with the root of a vital tooth
      • Pain and swelling are present in approximately 2/3 of reported patients
      • Slowly growing
    • Radiographic features:
      • Radiopaque mass fused to root, surrounded by a thin radiolucent rim
    • Macroscopy:
      • Calcified mass adherent to tooth root
    • Histopathology:
      • Calcified cementum-like material with reversal lines
      • The periphery of the lesion is uncalcified, which is why it appears with a radiolucent rim in radiograph

    Odontoma

    • Definition: a mixed epithelial and mesenchymal tumor-like malformation (hamartoma) composed of dental hard and soft tissues
    • Types:
      • Compound: composed of multiple small tooth-like structures
      • Complex: consists of a mass of enamel and dentin with no anatomic resemblance to a tooth
    • Clinical features:
      • Frequently associated with an unerupted tooth
      • Asymptomatic, often discovered on routine radiographs
    • Radiographic features:
      • Compound: a collection of tooth-like structures or denticles of varying size and shape
      • Complex: a disorganized mass of calcified tissue
    • Macroscopy:
      • Compound: a collection of tooth-like structures or denticles of varying size and shape
      • Complex: a white, bony, hard mass
    • Histopathology:
      • Compound: multiple structures resembling small single-rooted teeth (showing dentin, cementum, enamel matrix, and pulp) in a loose fibrous matrix
      • Complex: mature tubular dentin that encloses clefts or hollow circular structures (due to decalcification of mature enamel)
    • Treatment and prognosis:
      • Simple local excision
      • Prognosis is excellent

    Ameloblastic Fibroma

    • Definition: a true mixed tumor composed of odontogenic epithelium and mesenchyme, in which no dental hard tissues are present
    • Clinical features:
      • Posterior mandible is the most common site
      • Asymptomatic, but large tumors are associated with swelling of the jaws
    • Radiographic features:
      • Well-defined unilocular or multilocular radiolucency
      • Unerupted tooth is commonly associated with the lesion
    • Histopathology:
      • Mesenchymal portion: myxoid and highly cellular
      • Epithelial portion: long, narrow cords or small discrete islands of odontogenic epithelium
    • Treatment and prognosis:
      • Lesions should be removed conservatively
      • Extensive destructive tumors should be treated radically

    Odontogenic Fibroma

    • Definition: a rare neoplasm of mature fibrous tissue
    • Clinical features:
      • It has 2 clinical variants: intraosseous or central and extraosseous or peripheral
      • Small tumors are asymptomatic
      • Larger tumors may show pain, bony expansion, and loosening of teeth
    • Radiographic features:
      • Small tumors are usually well-defined unilocular radiolucency
      • Large tumors may show multilocular radiolucency
      • Divergence or resorption of roots of adjacent teeth
      • An unerupted tooth may be seen
    • Histopathology:
      • Composed of cellular or collagenous connective tissue
      • Varying amounts of inactive odontogenic epithelium
      • Foci of calcification may be present
    • Treatment and prognosis:
      • Enucleation and curettage
      • Recurrence is uncommon

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    Description

    This quiz covers the characteristics and features of odontogenic tumors, including adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor.

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