Odontogenic Tumors PDF

ODONTOGENIC TUMORS Adenomatoid odontogenic tumor - There are variety of tumorlike tissue which - 20 years old present in the jaws - gender predilection slight female - They have a spectrum behavior from slow...

ODONTOGENIC TUMORS Adenomatoid odontogenic tumor - There are variety of tumorlike tissue which - 20 years old present in the jaws - gender predilection slight female - They have a spectrum behavior from slow preponderance growing to aggressive - typically, in the maxillary canine region it - Causing extensive local destruction may be associated with ectopic or - Some are cystic and myxomatous but a unerupted tooth few metastasized outside the jaws - encapsulated - there's a widely accepted but frequently - cystic areas within it modified in WHO classification for - but equally common are densely calcified odontogenic tumors areas - lesion may arise from failed enamel organ EPITHELIAL and calcified tissue may be more dental Ameloblastoma type than osseus - simply enucleation is usually required - 1% of Jaw tumors - 20 to 50 years old Calcifying epithelial odontogenic tumor - About 80 percent occur in the mandible - Rare locally invasive lesion arising from adjacent to the angle odontogenic epithelium - They arise from odontogenic epithelial - it is commonest after 40 years of age remnants and cause painless expansion of - sex incidence = equal the jaw took trip and exfoliation - 75% aXect the mandibular premolar - Radiographically: multilocular cyst region - considered as the main diXerential - Unerupted tooth may be associated diagnosis in primordial or odontogenic - Radiographically: mixed radiolucent-radio- keratosis opaque lesion - histological variants: follicular type - Histology: unusual. With eosinophilic produced micro cyst polyhedral cells in a variable stroma of - Stromal cyst – common in plexiform hyaline material with calcified masses pattern adjacent to the epithelial tissue - Eosinophilic or granular variants - occasional tooth tissue or partial form - and squamous epithelial metaplasia with dental structure: present keratinization is also described - incomplete excision: risk of local - Malignant variants are described but recurrence extremely rare - Treatment: enucleation - follow up is preferred method - large lesion, recurrent lesion and those aXecting soft tissue: wider resection Squamous odontogenic tumor - relatively described but uncommon lesion B. Cementifying fibroma - arise from the periodontal rest of Malassez - Solitary lesion in the mandibular - incidence = jaws molar region of older patients - multifocal - Often accidental radiographic finding: - Histology: epithelial islands periapical radiopacity - microcyst and crystalloid material in a - Associated with vital tooth chronologically inflamed fibrous stroma - Enucleation is curative - extensive lesion: wide local excision is C. Periapical cemental dysplasia required to prevent recurrence and - Like cementifying fibroma, damage adjacent structures - lesion usually in mandibular incisor - commonly in women Calcifying odontogenic cyst - multifocal and more sclerotic - painless swelling which can occur in - enucleation is curative bone or extra osseous tissue D. Gigantiform cementoma - aXecting tooth-bearing tissues - least common variety - accordingly 80% occur in the mandible - has a familiar predisposition - lesion may be cystic or solid and cells - often in middle-aged negroid women assembling any of those in the enamel - aCects each jaw equally organ may be present - multifocal - aberrant keratinization may occur - mucosal ulceration and secondary - ‘Ghost cells’ and dystrophic calcification chronic osteomyelitis may be - if inflammation occurs or if the keratinous associated tissue into surrounding tissue: local - lesion may become quite large curettage - enucleation is usually curative Dentinoma CONNECTIVE TISSUE - A rare lesion consisting of mixed odontogenic epithelium and dysplastic Cementomas dentine - WHO Classification (4 types): - Mandibular and aXect the unerupted molar a. Benign cementoblastoma of young adults b. Cementifying fibroma - Local excision is curative c. Perioapical d. Gigantiform cementoma Odontogenic fibroma A. Benign cementoblastoma - A tumor consisting of mature collagenous - young males fibrous tissue - commonly in mandibular pre-molar - originate from the odontogenic region mesenchyme - a tendency to resorb adjacent teeth - unerupted tooth is usually associated - due to osteoclast like giant cells - peripheral gingival - simple enucleation is curative - complete excision is curative Myxoma Odontoameloblastoma - originating from odontogenic mesenchyme - A rare lesion like ameloblastoma in - this produces a characteristic of ‘soft appearance and behavior bubble’ central bone resorption with - young children sclerotic cortical margins (may expand or - maxillary premolar region erode) - Wide excision - associated with expansion, missing teeth Other lesions and loosening or displacement of adjacent teeth - Non-odontogenic lesions such as - jaws = equally melanotic neuroectodermal tumor of - tumor common in young patients infancy - diXicult tumor to excise fully - Primary bone tumors and tumor-like - incomplete removal can lead to caries lesions - metastatic deposits from carcinomas of MIXED ORIGINS breast or bronchus, kidney, thyroid, Odontomes prostate and colon - Tumors of lymphoid origin - Hamartomatous rather than neoplastic - Histiocytosis fibrous and osseous - This lesion is consisting of mature dentinal dysplasias tissue in a well-organized arrangement - Jaw cysts compound odontoma or denticle - Mixed patterns - Unerupted tooth = associated - Dens invaginatus – common related developmental abnormality where the enamel organ is persistent as inclusion in the fully formed tooth - spectrum of severity from: incisor lingual pits to gross deformation of dens in dente or gestalt odontoma exists Amelobastic fibroma - True mixed tumor comprising odontogenic epithelium in a mixed connective tissue stroma - childhood the teenage years - An array of mixed strands of odontogenic tissues and mixed hyaline and fibrous stroma - wide excision is required to prevent your recurrence - rare reports of Sarcomatous change in the stromal elements why