Odontogenic Tumor
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21 terms
Terms | Definitions |
|---|---|
 Odontogenic Tumor | Derived from the epithelial and or mesenchymal remnant of the tooth forming appatatus -thus only in maxilla and mandible -unkown cause -asymptomatic -mimic microscopically the cell or tissue of origin |
| Epithelial Tumor Ameloblastoma | SEEN MOST COMMONLY Originates within the mand. and max from epithelium that is involvedin formation of teeth Enamel organ Odontogenic rest(rests of Malassez, rest of Serres) Reduced enamel epithelium Epithelial lining of odontogenic cysts (esp. dentigerous cysts) Rest of Malassez most commomly seen |
| Ameloblastoma | Stimulus for neopastic trasformation=unkown Seen in Adults -40yrs -anywhere in mand. or max -Mand. molar=ramus area most favored -asymptomatic / seen as jaw expansion |
| Ameloblastoma | -cause tooth movement and malocclusion Osteolytic, typically found in tooth bearing area of jaws unilocular or multilocular margins well defined and sclerotic -slow growing Know* MER= multilocular expansile radiolucency |
| Ameloblastoma | Peripheral (extraosseous) amelobastoma -on gingiva -older adults (40-60yrs) CysticAmeloblastoma -may perforate bone -recurrence rate=40% Younger age = 35 yrs |
| Ameloblastoma | Malignant Ameloblastoma -difficult to control locally -Metastases may appear usually in lungs -Also to regional lymph nodes Treatment No single standard type -Individualize Curettage (50% recurrence) go in a cm on either side/bone graft Block resection (larger lesions) |
| Ameloblastoma Cont | Not a high recurrance rate Cystic ameloblastoma and peripherial may be treated less aggressively. -Asymptomatic red or white plaque or as ulcerated and malignant lesions should be treated as carcinomas Follow patients indefinitely -Radiotherapy not generally used. |
| Calcifying Epithelial Odontogenic Tumor | 2nd most common CEOT -Pindborg tumor -origin of cells throught to be dental lamina reminants ans stratum intermedium of enamel organ. 40yrs old mand. twice as maxilla affected molar ramus areas -islands if calcification -islands of epithelium tumor-solid |
| Calcifying cont. | Jaw expansion are seen on x-rays associated with impacted teeth Unilocular or multilocular (honeycomb) Maybe completely radiolucent or may be opaque foci (amyliod) may be all white, all black, or salt and pepper. Well circumscribed Test Question:ball of calcification |
| Calcifying cont. | concentric calcific deposits (Liesegang rings)seen in the amyloid material(look like bulls eye target) Treatment = enucleation to resection -slow growing -some invasive potential -metastases have not been reported -recurrence rate =20% Test question: (Liesegong rings) balls of calcification Radiolucent as you get older radiopaque |
| Adenomatoid Odontogentic Tumor | 3rd most common -duct like or gland like structure , but is odontogenic tumor more like hamatoma than neoplasm of salivary gand -ages 5-30yrs (2nd decade) teenages -Females most -anterior maxilla -associated with crowns of impacted teeth. radiolucency Well circumscribed white border unilocular lesion -usually around the crown of impacted tooth -usually radiolucent but may have opaque foci -may see divergence of roots Treatment= conservative enucleation all most never come back |
| Mesenchymal tumors Odontogenic Myxoma | Mimics microscopically dental pulp or follicular connective tissue. Benign neoplasm -may be infiltrative and aggressive may recur mean age=30yrs no gender anywhere in maxilla or mand. radiolucency |
| Odontogenic Myoma cont. | radiolucency, quite variable Well circumscribed or diffuse lesion often multlocular cortical expansion or perforation DD= ameloblastoma or central hemangioma Treatment= surgical excision Moderate recurrence because loose, genlatinous consistency and absence of encapsulation But prognosis is good (does not metastaize |
| Central Odontogenic Fibroma | 2nd most common fibroma -rare -central counterpart too peripheral odontogenic fibroma maxilla and mand. all age groups radiolucent lesionlesions (multlocular) Treatment:surgical enucleation |
| Cementoblastoma | -3rd most common fibroma -mesincimal cells "true cementoma" rare, benign neoplasm of cementobast Ages= 2nd and 3rd decades ( before 25 yrs.) No gender Mand, most (posterior) molars intimately associated with root of tooth- obliterates the root may cause cortical expansion -Low grade intermittent pain Opaque lesion that replaces the root of the tooth usually surrounded by radiolucent ring Treatment: it cannot be removed without sacrificing tooth Recurrence not seen |
| Periapical Cementoosseous Dysplasia | "Cementoma" formerly known as A reactive or dysplastic process (not a neoplastic one) -not a tumor Relatively common at apex of vital teeth no biopsy black females 40 yrs means age anterior mad. painless black, black or white, all white, 2 or 3 teethusually No Biopsy in or root canal ( vital tooth) this is on final |
| Periapical Cemnetoosseous Dysplasia cont | Anterior mand. teeth (22-27) Often two or more apices of teeth found on routine x-rarys first sign is periapical lucency as matures, the lucent lesion develops into a mixed pattern of lucency/opacity final stage isa solid, opaque mass surrounded by a thin lucent ring just watch |
| Periapical Cementoosseous Dysplasia cont | Florid, cemento-osseous dysplasia (florid means Flowery or excessive) exuberant for periapical cemental dysplasia blackfemales (25-60 yrs) Typically bilateral all 4 quads. Treatment =none, teeth are vital |
| Mixed (Epithelial and Mesencymal) Tumors | Mixed Amelobastic fibroma Amelobastic fibro-odontoma -both are benign mixed odontogenic tumor composed of neoplastic epithelium and mesenchyme See in younge people age 12 yrs Mand. molar ramus are most common are affected no gender impacted tooth of you ng kid 12 yrs. |
| Ameloblastic Fibroma and Ameloblastic Fibro-Odontoma | Maybe associated with impacted tooth Well circmscribed with sc;erotic border unilocular or multilocular Opaque focus in ameloblastic fibro-odontoma is due to an odontoma Treatment: Conservative curettage or excision |
| Odontoma | Mixed odontogenic tumor Epithelial and mesenchymal dental hard tissue (enamel and dentin) Compound odontoma =numerous miniature teeth (anterior jaw) max. and mand. small teeth cluster of 5 to 10 teeth Complex odontoma =amorphous congiomerations of hard tiisue posterior mush not seeth Most common odontogenic tumor children and young adults second decade of life maxilla>mad. usually see retained deciduous tooth and impacted tooth alveolar swelling No symptoms Compound odontoma= numerous tiny teeth in single focus Complex odontoma=amorphous opaque mass ( in tooth bearing area Treatment =enucleation ( no recurrence) |
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