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Oral candidiasis > 18. Odontogenic tumours > Flashcards

18. Odontogenic tumours Flashcards

1
Q

What is the inductive theory?

A
  1. Pre-ameloblasts induce dental papilla
  2. Dental papilla differentiates pre-odontoblasts
  3. Odontoblasts produce dentine
  4. Dentine induces pre-ameloblast maturation
  5. Ameloblast produce enamel
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2
Q

How would you describe what an ameloblastoma is?

A

Benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium in a fibrous stroma/

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3
Q

Which people is ameloblastoma seen most in?

A

Africans and African Americans
40-50 year olds

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4
Q

Where is ameloblastoma commonly found?

A

80% mandible
70% molar

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5
Q

What is the radiograph finding of ameloblastoma?

A

Multiocular radiolucency
Root resorption
Might mimic a dentigerous cyst

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6
Q

What is the symptoms of ameloblastoma?

A

Slow growing
Facial deformation
May be asymptomatic
Cortical perforation is a late finding

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7
Q

What is the recurrence of ameloblastoma?

A

High= 70-90%

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8
Q

What is ameloblastoma derived from?

A

Though to be from dental lamina residues

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9
Q

Describe histology of follicular ameloblastoma?

A

Discrete islands of epithelium
Varying amounts of fibrous stroma
Cyst formation in epithelial islands
Central angular cells- stellate reticulum
Peripheral columnar cuboidal cells with reverse nuclear polarity- preameloblasts

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10
Q

Describe histology of plexiform ameloblastoma?

A

Centrally stellate reticulum cells with peripheral preameloblasts
Cyst formation is due to stromal degeneration

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11
Q

What are the ameloblastoma variants?

A

Follicular- discrete islands of epithelium, epithelial cysts common
Plexiform- irregular masses or network strands, stromal cysts common
Acanthomatous- squamous metaplasia
Basal cell- like basal cell adenocarcinoma
Granular- cuboidal, columnar rounded cells with acidophilic granules

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12
Q

What age is a unicystic ameloblastoma found in?

A

Younger age- 20 to 30

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13
Q

What is the radiograph for unicystic ameloblastoma?

A

Well defined, unilocular- looks like dentigerous cyst

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14
Q

What are the 3 types of unicystic ameloblastoma?

A

Luminal- cyst has ameloblastoma tissue lining
Intraluminal- proliferation of intraluminal nodules
Mural- ameloblastoma nests deep in the cystic wall

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15
Q

What is the treatment for unicystic ameloblastoma?

A

Enucleation of luminal and intraluminal
Resection of mural

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16
Q

What is peripheral ameloblastoma?

A

Thought to derive from extraosseous dental lamina rests and basal cells
Seem to be not as invasive as intraosseous types

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17
Q

What are the symptoms of calcifying epithelial odontogenic tumour?

A

Rare, benign, locally invasive but less than ameloblastomas

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18
Q

Where is calcifying epithelial odontogenic tumour found?

A

Mandible molar premolar area
50% associated with crown of unerupted tooth

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19
Q

What is the radiograph for calcifying epithelial odontogenic tumour?

A

Irregular radiolucent and radiopaque bodies

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20
Q

What is the histology of calcifying epithelial odontogenic tumour?

A

Polyhedral cells with eosinophilic cytoplasm
Amyloid like material which can calcify
Fibrous stroma
Liesegang rings- concentric calcifications, diffusion, chemical reaction, precipitation

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21
Q

Where is an adenomatoid odontogenic tumour found?

A

20-30
Anterior maxilla
Can be associated to unerupted teeth

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22
Q

What is the radiograph for adnomatoid odontogenic tumour?

A

Radiolucent
Can have faint radiopacities
Might stimulate dentigerous cyst

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23
Q

What is the histology of adenomatoid odontogenic tumour?

A

Sheets, strands, whorled masses of columnar ameloblast like cells
Forming duct like structures
With eosinophilic material centres- maybe containing malformed dental organ. Origin- stratum intermedium
May contain dysplastic dentine and enamel matrix

24
Q

Where is a primordial odontogenic tumour found?

A

Very young, posterior

25
Q

What is the x ray for primordial odontogenic tumour?

A

Well defined radiolucency associated with unerupted teeth

26
Q

What is the histology of primordial odontogenic tumour?

A

Mesenchymal mass covered by odontogenic epithelium
Most likely an abortive tooth germ that has failed to develop

27
Q

Whee is ameloblastic fibroma found?

A

Molar premolar region

28
Q

What are the characteristics of ameloblastic fibroma?

A

Rare over the age of 21
Radical resection unnecessary
Low recurrence
Well circumscribed
Rare
Benign

29
Q

What is the x ray finding of ameloblastic fibroma?

A

Unilocular
Might mimic a dentigerous cyst or be associated with unerupted tooth

30
Q

What is the histology of ameloblastic fibroma?

A

Contains both epithelial and mesenchymal neoplastic components
Odontogenic epithelium in strands
Stellate reticulum less adundant
Highly cellular fibroblastic tissue resembling the dental papilla
Hyaline tissue bordering the epithelium

31
Q

What is ameloblastic fibrodentinoma?

A

Ameloblastic fibroma and dentine
Cellular dentine, dentine is poorly formed

32
Q

What is ameloblastic fibro-odontoma?

A

Ameloblastic fibroma and enamel and dentine
Hamartoma
Difficult to differentiate from complex odontome

33
Q

What is odontoameloblastoma?

A

Very rare
Ameloblast like epithelium with enamel and dentine

34
Q

What is an odontome and its lining?

A

Hamartoma
Encapsulated

35
Q

What is a compound odontome?

A

Made of small denticles or malformed teeth from overactivity of the dental lamina
Found in anterior maxilla

36
Q

What is a complex odontome?

A

All dental tissues well formed but they are disorderly arranged.
Molar/premolar area

37
Q

Where is a calcifying cystic odontogenic tumour found?

A

Anterior to first molar
75% intraosseous

38
Q

What does a calcifying cystic odontogenic tumour look like?

A

Dentinogenic ghost cell tumour is similar, but it is solid and true neoplasm

39
Q

What is the x ray of calcifying cystic odontogenic tumour?

A

Uni or multilocular
Plus radiopaque material
Can be associated to unerupted tooth crown

40
Q

What is the histology of calcifying cystic odontogenic tumour?

A

Cyst lined by epithelium with basal layer of ameloblast like cells
Overlying stellate like reticulum
Ghost cells which may calcify

41
Q

What tumours are derived from just mesenchymal tissue?

A

Odontogenic fibroma
Myxoma
Myxofibroma

42
Q

Where can a fibroma be found?

A

In place of a missing tooth
Or in relation to crown or root of unerupted tooth

43
Q

What is the histology of odontogenic fibroma?

A

Fibroblastic neoplasm containing varying amounts of inactive odontogenic epithelium
Fibrous tissue more mature than AF
Contains dentinoid
Cementoid may be present

44
Q

What does a peripheral case of odontogenic fibroma look like clinically?

A

Fibrous epulis

45
Q

What is an odontogenic myxoma?

A

Rare but locally aggressive

46
Q

What is the x ray for odontogenic myxoma?

A

Multilocular radiolucency- soap bubble appearance

47
Q

What is the histology for odontogenic myxoma?

A

Non encapsulated
Stellate fibroblasts
Abundant connective tissue ground substance-glycosaminoglycans
Sometimes odontogenic epithelium

48
Q

Where is cementoblastoma found?

A

Under 25 years
Associated with roots of tooth, otherwise osteoblastoma
Mandible premolar molar areaa

49
Q

What is the x ray for cementoblastoma?

A

Well demarcated mottled dense radiopaque
Attached to root
Root resorption
Surrounded by thin radiolucent line

50
Q

What is the histology of cementoblastoma?

A

Mass of calcified cementum like material
Cells in lacunae
Cementicle like cells
Mass uncalcified at periphery
Cementoclasts
May recur if not removed completely

51
Q

What comes under cemento osseous dysplasia?

A

Periapical cemental dysplasia
Florid cemento osseous dysplasia

52
Q

Where is periapical cemental dysplasia found?

A

Anterior maxilla
Vital teeth
Afrocarirbean adult women

53
Q

What is the histology of periapical cemental dysplasia?

A

Fibroblastic first then patches of sclerotic bone- cementifying fibroma

54
Q

What is florid-cemento osseous dyslasia found?

A

Middle aged black females
Bilateral and symmetrical

55
Q

What is the histology of florid cemento osseous dysplasia?

A

Diffuse radiopaque masses of basophilic acellular cementum
No radiolucent border

Oral candidiasis (18 decks)

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