Cysts and Odontogenic Tumors Part 4

Question 1

what is the predeliction and recurrence of the calcifying epithelial odontogenic tumor

Answer 1

• adults - mean = 40 years old
• posterior mandible- molar ramus region
• recurrence but less aggressive than ameloblastoma

Question 2

what is the radiographic presentation of the calcifying epithelial odontogenic tumor

Answer 2

mixed

Question 3

describe the calcifying epithelial odontogenic tumor

Answer 3

• a solid epithelial tumor (not cystic)
• pink polygonal polyhedral epithelial cells
• contains amyloid
• concentric liesegang ring calcifications

Question 4

describe an odontogenic myxoma and its predilection

Answer 4

• ectomesenchymal odontogenic neoplasm
• young adults - mean = 30 years old
• the mandible more commonly involved than the maxilla
• a radiolucency often multilocular, may cross midline
• an encapsulated lesion- recurrence is common

Question 5

what is the tx for an odontogenic myxoma

Answer 5

resection not currettage

Question 6

what is the composition of an odontogenic myxoma

Answer 6

• resembles dental papilla with stellate and spindled cells in a myxoid extracellular matrix
• termed myxofibroma if there is increased collagen
• odontogenic rests variable

Question 7

what is the histologic presentation of an odontogenic myxoma

Answer 7

• hypocellular mesenchymal proliferation

Question 8

what are the two types of odontogenic fibromas

Answer 8

• central odontogenic fibroa
• peripheral odontogenic fibroma

Question 9

what are the two types of central odontogenic fibromas

Answer 9

• simple type
• WHO (world health organization) type

Question 10

describe the odontogenic fibroma and its prevalance

Answer 10

• most common in adult females (2:1) mean age = 40 years old
• well circumscribed unilocular or multilocular lucency of anterior maxilla and posterior mandible
• +/- radiopaque flecks
• one third of cases are associated with an unerupted tooth
• treatment by enucleated and vigorous curretage

Question 11

describe the histology of odontogenic fibroma

Answer 11

• mature, fibrous stroma with varying amounts of inactive odontogenic epithelium
• epithelium poor type- simplex type
• epithelium rich type: complex type (WHO type)

Question 12

what is the clinical presenation of a peripheral odontogenic fibroma

Answer 12

bump on the gums

Question 13

describe the cementobalstoma and its predilection

Answer 13

• neoplasm
• young adults less than 25 years old
• mandibular first molar
• pain, expansion, root destruction
• does not recur after complete removal

Question 14

describe the ameloblastic fibroma and its predilection

Answer 14

• “kiddie” tumor mean age of 14.8 years old
• a painless swelling of posterior mandible
• well circumscribed lucency, frequently associated with the crowns of impacted teeth
• treatment by enucleation and currettage, may recur
• pericoronal

Question 15

what is the histology of the ameloblastic fibroma

Answer 15

• ectomesenchyme resembling dental papilla
• epithelial strands and cords resembing dental lamina and enamel organ
• mixed tumor

Question 16

describe the ameloblastic fibro-odontoma and its predilection

Answer 16

• a “kiddie” tumor mean age = 8-12 years
• most frequent in posterior mandible
• a unilocular or multilocular mixed density lesion, often associated with the crown of an erupted tooth
• less common than ameloblastic fibroma
• treatment by enucleation, recurrence is rare
• mixed

Question 17

what are the histologic features of ameloblastic fibroma

Answer 17

enamel and dentin prevalance

Question 18

describe the odontoma and its predilection

Answer 18

• teenagers
• viewed as an hamartoma
• well- circumscribed
• treated by enucleation
• no recurrence expected
• compound- anterior maxilla
• complex- posterior mandible

Question 19

what percentage of gorlin cysts are associated with odontomas

Answer 19

20%

Question 20

what are the mixed epithelial and mesenchymal odontogenic tumors from early stage of odontogenesis to end stage

Answer 20

• ameloblastic fibroma -> ameloblastic fibro odontoma -> odontoma