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Oral Path 2 > Odontogenic Mixed & Radiopaque Lesions > Flashcards

Odontogenic Mixed & Radiopaque Lesions Flashcards

1
Q

RL or mixed RL-RO Odontogenic lesions

A

These lesions are RL but may produce a pdt causing them to have a mixed radiographic appearance

  • Calcifying odontogenic cyst
  • Adenomatoid odontogenic cyst
  • Calcifying epithelial odontogenic tumor
  • ​Ameloblastic fibro-odontoma**
    • ​Always MIXED, never RL
  • Cemento-osseous dysplasia
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2
Q

Another name for Calcifying Odontogenic Cyst

A

Gorlin Cyst

Calcifying Cystic Odontogenic Tumor

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3
Q

Calcifying Odontogenic Cyst

A

RL or Mixed RL-RO Odontogenic Lesions

  • AKA Gorlin Cyst, Calcifying Cystic Odontogenic Tumor
  • Presents as a cyst or solid benign neoplasm
  • Has capacity to produce a calcified pdt
    • If enough calcified pdt is present, lesion will have RO areas
  • Can be be associated w/ other odontogenic tumors, esp odontomas
  • Well defined RL, w/ or w/o RO areas
  • Can cause root resorption or divergene of adjacent roots, just like any other odontogenic cysts
  • Less common than other odontogenic cysts
    • Displays unique rad & histo features
    • May or may not be assoc w/ an unerupted tooth
    • Can become large and destructive
  • Any odontogenic bearing area of the jaw can be involved
  • 30% show RO
  • 30% show unerupted tooth is present
  • 30% of tumors are peripheral
    • Of all tumors and cysts that occur, all can be central and all can be peripheral
  • THE ONLY CYST THAT CAN BE MIXED; ALL OTHER CYSTS ARE ALWAYS RL
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4
Q

Calcifying Odontogenic Cyst: Rad

A

RL or Mixed RL-RO Odontogenic Lesions

  • RO center surrounded by RL zone, surrounded by corticated border
  • Well-defined RL
  • Usually unilocular
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5
Q

Calcifying Odontogenic Cyst: Clinical behavior

A

RL or Mixed RL-RO Odontogenic Lesions

  • Majoriy of these lesions occur w/in bone
  • Can be associated w/ unerupted tooth
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6
Q

Calcifying Odontogenic Cyst: Tx

A

RL or Mixed RL-RO Odontogenic Lesions

  • Tx’d w/ surgery
  • Recurrence is UNcommon (esp if peripheral)
  • Good px w/ few recurrences after simple enucleation
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7
Q

Calcifying Odontogenic Cyst: Differential dx

A

RL or Mixed RL-RO Odontogenic Lesions

  • Peripheral ossifying
  • Peripheral giant cell
  • Pyogenic granuloma
  • Parulis
  • Plain fibroma
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8
Q

Calcifying Epithelial Odontogenic Tumor

A

RL or Mixed RL-RO Odontogenic Lesions

  • May produce mineralized pdt - so it can be mixed
  • Pts b/w 30-50yo - don’t get hung up on age
  • No gender predilection
  • Painless, slow growing swelling
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9
Q

Calcifying Epithelial Odontogeic Tumor: Rad

A

RL or Mixed RL-RO Odontogenic Lesions

  • Well-defined, corticated, odontogenic, MIXED
  • Unilocular or multilocular RL, usually containing calcified structures
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10
Q

Calcifying Epithelial Odontogenic Tumor: Tx

A

RL or Mixed RL-RO Odontogenic Lesions

  • Remove some normal bone surrounding the lesions
  • Tx w/ conservative surgery
  • Recurrence of 15%
  • Less aggressive than ameloblastoma
  • Conservative local resection is tx of choice
  • Overall px good
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11
Q

Adenamatoid Odontogenic Tumor

A

RL or Mixed RL-RO Odontogenic Lesions

  • 2/3 tumor
    • ​2/3 Impacted tooth - assoc w/ unerupted tooth
    • 2/3 b/w 10-19yo - teenagers
    • 2/3 seen in females
    • Anterior
    • MX
  • Does not infiltrate bone
  • Has ST capsule, easily removed
  • Gets name bc histologically, looks glandular
  • Completely benign
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12
Q

Adenomatoid Odontogenic Tumor: Tx

A

RL or Mixed RL-RO Odontogenic Lesions

  • Easily excised
  • No recurrence expected
  • Enucleates easily from adjacent bone
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13
Q

Ameloblastic Fibro-Odontoma

A

RL or Mixed RL-RO Odontogenic Lesions

  • Represents a developing odontoma
  • Most common <20yo
    • Only occurs under age of 20
  • ​Does not infiltrate surrounding bone
  • ALWAYS MIXED IN RADS
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14
Q

Ameloblastic Fibro-Odontoma: Tx

A

RL or Mixed RL-RO Odontogenic Lesions

  • Conservative removal
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15
Q

Neoplasm

A
  • New growth of abnormal tissue, uncoordinated w/ growth of surrounding tissue persisting after cessation of the stimuli which evoked the change
  • Benign:Localized
  • Malignant = Cancer: Invades and destroys adjacent structures and metastasizes
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16
Q

Teratoma

A
  • Neoplasm that arises from stem cells or plurpotent cells
    • Made up of multiple germ cell laayers
    • Can be malignant or benign
17
Q

Hamartoma

A
  • Overgrowth of mature cells/tissue that normally occur in the affected part, but disorganized
  • An overgrowth of tooth tissues that STOPS so it is not a true tumor
  • Ex: Odontoma
18
Q

Choristoma

A
  • Overgrowth of mature cells/tissue in the body other than the s ite which it is normally located
  • Aberrant rest, heterotropic tissue
  • Stops growing when normal tissue stops growing
19
Q

RO w/ a thin RL periphery

A
  • Odontomas
  • Cementoblastoma
20
Q

End of spectrum development

A

Ameloblastic fibroma ⇒ Ameloblastic Fibro-Odontoma ⇒ Odontoma

21
Q

Odontoma

A

RO Odontogenic Tumor

  • Most commonly dx’d/common type of odontogenic tumor
  • Better classified as a hamartoma rather than a tumor
  • Disorganized growth of enamel, dentin, cementum, pulpal tissue
  • Most seen in young pts (avg 14yo), but this is the time they develop. A pt can be unaware of it until 40-60s, depending on when rad exam shows it
  • Key: RO area surrounded by RL line, surrounded by RO line
  • Asymptomatic, slow growing
  • Typically found in anterior MX, but can occur anywhere
  • May be associated w/ dentigerous cyst or prevent tooth eruption
22
Q

Two types of odontomas

A

RO Odontogenic Tumor

  • Compound
  • Complex
23
Q

Odontoma: Compound

A

RO Odontogenic Tumor

  • Multiple tooth like structures
  • Various ROs w/in central region
  • Little toothlets
  • Outside looks more like RO and more translucent inside
24
Q

Odontoma: Complex

A

RO Odontogenic Tumor

  • Does not resemble tooth
  • Typically found in posterior MN, but can occur anywhere
  • No resemblance to tooth whatsoever
  • Various ROs w/in central region
25
Q

Odontoma: Tx

A

RO Odontogenic Tumor

  • Conservative surgical removal
26
Q

Cementoblastoma

A

RO Odontogenic Tumor

  • Benign neoplasm of cementoblasts
  • Dx’c radiographic appearance
    • RO mass, surrounded by RL line and then RO line
    • Fused to tooth root and causes partial root resorption
  • ​65% pain & swelling
  • Originates from cementoblasts
27
Q

Cementoblastoma: Tx

A

RO Odontogenic Tumor

  • Surgical removal of tooth or root amputation w/ removal of lesion
  • Remove lesion & tooth (less recurrence)
  • Remove lesion & endo
  • Up to 20% recurrence rate
  • Total removal of lesion minimizes recurrence
28
Q

What are Radiopaque Odontogenic Lesions?

A
  • Odontoma
  • Cementoblastoma

Oral Path 2 (11 decks)

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