Odontogenic tumors

Question 1

Name the Ectodermal (Epithelial) odontogenic tumors

Answer 1

Ameloblastoma
Calcifying Epithelial Odontogenic Tumor (pindborg tumor or CEOT)
Adenomatoid Odontogenic Tumor (AOT)
Squamous Odontogenic Tumor (SOT)

Question 2

Clinical aspects of Ameloblastoma

Answer 2

Affects all ages (&raquo_space; middle age)
Most are painless
+- cortical expansion

Question 3

Where are ameloblastomas most common

Answer 3

75% Mandible (posterior)

Question 4

Describe the radiographic aspects of ameloblastomas

Answer 4

May be pericoronal
Always radiolucent
Fairly well circumscribed
Classically multilocular, move teeth, root resorption

Question 5

Treatment of ameloblastomas

Answer 5

Surgical 
Aggressive curettage (50% recur) vs resection

Question 6

Name the 4 variants of ameloblastomas

Answer 6

• Peripheral (extrosseous) - less aggressive
• Unicystic - cyst in which it is confined
• Malignant ameloblastoma - benign - metastasizes
• Ameloblastic carcinoma - histologic features of malignancy, aggressive, metastasizes.

Question 7

Describe how to diagnose a unicystic ameloblastoma

Answer 7

Cannot definitively diagnose on incisional biopsy.

Question 8

Clinical aspects of Pindborg Tumors. Where is it found most commonly?

Answer 8

Affects all ages

|&raquo_space; Mandible, midbody

Question 9

Radiographic aspects of Pindborg Tumors

Answer 9

Lucent to mixed lucent/opaque (“driven snow”)

Often associated with unerupted teeth

Question 10

Treatment of Pindborg Tumors

Answer 10

Surgical

Question 11

Clinical aspects of Adenomatoid Odontogenic Tumors (AOT)

Answer 11

• Affects mostly individuals in 1-3 decades (Teens)
• Affects Females more often
• More common in unerupted teeth

Question 12

Where are Adenomatoid Odontogenic Tumors most commonly found?

Answer 12

> > Maxilla, 3/4 anterior jaws

Question 13

Radiographic aspects of Adenomatoid Odontogenic tumors

Answer 13

Lucent (pericoronal), may contain flecks of opacity.

Question 14

Treatment of Adenomatoid Odontogenic tumors

Answer 14

Enucleation

Question 15

Name the Mesodermal (Connective tissue) odontogenic tumors

Answer 15

• Central Odontogenic fibroma
• Peripheral Odontogenic fibroma
• Odontogenic Myxoma
• Cementum lesions

Question 16

Clinical aspects of Peripheral Odontogenic fibroma?

Answer 16

(covered under non-neoplastic lesions)

• Reactive gingival lesion of PDL origin
• More common in young people
• More common in anterior gingiva

Question 17

Clinical aspects of Odontogenic myxoma

Answer 17

Affects all ages (Increased in young)
Asymptomatic
+- Expansion

Question 18

Radiographic aspects of Odontogenic Myxoma

Answer 18

Lucency often containing residual opaque trabeculae

Question 19

Treatment of Odontogenic myxoma

Answer 19

Block resection

Question 20

Name the types of Cementum lesions

Answer 20

• Central cemento-ossifying fibroma
• Benign cementoblastoma (true cementoma)
• Gigantiform cementoma

Question 21

Which Cementum lesion is a neoplasm of PDL origin

Answer 21

Central cemento-ossifying fibroma

Question 22

Clinical aspects of central cement-ossifying fibroma

Answer 22

• Affects Adults
• more commonly in Females
• More commonly in Blacks
• More commonly in Mandible
  Asymptomatic & +-Expansion

Question 23

Radiographic aspects of central cemento-ossifying fibroma

Answer 23

Well circumscribed
Associated with tooth roots
Completely lucent to mixed lucent/opaque to mostly opaque.

Question 24

Treatment of Cemento-ossifying fibroma

Answer 24

Enucleation

Question 25

Clinical aspects of Benign cementoblastoma

Answer 25

Seen in people of 2-4 decades.

• More commonly seen in Mandible (Md 1st molar)
• Pain and/or expansion
• Tooth vital/vs condensing osteitis - non vital

Question 26

Radiographic aspects of Benign cementoblastoma

Answer 26

Pathognomonic - sclerotic mass with peripheral radiolucent zone. Fused with tooth root

Question 27

Treatment of Benign cementoblastoma

Answer 27

Surgical removal

Recurrence 0-37%

Question 28

Clinical aspects of Gigantiform Cementoma

Answer 28

Must be autosomal dominant

Question 29

Radiographic aspects of Gigantiform Cementoma

Answer 29

Multiquadrant globular opacities

Question 30

Treatment of Gigantiform Cementoma

Answer 30

Usually, none

Question 31

Name the Mixed (epithelial & Connective tissue) Odontogenic tumors

Answer 31

Ameloblastic fibroma
Ameloblastic fibro-odontoma
Odontoma

Question 32

Clinical aspects of Ameloblastic fibroma

Answer 32

Young, 1-3 decades
» Posterior Mandible
Asymptomatic

Question 33

Radiographic aspects of Ameloblastic fibroma

Answer 33

Always lucent

Question 34

Treatment of Ameloblastic fibroma

Answer 34

Surgical removal

Question 35

Variant of Ameloblastic fibroma

Answer 35

Ameloblastic fibrosarcoma - rare malignant transformation of mesenchymal component

Question 36

Clinical aspects of Ameloblastic fibro-odontoma

Answer 36

Young, 1-3 decades

Asymptomatic

Question 37

Radiographic aspects of Ameloblastic fiber-odontoma

Answer 37

Mixed lucent/opaque, often overlying unerupted tooth.

Question 38

Treatment of Ameloblastic fibro-odontoma

Answer 38

Surgical removal

Question 39

Clinical aspects of Odontoma

Answer 39

• *Most common odontogenic tumor. Viewed as a developmental hamartoma, not a neoplasm
• Young, 1-3 decades
• Asymptomatic

Question 40

Radiographic aspects of Odontoma

Answer 40

Radiopaque with thin lucent border (follicle) often overlying unerupted teeth.

• Compound –> tooth-like,&raquo_space; Anterior jaws
• Complex –>random deposition,&raquo_space; Posterior jaws

Question 41

Treatment of Odontomas

Answer 41

Surgical removal

Question 42

Complications of Odontomas

Answer 42

Dentigerous cysts, Ameloblastoma