Odontogenic Tumours

Question 1

Definition

Answer 1

Tumors are abnormal growths in oral cavity which can be benign or malignant

Question 2

Classifications of odontogenetic tumors

Answer 2

1. Odontogenic Epithelium tumors
2. Ectomesenchyme
3. Mixed odontogenic tumors

Question 3

Epithelium

Question 4

Ectomesenchyme

Question 5

Mixed

Question 6

Ameloblastoma

Answer 6

Most clinically significant because it causes more problems and comes from cell rests of enamel organ

Slow growing, no pain

Question 7

3 clinico-radiographic sub classifications of ameloblastomas

Answer 7

-multicystic
30-70 y/o, equal gender, more in mandible mostly posteriorly (angle/body)
Radiolucent unilocular or multilocular (soap bubble appearance), well circumscribed (white ring around turmor)
Eggshell cracking on palpation, paraaesthesia, teeth are mobile (suspended), pathological fracture

-unicystic
-peripheral

Question 8

Describing a swelling

Answer 8

Swelling, unilateral, right side on the lower border of mandible, with a smooth normal overlying skin with no nodules (uniform)

Question 9

Clinical features of ameloblastoma

Question 10

Histological features of ameloblastoma

Answer 10

1. Follicular
2. Plexiform
3. Acanthomatous

Follicular type is composed of islands of epithelium which resemble the enamel organ in a mature fibrous connective tissue stoma

Plexiform has long cords (large sheets of (odontogenic epithelium) with loose and vascular stroma

Acanthomatous type shows extensive squamous metaplasia with keratin formation in the island of odontogenic epithelium (cells around odontogenic epithelium have changed from columnar to squamous)

Question 11

Other histological type

Question 12

Treatment of ameloblastoma (multicystic or solid)

Answer 12

Simple enucleation
Marginal resection (has least recurrence)
Most common issue of ameloblastoma are recurrences

Marginal resection (removing portion of mandible)
1. Expensive (a plate is used is temporary)

Enucleation (ameloblastoma is removed and scrape off some bone) therefore high chance of recurrence in 7-10 years

Question 13

Unicystic ameloblastoma

Answer 13

Main difference with multicystic is age
Unicystic patients are usually younger (20 years)

Primary treatment of choice is enucleation with little recurrence as compared to solid type

Question 14

3 Histological features

Answer 14

1. Luminal - confined to luminal surface of cyst
2. Intraluminal - projects from cyst lining and resembles Plexiform of solid
3. Mural

Question 15

Peripheral ameloblastoma

Answer 15

This one is not in the bone like the other two but in the gums (extraosseous)

Question 16

Clinical features of peripheral ameloblastoma

Answer 16

Radio graphic features- superficial erosion of bone

Question 17

Ameloblastoma carcinoma/ Malignant Ameloblastoma

Answer 17

Only 1% of ameloblastoma show malignant behavior

Malignant ameloblastoma- Benign lesion found in different sites not limited to mandible

Ameloblastoma carcinoma- cylotogical features of malignancy in the primary tumor
Poor differentiation, multiple nuclei

Metastasis is common in the lungs raising questions of aspiration during surgery,cervical lymph nodes and vertebrae

Ameloblastic carcinoma are aggressive