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BDS4 VIROLOGY > Odontogenic Tumours > Flashcards

Odontogenic Tumours Flashcards

1
Q

What is the prevalence of odontogenic tumours in the UK?

A

1% of oral&maxfax lesions sent for histopathological assessment in uk

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2
Q

What is the ratio of benign > malignant odontogenic tumours?

A

100:1

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3
Q

How do odontogenic tumours tend to present?

A
  • asymptomatic
  • non eruption of teeth
  • late stage bone expansion
  • pain usually secondary to infection or pathological fracture of bone
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4
Q

How are odontogenic tumours sometimes found?

A

Incidental finding when imaging for other dental reasons

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5
Q

What determines the classification of odontogenic tumours? What are the classification groups?

A

Based on tissue of origin
- epithelial
- mesenchymal
- mixed [epithelium and mesenchyme]

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6
Q

What odontogenic tumour classification can have dentine/enamel formation?

A

MIXED
- concept of induction
- dentine is formed from mesenchymal cells

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7
Q

What does induction mean in reference to enamel and dentine?

A

You cannot have enamel until dentine has been deposited

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8
Q

What are some odontogenic tumours sources of epithelium?

A

SAME AS ODONTOGENIC CYSTS
- Rests of Malassez
- Rests/glands of Serres
- Reduced enamel epithelium

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9
Q

What is the function of the dental lamina?

A

Formation of tooth germs

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10
Q

What are examples of odontogenic tumours from the epithelial classification?

A
  • ameloblastoma
  • adenomatoid odontogenic tumour
  • calcifying epithelial odontogenic tumour
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11
Q

What are examples of odontogenic tumours from the mesenchymal classification?

A

odontogenic myxoma

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12
Q

What are examples of odontogenic tumours from the mixed classification?

A

odontoma

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13
Q

What do odontogenic tumours usually tend to be?

A

> 50% are either ameloblastoma or odontoma

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14
Q

What is an ameloblastoma?

A

Benign epithelial tumour
- locally destructive but slow growing
- typically painless

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15
Q

What is the incidence of Ameloblastomas?

A
  • 1% of oral & maxillofacial tumours
  • most common in 4-6th decade
  • 80% occur in posterior mandible
  • M > F
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16
Q

Where do Ameloblastoma tumours tend to be located?

A

Posterior mandible (80%)

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17
Q

What type of tumour is seen radiographically here?

A

Ameloblastoma

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18
Q

What are the different types of Ameloblastomas based on the radiographic classification?

A
  • multicystic [80-90%]
  • unicystic
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19
Q

What are the different types of Ameloblastomas based on the histological classification?

A
  • follicular
  • plexiform
  • desmoplastic
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20
Q

How do ameloblastomas present radiographically?

A
  • well defined corticated margins
  • potentially scalloped margins
  • ‘Knife edge’ external root resorption of adjacent teeth
  • ‘soap bubble’ appearance in multicystic types
  • primarily radiolucent
  • displacement of adjacent structures
  • cause thinning of bony cortices
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21
Q

How does the histology of follicular ameleblastomas present?

A

Islands present in a fibrous tissue background

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22
Q

How does the histology of plexiform ameleblastomas present?

A
23
Q

Why can ameloblastomas grow & infiltrate into the jaw bone?

A

No connective tissue capsule
- leads to high recurrence rate

24
Q

How are ameloblastomas managed?

A

Surgical resection with margin
- due to recurrence being common

25
Q

What % of ameloblastoma cases tend to recur after surgical removal?

A

up to 15%

26
Q

Why should ameloblastomas be surgically resected?

A
  • risk of malignant change (<1% of cases)
27
Q

What are adenomatoid odontogenic tumours?

A

Benign epithelial tumours

28
Q

How do adenomatoid odontogenic tumours classically present?

A

Unilocular radiolucency with internal calcifications around crown of unerupted maxillary canine

29
Q

What is the incidence of adenomatoid odontogenic tumours?

A
  • 3% of odontogenic tumours
  • most common in 2nd decade
  • F > M
  • majority occur in anterior maxilla
30
Q

Where in the mouth are you most likely to find an adenomatoid odontogenic tumours?

A

Anterior maxilla

31
Q

What do adenomatoid odontogenic tumours tend to be associated with?

A

Unerupted tooth
- commonly maxillary canines

32
Q

What is the difference between AOTs and dentigerous cysts?

A

AOTs attached apical to cemento-enamel junction VS dentigerous cysts attached AT cemento-enamel junction

33
Q

How do adenomatoid odontogenic tumours present radiographically?

A
  • unilocular radiolucency
  • internal calcifications/radiopacities
  • well defined & corticated margins
  • may displace adjacent structures BUT external root resorption rare
34
Q

What is seen here on this radiograph?

A

Adenomatoid odontogenic tumour

35
Q

How does the histology of AOTs present?

A
36
Q

What is a calcifying epithelial odontogenic tumour?

A

Benign epithelial tumour
- 1% of odontogenic tumours

37
Q

Where are calcifying epithelial odontogenic tumours located typically?

A

Posterior mandible most common site

38
Q

What is seen on this OPT radiograph?

A

Calcifying epithelial odontogenic tumour

39
Q

How do calcifying epithelial odontogenic tumours present?

A
  • slow growing but can become very large
  • half are associated with an unerupted tooth
  • radiolucency often with internal radiopacities
  • variable radiographic presentation otherwise
40
Q

What pathology is seen on this radiograph?

A

CEOT (calcifying epithelial odontogenic tumour)

41
Q

What is an odontogenic myxoma?

A

Benign mesenchymal tumour
- 3-6% of odontogenic tumours (second most common tumour after ameloblastoma)
- mandible > maxilla

42
Q

What pathology is seen on this radiograph?

A

Odontogenic myxoma

43
Q

How do odontogenic myxoma’s present radiographically?

A
  • well defined radiolucency ± thin corticated margin
  • smaller lesions unilocular
  • larger lesions multilocular with scalloped margins [soap bubble appearance]
  • larger lesions may cause displacement
  • external root resorption rare
44
Q

How do odontogenic myxoma’s present histologically?

A
  • loose myxoid tissue with stellate cells
  • islands of inactive odontogenic epithelium
  • no capsule –> locally invasive
45
Q

How are odontogenic myxoma’s managed?

A
  • curettage or resection [depending on size]
  • MUST FOLLOW UP = high recurrence rate: 25%
46
Q

What are odontomas?

A

Benign mixed “tumour”
- technically a hamartoma
- malformation of dental tissue
- made up of enamel, dentine, cementum & pulp

47
Q

How do odontomas present similarly to teeth?

A
  • surrounded by dental follicle
  • made up of enamel, dentine, cementum & pulp
48
Q

Where are odontomas usually located?

A

lie above inferior alveolar canal

49
Q

What pathology is seen in this radiograph?

A

odontoma

50
Q

What are the different types of odontomas?

A
  1. Compound odontoma [ordered dental structures]
  2. Complex odontoma [disorganised mass of dental tissues]H
51
Q

How are compound odontomas described? Where are they typically located?

A
  • multiple mini teeth
  • “denticles”
  • more common in anterior maxilla
52
Q

How are complex odontomas described? Where are they typically located?

A
  • disorganised mass of dental tissues
  • more common in posterior body of mandible
53
Q

What type of odontoma is more common?

A

Compound > complex (2:1)

54
Q
A

BDS4 VIROLOGY (5 decks)

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