Odontogenic tumours and tumour-like malfunctions Flashcards
Classification system for odontogenic tumours and tumour-like malfunctions
Benign
- Od epithelium without Od ectomesenchyme (ameloblastoma and CEOT)
- Od epithelium with Od ectomesenchyme with hard tissue
- mesenchyme and od ectomes (fibromyxoma and cementoblastoma)
Malignant
- Od carcinomas (malignant ameloblastoma and ameloblastic carcinoma)
- Odontogenic sarcomas (ameloblastic fibrosarcoma)
- Od carcinosarcoma
Ameloblastoma
Rare, non cancerous tumour that develops most often int the jaw near the molars.
Odontoma
Tumour, benign
Require surgical removal
made up of dental hard tissue that resembles abnormal teeth or calcified mass that invade around your teeth and could affect how your teeth develop
aetiology ameloblastoma
injury to mouth/jaw, infections of the teeth/gums
infections by viruses or lack of protein or minerals
development of ameloblastoma
arises of Od epithelium
epithelium has marked proliferative capacity
grows by epithelial proliferation, extends between trabeculae of bone
Ameloblastic fibroma
rare
younger pts
uni/multilocular
Epidemiology ameloblastoma
commonest odontogenic tumour
rare under 10yrs
peak around 30-60 yrs
M=F
80% near in mandible near angle
clinical presentation ameloblastoma
not site specific
incidental finding
radiological features ameloblastoma
large
radiolucent
multilocular
expand bone, displace and resorb bone teeth
often destroys lower border of mandible
histological feature ameloblastoma
ameloblastoma
- strands and islands of epithelial cells
- tall columnar cells at periphery
- loosely packed smaller central cells resembling stellate reticulum
ameloblastic fibroma
- solid tumour
- predominately mesenchymal, ameloblasta-like epithelium as less component
- no calcification of matrix
- hard tissue is present
management of ameloblastoma
requires resection at least 15mm beyond radiological margins
recurrence inevitable if removal incomplete
annual follow up 5yrs then 3yrs thereafter
benign but up to 5% registered as death due to tumour
malignant transformation rate
Aetiology of odontome
local trauma
infammatory
infectious processes
hereditary anomalies such as Gardener’s Syndrome and Hermanns Syndrome
odontoblastic hyperactivity
mature odontoblasts
dental lamina remnants (cell rests of serres)
development of odontome
bulk formed by dentine
areas of active odontogenesis, reduced enamel epithelium and pulp may be present
CEOT
Calcifying epithelial odontogenic tumour
rare
older patients
pre-molar, molar region
multilocular
AOT
Adenomatoid Odontogenic Tumour (AOT)
rare
younger pts
maxilla
anterior to molar region
unilocular
speckled calcification
associated with U/E tooth
CCOT
Calcifying cystic odontogenic tumour
rare
younger pts
either jaw
anterior to molar region
unilocular
large
varying calcification
associated with U/E tooth
CB
Benign cementoblastoma
young females predominately 15-30yrs
well defined speckled radiopaque mass attached to root mandibular molar or premolar tooth
peripheral radiolucent zone
resorption of tooth root
CF
Cemento-ossifying fibroma
young adults
F>M
Well defined radiolucent mass in mandible near roots of teeth
cellular fibrous tissue with calcified bone/cementum
benign tumour
Epidemiology odontome
70% tumours
young patients
F>M
Maxilla>Mandible
Gardener’s syndrome
Radiological features of odontomes
speckled/dense radiopacity with radiolucent areas
circumscribed mass, well-defined periphery
may displace adjacent teeth
histological CEOT
sheets and islands of pleomorphic and hyperchromatic epithelium
amyloid accumulation with epithelial groups
calcification of amyloid material
histological AOT
tubular structures of ameloblast-like epithelium
sheets of cuboidal/spindle epithelial cells
calcification of intratubular secretions
histological CCOT
Ameloblastic like epi
calcification of ghost cells
irregular dentine may be produced
histological CB
mass of cementum resembling pagetic bone
pleomorphic cementoblasts
unmineralised osteo-cementum at border
management of odontomes
enucleation
gardener’s syndrome
- multiple odontomas
- supernumerary
- shortened/deformed roots