Odontomes and Odontogenic Tumours

Question 1

Define tumour

Answer 1

A swelling or excessive growth

Question 2

Define neoplasm

Answer 2

New growth of tissue occurring outside of normal homeostatic mechanism
May be histologically/cytologically immature or abnormal

Question 3

Define hamartoma

Answer 3

A mass of disorganised tissue native to the anatomical location
Histological mature cells but arranged in a disorganised manner
It develops as we develop

Question 4

Where can harmatomas form

Answer 4

1. Lungs
2. Liver

Question 5

All cancers are what

Answer 5

Neoplasms (but not all neoplasms are cancers)

Question 6

All harmatomas are what

Answer 6

Tumours (but not all tumours are harmatomas)

Question 7

Define malignant

Answer 7

Disease process with potential for impairing quality of life and life expectancy
If untreated is likely to kill the patient

Question 8

Define benign

Answer 8

Disease process with limited potential for impairing life expectancy
It is unlikely to kill the patient if untreated buy may persist and impair quality of life

Question 9

If benign and malignant make up two opposite ends of a spectrum what category may we find in the middle

Answer 9

Locally invasive/ aggressive

Question 10

Give an example of a locally invasive/ aggressive cancer

Answer 10

Basil cell carcinoma

Question 11

What are odontomes

Answer 11

Abnormal growth of tooth forming tissues (harmatomas)

Question 12

Give examples of odontomes

Answer 12

1. Invaginated odontome
2. Evaginated odontome
3. Enamel pearl
4. Complex odontome
5. Compound odontome

Question 13

How can invaginated odontomes present as

Answer 13

A deep cingulum pit
Dens in dentre

Question 14

What is dens in dente

Answer 14

Invagination of a tooth to the point a new tooth forms from a previous tooth

Question 15

How can evaginated odontomes present

Answer 15

1. Extra enamel on tooth
2. Talon cusps

Question 16

In which teeth are invaginated and evaginated odontomes more common in

Answer 16

Anterior teeth
Maxilla more common than mandible

Question 17

What causes the formation of an enamel pearl

Answer 17

Disruption of the enamel follicle leading to a small pearl of enamel forming

Question 18

Where do compound and complex odontomes arise form

Answer 18

Tooth forming tissues

Question 19

What are compound odontomes

Answer 19

A mass of little teeth

Question 20

What are complex odontomes

Answer 20

Hermatomas of dental tissue that are much more disorganised and present as a disorganised mass

Question 21

When do odontomes occur

Answer 21

Can occur at any age but more common in teens

Question 22

What might odontomes be associated with

Answer 22

Failure to erupt or missing teeth

Question 23

How are odontomes treated

Answer 23

Removal

Question 24

How do odontomes present on a radiograph

Answer 24

As radiopacities

Question 25

What is na ameloblastoma

Answer 25

A tumour

Question 26

Describe amelobalstomas

Answer 26

Painless slow growing locally aggressive/invasive tumour

Question 27

Do ameloblastoma matastesitse

Answer 27

Very rarely but ameloblasts are likely to reoccur

Question 28

What is the origin of amelobalstomas

Answer 28

dental lamina

Question 29

How many people have an ameloblastomas

Answer 29

2 per million

Question 30

In whom are ameloblastomas most common

Answer 30

40-50 Years 10 time more common in black African people

Question 31

Where are ameloblastomas usually found

Answer 31

Mandible>maxilla Posterior> antieror

Question 32

How do ameloblastomas present on a radiograph

Answer 32

As a multilocular radiolucency

Question 33

What can ameloblastomas cause

Answer 33

Significant expansion of bone External resorption of teeth Damage to teeth

Question 34

How do ameloblstomas present clinically

Answer 34

Slow growing painless expansile lesions They may be an incidental finding

Question 35

List the different classifications of ameloblastomas

Answer 35

1. Follicular 2. Plexiform 3. Unicystic

Question 36

How do we confirm a diagnosis of amelobalstoma

Answer 36

Biopsy

Question 37

How do we manage ameloblastomas

Answer 37

1. Confirm diagnosis 2. Assess extent with a radiograph 3. Remove by local resection +/- reconstruction

Question 38

How do we remove a periodical cyst

Answer 38

Enucleation

Question 39

How do we remove a keratocyst

Answer 39

Enucleation/ curettage

Question 40

How do we remove an ameloblastoma

Answer 40

Local resection +/- reconstruction

Question 41

How do we remove an oral cancer

Answer 41

Wide excision, reconstruction, radiotherapy

Question 42

Rank ameloblastomas, oral cancer, periapcial cyst and keratocyst in most to least likely to reoccur

Answer 42

1. Oral cancer (+++) 2. Ameloblastoma (++) 3. Keratocyst (+) 4. Periapical cyst (-)

Question 43

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