Odontomes and Odontogenic Tumours Flashcards
What is a a tumour?
a swelling or excessive growth of tissue
what is a neoplasm?
new growth occuring outside of normal homeostatic mechanisms (may be histologically/cytologiaclly immature or abnormal cells
what is a hamartoma?
mass of disorganised tissue native to the anatomical location (eg: lung hamartoma in the lung, odontomes in the mouth)
what are odontomes?
abnormal growth of tooth forming tissue
what are the 5 types of odontoma?
invaginated odontome (more severe called dens-in-dente)
evaginated odontome
enamel pearl
complex odontoma
compound odontoma
what can you apply to a deep cingulum pit caused by invaginated odontome?
fissure sealant
what is an evaginated odontome?
little bit of extra enamel or dentine on the crown of the tooth
what are evaginated odontomes sometimes called when they get a bit bigger?
talon cusp
which teeth are invaginated/evaginated odontomes more common in?
maxillary teeth (most commonly lateral incisors)
how is an enamel pearl formed?
disruption of the enamel follicle (forms a little pearl of enamel usually at the furcation of a multi-rooted tooth)
what is the difference between compound and complex odontome?
they both have all the tooth tissue (enamel, dentinea nd cementum in the correct relationship) but complex odontomes are not organised
what age can odontomes occur?
any age but more common in teens
what are odontomes usually associated with?
failure to erupt or missing teeth
what is the treatment for odontomes?
removal
what is an ameloblastoma?
presented as a tumour
are ameloblastomas painful
no
are ameloblastomas likely to metastisize?
very rarely but can still cause disruption to quality of live
what do they typically present as radiographically? what do they appear similar to?
multi-locular radiolucency
odontogenic keratocyst
how can you distinguish between keratocyst and ameloblastoma?
ameloblastoma tends to cause significant expansion of the bone (whereas keratoyst doesn’t) and will also cause external resorption of a number of teeth (OKC less likely to do so)
how do ameloblastomas present clincially?
slow growing, painless, expansile lesion
what does the management of periapical cysts, OKC, ameloblastoma and oral cancer depend on?
the aggressiveness and severity
what is the recurrence rate for the following: periapical cysts, OKC, ameloblastoma and oral cancer
periapical cysts - (if treated properly)
OKC +
ameloblastoma ++
oral cancer +++
what is the treatment for periapical cysts?
enucleate it or RCT or XLA
what is the management for keratocyst?
enucleation w curettage (gold standard)/ Carnay’s (solution which fixes the tissue, kills the cells and makes them easier to remove)
why are keratocysts a bit more complex than periapical cysts to manage?
they are multilocular so it can be difficult to get all the bits of tissue out and the cyst lining is very delicate which is easy to leave behind
what is the management for ameloblastoma?
local resection (remove the tumour with a margin of normal bone either side) +/- reconstruction
what kind of tumour is an ameloblastoma?
neoplasm
what is the management for oral cancer?
wide excision with a good margin of tissue, reconstruction, radiotherapy
what can happen if oral cancer is not treated properly?
it is highly likely to reoccur
why it is important to consider treating the lymph nodes with radiotherapy?
because it is cancer it has the potential to metastasize
what might you reconstruct an area with?
fibula bone graft and denta implants
what are examples of other odontogenic tumours
cementoma, cemtnal dysplasia, cemento-osseous dysplsia
