Surgical Mgmnt of Odontogenic tumors Flashcards
What is the biologic classification of the following tumors?
* Adenomatoid odontogenic tumor
* Squamous odontogenic tumor
* Cementoblastoma
* Periapical cemento-osseous dysplasia
* Odontoma
BENIGN, NO RECURRENCE POTENTIAL
What is the biologic classification of the following tumors?
* Cystic ameloblastoma (unicystic)
* Calcifying epithelial odontogenic tumor
* Central odontogenic fibroma
* Florid cementoosseous dysplasia
* Ameloblastic fibroma and fibroodontoma
Benign (some recurrence potential)
What is the biologic classification of the following tumors?
Ameloblastoma(Multicystic/Solid)
Clear cell odontogenic tumor (some consider this a carcinoma)
Odontogenic ghost cell tumor (COC, solid type)
Odontogenic myxoma
Odontoameloblastoma
Benign aggressive
Does paresthesia more commonly occur w tumors or cytic lesions?
Tumors
Local removal of tumor by appropriate instrumentation in direct
contact with the lesion: used for very benign types of lesions.
Enucleation
Do you aspirate a lesion before or after obtaining a CT scan of the area?
Aspirate after
- Removal of a tumor by incising through uninvolved tissues
around the tumor, thus delivering the tumor without direct
contact during instrumentation (
Surgical resection
- Resection of a tumor without disruption of the continuity of the bone.
Marginal (Segmental) resection
Resection of a tumor by removing full-thickness portion of the
jaw.
* In the mandible, this can vary from a small continuity defect to
a hemimandibulectomy.
* Jaw continuity is disrupted.
Partial resection
- Resection of a tumor by removal of the involved bone.
Total resection
- Resection of tumor with bone, adjacent soft tissues and contiguous
lymph node channels (This is an ablative procedure used most
commonly malignant tumors)
Composite resection
What type of reconstruction graft is done for smaller defects?
Free bone graft
What type of reconstruction graft is done for larger defects?
Vascularized bone graft
- Benign, but locally invasive (Except for the Malignant variant).
- It is unencapsulated and infiltrates surrounding bone marrow.
- Even though they are locally infiltrative, they do not metastasize
(Except for the Malignant variant). - Occasionally arise from dentigerous cysts.
Ameloblastoma
HOw are unicystic ameloblastomas treated?
Ennucleation w/ peripheral ostectomy
How do you treat solid ameloblastomas?
Resection 1.5 cm beyond tumor margins
- It occurs chiefly in middle age people long after odontogenesis
has ceased. - They may occur in any part of both jaws but most are in the
middle and posterior regions of the mandible. - They may be unilocular but frequently become multilocular as they
increase in size. - The unilocular lesion is indistinguishable from an odontogenic cyst.
- Well-circumscribed, “soap- bubble appearance” (Multicystic or Solid
variant).
Ameloblastoma
- This is a tumor that is commonly found in teenagers.
- It occurs in the middle and anterior portions of the jaws
- Commonly associated with the crown of an impacted anterior tooth.
- Two-thirds occur in the maxilla and it is more common in females.
- The maxillary incisor-cuspids are common sites.
- Painless expansion is often the chief complaint.
Adenomatoid odontogenic tumor
The radiographic appearance is a unilocular radiolucency, often around
the crown of an unerupted tooth in which case they resemble a
dentigerous cyst.
Adenomatoid odontogenic tumor
How do you treat an AOT?
Enucleation
What are the most common type of odontogenic tumors seen in OS clinic?
Odontomas
The tumors in which odontogenic differentiation is fully expressed
are the ______
In these tumors, the epithelium and ectomesenchyme realize their potential and make enamel and dentin respectively. As a result, these tumors are mostly radiodense.
odontomas.
In the ______ odontoma, there is little or no tendency to form
tooth-like structures.
- The dentin and enamel are entwined in a mass that bears no
resemblance to teeth.
Complex odontoma
In the _____ odontoma, multiple small and malformed tooth-
like structures are formed creating a “bag of marbles” radiographic
appearance.
compound odontoma
Is compound or complex odontoma more found in anterior jaw?
Compound
Is compound or complex odontoma more found in posterior jaw?
Complex
What is tx for odontomas?
Elective surgery
- True benign neoplasm of cementoblasts
- This tumor typically occurs around the roots of the lower posterior
teeth (First Mandibular molars) - Cortex expanded without pain
- Involved tooth ankylosed.
Radiographically it appears as a ball of dense material attached to
the end of the root.
Cementoblastoma
What is tx for cementoblastoma
Complete excision of the lesion along with extraction of the
involved tooth.
What are ameloblastomas and AOTs derived from?
Odontogenic epithelium
What are complex and compound odontomas classified as?
Mixed tumors
What are cementoblastomas derived from?
Cementoblastoma
