W2 - Odontogenic Tumors - Curtin

Question 1

What is marsupialisation? Controversy?

Answer 1

Treating a cyst by opening it and letting it drain

• Controversial tx as opposed to enucleation -> pathologists won’t be able to make diagnosis bc the bioenvironment will have changed

Question 2

Be able to :
Describe the relevance of ondontogenic tumours to dental practice
Recognise and describe clinical features that may indicate odontogenic tumour
Appreciate the pathogenesis of odontogenic tumours
Explain the role of biopsy in the diagnosis of odontogenic tumours
name examples odontogenic tumours

Answer 2

learning objectives from this lecture

Question 3

What are some clinical features that may indicate odontogenic tumours (4)

Answer 3

1. Vital teeth with periapical radiolucency
2. Vital teeth with root resorption
3. Displaced teeth
4. Bony expansion

Question 4

What are odontogenic tumours? Example?

Answer 4

Neoplastic growths originating from and resemble tissues that form teeth and periodontium

Ex. OKC, ameloblastoma, odontoma

Question 5

What is the most common odontogenic tumour?

Answer 5

Odontoma

Question 6

Where does odontoma develop form from?

Answer 6

Forms from the growth of differentiated epithelial and mesenchymal cells that give rise to ameloblasts and odontoblasts

Question 7

What is the second most common odontogenic tumour?

Answer 7

Ameloblastoma

Question 8

Where are ameloblastomas most commonly seen? How are they found?

Answer 8

Found incidentally

Seen in posterior mandible

Question 9

Answer 9

Ameloblastoma - biopsy to confirm tho

Question 10

Answer 10

Ameloblastoma - biopsy to confirm tho

Question 11

What happens if ameloblastoma is left untreated?

Answer 11

Keeps growing → pathological fracture of md

Question 12

Features of ameloblastoma (symptoms, behaviour)

Answer 12

Locally destructive,

Agggressive,

Painless swelling

Question 13

Answer 13

“Soap bubble appearance” of ameloblastoma

• Discrete islands of tumor

Question 14

Answer 14

Differential diagnosis: OKC

“Well-defined radiolucency from apex to coronal aspect of 48, impinging on the IAN canal”

Question 15

Describe the walls of odontogenic cysts

Answer 15

Walls of cyst are extremely thin

• Parakeratinised epithelium
• 6-8 cells thick

Question 16

Answer 16

Odontogenic cyst of some kind, will need biopsy

Question 17

Do OKC recur?

Answer 17

Yes they can recur locally

• very likely

Question 18

Dentigerous cyst (what is it, features) (5)

Answer 18

• Fluid btw reduced enamel epithelium and crown
• Attached at CEJ
• Associated with unerupted teeth
• No root resorption
• May displace tooth

Question 19

Answer 19

Dentigerous cyst

Question 20

What are the tx options for cysts (3)

Answer 20

• Resection
• Enucleation
• Marsupialisation

Question 21

How do dentigerous cysts form? Where?

Answer 21

Buildup of fluid between the reduced enamel epithelium and the crown

• located at CEJ

Question 22

Answer 22

Radicular cyst

• Low chance recurrance due to size
• Tx: remove and either suture tissues around with nothing inside OR place hip bone and suture

Question 23

Answer 23

OKC

Question 24

Features of OKC

Answer 24

Teeth are vital

Root resorption

Question 25

Why is biopsy of cysts important? (2)

Answer 25

Diagnosis is important even AFTER you have removed it

• Helps with understanding behaviour
• Helps with treatment planning - how much follow up is necessary?

Question 26

Answer 26

“Daughter cells” of OKC - could cause possible recurrance

• Some practitioners burn them out

Question 27

DX: ? TX?

Answer 27

Radicular cyst

Extract tooth and marsupialise

Question 28

What to do for this pt

Answer 28

Open, biopsy, close, come back and sort after dx

Question 29

What is critical size bone defect?

Answer 29

In enucleation cases, cavity usually fills with blood and ossifies

Can only do this up to a certain size - critical size bone defect - large cavities will not be able to heal bc neovascular structures cannot extend fully into space

If too big, will need graft