W2 - Odontogenic Tumors - Curtin Flashcards
What is marsupialisation? Controversy?
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
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
learning objectives from this lecture
What are some clinical features that may indicate odontogenic tumours (4)
- Vital teeth with periapical radiolucency
- Vital teeth with root resorption
- Displaced teeth
- Bony expansion
What are odontogenic tumours? Example?
Neoplastic growths originating from and resemble tissues that form teeth and periodontium
Ex. OKC, ameloblastoma, odontoma
What is the most common odontogenic tumour?
Odontoma
Where does odontoma develop form from?
Forms from the growth of differentiated epithelial and mesenchymal cells that give rise to ameloblasts and odontoblasts
What is the second most common odontogenic tumour?
Ameloblastoma
Where are ameloblastomas most commonly seen? How are they found?
Found incidentally
Seen in posterior mandible
Ameloblastoma - biopsy to confirm tho
Ameloblastoma - biopsy to confirm tho
What happens if ameloblastoma is left untreated?
Keeps growing → pathological fracture of md
Features of ameloblastoma (symptoms, behaviour)
Locally destructive,
Agggressive,
Painless swelling
“Soap bubble appearance” of ameloblastoma
- Discrete islands of tumor
Differential diagnosis: OKC
“Well-defined radiolucency from apex to coronal aspect of 48, impinging on the IAN canal”
Describe the walls of odontogenic cysts
Walls of cyst are extremely thin
- Parakeratinised epithelium
- 6-8 cells thick
Odontogenic cyst of some kind, will need biopsy
Do OKC recur?
Yes they can recur locally
- very likely
Dentigerous cyst (what is it, features) (5)
- Fluid btw reduced enamel epithelium and crown
- Attached at CEJ
- Associated with unerupted teeth
- No root resorption
- May displace tooth
Dentigerous cyst
What are the tx options for cysts (3)
- Resection
- Enucleation
- Marsupialisation
How do dentigerous cysts form? Where?
Buildup of fluid between the reduced enamel epithelium and the crown
- located at CEJ
Radicular cyst
- Low chance recurrance due to size
- Tx: remove and either suture tissues around with nothing inside OR place hip bone and suture
OKC
Features of OKC
Teeth are vital
Root resorption
Why is biopsy of cysts important? (2)
Diagnosis is important even AFTER you have removed it
- Helps with understanding behaviour
- Helps with treatment planning - how much follow up is necessary?
“Daughter cells” of OKC - could cause possible recurrance
- Some practitioners burn them out
DX: ? TX?
Radicular cyst
Extract tooth and marsupialise
What to do for this pt
Open, biopsy, close, come back and sort after dx
What is critical size bone defect?
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
