Odontogenic tumours

Odontogenic tumours

1. Benign

   • Epithelial
     • Without odontogenic mesenchyme
       • Ameloblastoma
         • Most common tumour
         • Benign but locally aggressive
         • Most common = Angle of mandible
         • Well-defined, corticated outline
         • Treatment = surgical excision + 1cm margin of healthy tissue
         • High recurrence rate
         • Differential diagnosis = Odontogenic keratocyst
         • Malignant potential -> carcinoma
         • Wide age range
       • Squamous odontogenic tumour
         • Lesion of periodontal ligament
         • Mandible = Maxilla
         • Triangular vertical bony defect
         • Well defined
         • Alveolar process
         • Differential diagnosis = Lateral periodontal cyst
         • Young adults
       • Adenomatoid odontogenic tumour
         • Upper 345 region
         • Well-defined, corticated outline
         • Young adults (10-30yrs)
       • Calcifying epithelial odontogenic tumour
         • 2nd most common
         • Benign but locally invasive
         • Mandible > Maxilla
         • Molar region
         • Adults
     • With Odontogenic mesenchyme
       • Ameloblastic fibroma
         • Molar/premolar region
         • <20 yrs old
         • Well defined, corticated
       • Calcifying odontogenic cyst
         • Maxilla = Mandible
         • Well-defined, corticated
         • Differential diagnosis = Dentigerous cyst
         • <40yrs
   • Mesenchymal
     • Odontogenic fibroma
       • Well defined
       • Variable age
     • Odontogenic myxoma
       • Maxilla = Mandible
       • Benign but locally aggressive
       • Children & young adults
     • Cementoblastoma
       • Mandible premolar/molar region
       • Vital tooth
       • Treatment = surgical removal + XTN tooth (fused)
       • Young adults (<25yrs)

2. Malignant

   • Carcinomas
     • Ameloblastic carcinoma
   • Presentation
     • Pain
     • Swelling (rapid)
     • Ulceration
     • Tooth mobility
     • Nerve dysfunction
     • Bone destruction
     • LN swelling
   • Sarcomas

3. Presentation

   • Asymptomatic
     • All benign
   • Unerupted tooth
     • Ameloblastoma
     • Calcifying epithelial odontogenic tumour
     • Adenomatoid odontogenic tumour
     • Ameloblastic fibroma
     • Calcifying odontogenic cyst
     • Odontogenic myxoma
   • Swelling
     • Facial deformity
       • Ameloblastoma
       • Ameloblastic fibroma
       • Odontogenic myxoma
     • Squmous odontogenic tumour
     • Calcifying epithelial odontogenic tumour
     • Calcifying odontogenic cyst
     • Odontogenic fibroma
     • Cementoblastoma
   • Shape
     • Unilocular
       • Calcifying odontogenic cyst
     • Multilocular
       • Odontogenic myxoma
         • Soap bubbles
     • Either
       • Ameloblastoma
       • Calcifying epithelial odontogenic tumour
       • Ameloblastic fibroma
       • Odontogenic fibroma
   • Buccal expansion
     • Ameloblastoma
     • Calcifying epithelial odontogenic tumour
     • Ameloblastic fibroma
     • Odontogenic fibroma
     • Odontogenic myxoma
     • Cementoblastoma
   • Radiodensity
     • Radiolucent
       • Ameloblastoma
       • Squamous odontogenic tumour
       • Odontogenic fibroma
     • Radiopaque
       • Cementoblastoma
     • Mixed
       • Calcifying epithelial odontogenic tumour
       • Adenomatoid odontogenic tumour
       • Calcifying odontogenic cyst
   • Tooth effects
     • Tooth mobility
       • Ameloblastoma
       • Squamous odontogenic tumour
       • Ameloblastic fibroma
     • Root resorption
       • Ameloblastoma
       • Calcifying epithelial odontogenic tumour
       • Odontogenic fibroma
       • Odontogenic myxoma
       • Cementoblastoma
     • Tooth displacement
       • Ameloblastoma
       • Squamous odontogenic tumour
       • Calcifying epithelial odontogenic tumour
       • Ameloblastic fibroma
       • Odontogenic fibroma
       • Odontogenic myxoma