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Odontogenic cysts and neoplasms

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Odontogenic cysts and neoplasms Adenomatoid Odontogenic Tumor Enamel organ or dental lamina origin Young patients, females males, anterior maxilla and mandible ... – PowerPoint PPT presentation

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Title: Odontogenic cysts and neoplasms


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Odontogenic cysts and neoplasms
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Adenomatoid Odontogenic Tumor
  • Enamel organ or dental lamina origin
  • Young patients, females gt males, anterior maxilla
    and mandible
  • Unilocular lucency, commonly (75) with unerupted
    tooth, may develop radiopacities
  • Larger lesions may cause expansion

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Adenomatoid Odontogenic Tumor
  • When associated with impacted teeth tendency for
    radiolucent margin to extend apically past the CEJ

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Adenomatoid Odontogenic Tumor
  • Well-encapsulated
  • Sheets of epithelial cells, cellular whorls and
    duct-like structures resembling glandular
    (adenomatoid) tissue

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Adenomatoid Odontogenic Tumor
  • Enucleation
  • Excellent prognosis

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Ameloblastic Fibroma
  • Enamel organ or dental lamina with dental
    papilla-like connective tissue
  • 1st and 2nd decades, mean age 12 yrs, posterior
    mandible
  • Unilocular radiolucency, often with unerupted
    tooth (50), may become multilocular

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Ameloblastic Fibroma
  • Strands and nests of odontogenic (ameloblastic)
    epithelium within a loosely cellular mesenchymal
    tissue that resembles primitive dental pulp

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Ameloblastic Fibroma
  • Conservative excision, aggressive curettage
  • Prognosis good
  • Recurrence rate is probably rather low (lt15)
    highest reported (44) was an AFIP series
  • Rarely, sarcomatous transformation

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Odontoma
  • Hamartoma of odontogenic organ
  • 1st and 2nd decades, mean age 14 yrs, frequently
    associated with unerupted tooth
  • Types compound (usually anterior jaws) and
    complex (usually posterior jaws)

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Odontoma
  • Compound tooth-like arrangements of dental hard
    tissues
  • Complex haphazard mixture of dental hard tissues

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Odontoma
  • Enucleation
  • Excellent prognosis

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Ameloblastic Fibro-Odontoma
  • Development of odontoma within background of
    ameloblastic fibroma
  • 1st and 2nd decades, mean age 10 yrs, posterior
    mandible, usually associated with impacted tooth
  • Well-defined radiolucency with variable
    radiopaque component

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Ameloblastic Fibro-Odontoma
  • Odontoma portion is usually a complex odontoma
  • Areas of ameloblastic fibroma are evident
  • Relative amounts of each type of tissue vary from
    lesion to lesion

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Ameloblastic Fibro-Odontoma
  • Conservative excision
  • Excellent prognosis

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Central Odontogenic Fibroma
  • Rare benign odontogenic tumor
  • Adult patient, mean of 40 years
  • Female predilection - 21 ratio
  • Anterior maxilla posterior mandible

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Central Odontogenic Fibroma
  • Painless swelling, maxillary lesions may
    demonstrate palatal depression
  • Unilocular to multilocular lucency,
    displacement/resorption of adjacent roots
    commonly noted

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Central Odontogenic Fibroma
  • Connective tissue stroma (fibroma) with variable
    amounts of odontogenic epithelium
  • Scattered calcifications may be seen

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Peripheral Odontogenic Fibroma
  • Uncommon, but not rare - may be confused with
    peripheral ossifying fibroma
  • Firm, sessile gingival mass
  • Most are less than 1 cm.
  • Wide age range affected

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Central Odontogenic Fibroma
  • Conservative excision
  • Good prognosis, routine follow-up is recommended

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Odontogenic Myxoma
  • Arises from dental papilla
  • Young adults, mandible slightly more affected
    than maxilla
  • Asymptomatic, larger lesions lead to painless
    swelling

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Odontogenic Myxoma
  • Unilocular to multilocular
  • Tooth displacement or resorption may be seen
  • Cortical thinning and expansion may be dramatic

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Odontogenic Myxoma
  • Loose, relatively acellular proliferation of
    stellate to spindle-shaped cells
  • No capsule, lesion tends to infiltrate
    surrounding host bone

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Odontogenic Myxoma
  • Smaller lesions aggressive curettage
  • Larger lesions marginal or en bloc resection
  • Overall 25 recurrence

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Benign Cementoblastoma
  • Rare neoplasm that arises from PDL
  • Young adults, posterior mandible, especially 1st
    permanent molar
  • Pain and swelling often presenting features
  • Opaque mass fused to root(s), thin lucent rim
    around mass

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Benign Cementoblastoma
  • Cellular cementum with plump cementoblasts
  • Often a periphery of radiating columns of
    calcified material
  • May be mistaken for osteosarcoma

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Benign Cementoblastoma
  • Conservative excision with tooth
  • Root amputation and endodontic tx
  • Good-excellent prognosis

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