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30 Cards in this Set
- Front
- Back
Odontogenic Tumors of Epithelial origin
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Ameloblastoma
Calcifying epithelial odontogenic tumor Adenomatoid odontogenic tumor Squamous odontogenic tumor Clear cell odontogenic tumor |
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Ameloblastoma characteristics, factors, Histology, types
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Most common odontogenic neoplasm not counting odontoma
- Non inductive - Often seen with unerupted teeth - Presents as painless expansion of bone - Overexpression of Fibroblast growth factor and MMPs 9&20 assist in infiltration into surrounding tissue. - Palisaded basal cell layer - Hyperchromatic and reverse polarity Nuclei - Subnuclear Vacuolization - Stellate reticulum-like cells - Subepithelial Hyalinization - Follicular - Plexiform - Acanthomatous - Granular cell |
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Unicystic Ameloblastoma
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Ameloblastoma arising in a cyst
- Well circumscribed radiolucency surrounding the crown of an unerupted tooth - Enucleation and curretage has much lower rate of recurrence than regular ameloblastoma Luminal - Confined to surface lining of the cystic space Intraluminal - One or more areas of epithelial lining proliferating into cystic lumen Mural - Small islands of cells in surrounding FCT wall |
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Desmoplastic Ameloblastoma
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Mixed radiopaque-radiolucent lesion
- Islands become so compressed that they lose the typical histology of columnar epithelim associated with ameloblastoma |
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Peripheral Ameloblastoma
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Found on gingiva or alveolar mucosa and does not invade underlying bone
- Local exicision is treatment of choice and not as aggressive as central lesions |
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Conventional/Solid Ameloblastoma treatment
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Due to high risk of recurrence, most surgeons don't do Enucleation and Curettage
Use resection based on extent of lesion and anatomy of involved bone - Segmental, Enbloc, Composite/Commando procedure Long term followup of decades is needed |
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Malignant Ameloblastomas
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Malignant Ameloblastoma
- Primary lesion with well differentiated benign histology - Most commonly metastasizes to lung Ameloblastic carcinoma - Poorly differentiated hisology and may metastasize |
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CEOT characteristics, histology, treatment
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Calcifying Epithelial Odontogenic tumor
- Similar presentation to ameloblastoma and also does not have inductive effect - Also painless slowly expanding swellings that may appear multilocular or unilocular with calcifications - Often associated with an unerupted tooth - Cellular and Nuclear PLEOMORPHISM - AMYLOID-like deposits that stain eosinophilic - Liesegang rings which are concentric lamellar ring calcifications responsible for radiopacity - Treat with Enucleation with peripheral ostectomy |
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AOT characteristics, radiology, Histology
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Adenomatoid odontogenic tumor
- Tumor of 2/3: Females, Maxilla, Anterior jaws, Impacted canine, 2nd decade - 75% are well circumscribed unilocular lesion associated with an unerupted tooth - Radiolucency may extend down root of tooth to help differentiate from a dentigerous cyst - Mixed radiolucent/radiopaque appearance compared to snowflakes - Well defined fibrous capsule - Epithelial cells may form duct-like spaces. Not true ducts because they have a blind end - Adenomatoid - Also contains Amyloid-like material |
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SOT characteristics, radiology, Histology, treatment,
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Squamous Odontogenic Tumor
- Typically involves alveolar ridge derived from epithelial rests - Can be multiquadrant 1/4 of the time - Appears as semilunar radiolucency of alveolar ridge - Islands of benign looking squamous epithelium mistaken for ameloblastoma and SCC - Treatment with conservative exicsion. Rare recurrence |
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Tumors of Mesenchymal origin
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Odontogenic Fibroma
Odontogenic Myxoma Granular Cell Odontogenic tumor Cementoblastoma Cementifying fibroma |
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Central Odontogenic Fibroma characteristics, types, treatment
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Believed to be the counterpart of peripheral ossifying odontogenic fibroma in soft tissue
- 1/3 associated with unerupted tooth - Often peri-radicular so can mimic periapical granulomas/cysts - Well circumscribed but unencapsulated Simple: Scant odontogenic epithelium WHO type: Islands of odontogenic epithelium throughout the lesion - Enuclation with Curettage. Don't recur |
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Microscopic differential diagnosis of Odontogenic fibroma
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Desmoplastic fibroma - More aggressive
Fibromyxoma - Variant of odontogenic myxoma with abundant collagen Hyperplastic tooth follicle - Loose immature stroma |
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Odontogenic Myxoma characteristics, radiology, and treatment
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Arise from tooth follicle or dental papilla
- Mimics histology of pulp - All radiolucent - Can see scalloping around the roots of teeth - Surgical excision - Because its not encapsulated and is gelatinous, difficult to remove completely and has high recurrence rate |
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Cementoblastoma characteristics, radiology, histology
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- Benign tumor of Cementoblasts attached to a VITAL tooth root
- Many cases have Pain and Swelling - Thin radiolucent halo or rim surrounding radiopacity - Similar histology to Osteoblastoma but is attached to a root |
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Odontogenic Tumors of Mixed origin
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- Ameloblastic Fibroma/Fibrosarcoma
- Amelobastic Fibro-odontoma - Odontoma *- Odontogenic epithelial component causes induction of the mesenchymal tissue produce product |
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AF and AFO characteristics, treatment
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Ameloblastic Fibroma and Amoloblastic Fibro-Odontoma
- 12yrs mean age associated with unerupted teeth AF - Immature mesenchymal stroma with stellate shaped cells in a loose matrix AFO - Mixed radiolucent/radiopaque due to formation of odontomas - Development of enamel and dentin matrix - Treat with conservative removal. Recurrence is rare |
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Ameloblastic Fibrosarcoma characteristics, histology
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- 1.5 times more common in males
- Presents with rapid growth with pain - Ameloblastic epithelium surrounded by Atypical mesenchymal stroma |
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Odontoma characteristics, types
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Most common odontogenic tumor made of masses of enamel and dentin with some cementum/pulp
- Often associated with an unerupted tooth Compound: Often Maxillary anterior. Well developed rudimentary tooth forms Complex: Posterior mandible. Poorly developed masses of calcified deposits |
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Concrescence
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Fusion of two or more teeth by cementum only
- Mx second and 3rd molars most commonly affected |
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Taurodontism
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Teeth with elongated crowns and pulp chambers with an increase in occlusal height
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Dentin Dysplasia Types
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Type 1:
Rootless teeth due to loss of organization of root dentin - Presents with tooth mobility Type II - Root length is normal - Pulp stones are common - Atubular and amorphous dentin |
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Regional Odontodysplasia
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aka Ghost teeth
- Maxilla 2.5x more likely - Due to disruption in blood supply so affects several contiguous teeth in an arch - Thin enamel and dentin surrounding enlarged pulp chambers |
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Cleidocranial dysplasia
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Lack of clavicle
- Numerous unerupted permanent supernumerary teeth - Small or absent MX sinuses |
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Crouzon's syndrome
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Characterized by Craniosyostosis: Premature closure of cranial sutures
- Cloverleaf head associated with PATERNAL age - Beaten metal apperance - Underdeveloped maxilla leading to midface hypoplasia - Expansion of posterior lateral palate causing pseudocleft |
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Apert syndrome
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Also shows Craniosynostosis like Crouzon's
- Syndactyly of second and fourth digits is common - Also shows pseudocleft due to expansion of maxillary soft tissue along lateral hard palate |
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Mandibulofacial Dysostosis
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aka Treacher Collins
- 60% of cases are new mutations - Hypoplasia of zygomatic arch and some have lateral facial clefting |
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Ectodermal dysplasia
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Number of teeth markedly reduced and crowns are malformed
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Obliteration of pulp chamber
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Dentinogenesis Imperfecta
Dentin dysplasia |
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Malignancy order
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Amelobastic Carcinoma
Ameloblastoma CEOT OKC AOT/COC Radicular cyst Odontoma |