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Odontogenic Tumors Dr.Suffiyan Saleem
B.D.S, R.D.S, M.Phil (oral pathology)
University of health sciences,LAHORE PAKISTAN
e.Mail = suffiyan.u2@gmail.com |
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Calcifying Epithelial Odontogenic Tumor (CEOT; Pindborg Tumor) Aggressive tumor of epithelial derivation
accounts for < 1 % of all odontogenic tumors.
Odontogenic in origin
Tumor cells resemble cells of the stratum intermedium. |
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Clinical Features Age: 2nd-10th decades. mean=40 years.
no sex predilection.
75 % occur in the mandible in the posterior region
Associated with Impacted tooth
Chief sign – cortical expansion
Usually painless |
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Radiographic findings Expanded cortices in all dimensions
Radiolucent; poorly defined, noncorticated
borders
Unilocular, multilocular, or “moth-eaten”
“Driven-snow” appearance from multiple radiopaque foci
Root divergence/resorption; impacted tooth |
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Histologic Features lesion composed of islands, sheets or strands of polyhedral epithelial cells in a fibrous stroma.
Areas of amorphous, eosinophilic, hyalinized extracellular material may be scattered throughout.
Cells outlines are distinct and intercellular bridges may be seen.
Nuclei show considerable variation with giant nuclei and pleomorphism observed.
Calcifications may be noted. |
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Treatment and Prognosis painless, slow-growing swellings.
Peripheral lesions appear as sessile gingival masses.
Conservative local resection is the treatment of choice
recurrence rate is 15 %
overall prognosis is good. |
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Adenomatoid Odontogenic Tumor (AOT) Formerly called adenoameloblastoma
3-7 % of all odontogenic tumors. |
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Clinical Features occur in 2nd , mean of 17 years.
Females predilection: 2:1.
75% occur in the maxilla with 65 % in the canine region.
associated with impacted anterior teeth.
can be extraosseous.
Cause painless expansion |
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Radiographic appear as pericoronal radiolucencies, with radiopaque material (“snowflake” calcifications).
Cause impaction of permanent tooth and be discovered when radiographs are taken to “search for” the unerupted tooth.
asymptomatic.
Can cause root divergence of adjacent tooth |
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Histological Features surrounded by a thick, fibrous capsule.
composed of spindle-shaped epithelial cells that form sheets, strands or whorled masses with little connective tissue.
epithelial cells may form rosette-like structures, tubular or duct-like structures may be prominent or absent.
Calcifications may be observed in the tumor mass. |
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Treatment and Prognosis Enucleation is the treatment of choice
seldom recur.
Prognosis is good. |
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Squamous Odontogenic Tumor (SOT): Clinical Features 2nd-7th decades (mean 40 years).
No gender predilection
equal frequency in maxilla and mandible.
more common in the anterior.
lesions occur in the alveolar process.
Cause tooth mobility |
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Radiographic non-specific radiolucent lesions.
well-circumscribed or ill-defined.
appear lateral to tooth root.
cause root divergence
expansion of bone is seen |
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appear as islands of bland-appearing squamous epithelium in a mature fibrous connective tissue stroma.
peripheral cells do not show polarization
Nests and islands of well-differentiated squamous epithelium:
lacking atypia and mitotic activity
within collagenous stroma of low to moderate cellularity
Histologic Features |
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Treatment and Prognosis painless gingival swellings
Extraction of involved tooth.
curettage appears to be effective treatment
recurrence is rare. |
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