2. benign tumors of the jaw

old info: unlike benign tumors which disease affecting structures of the jaws displaces the IANC superiorly?

fibrous dysplasia

what are the three odontogenic tumors?

• epithelial

• ectomesenchymal

• mixed (both cell types)

what are the three epithelial benign odontogenic tumors discussed?

• Ameloblastoma

• Adenomatoid odontogenic tumor

• Calcifying epithelial odontogenic tumor

what are the two ectomesenchymal benign odontogenic tumors discussed?

• odontogenic myxoma

• Cementoblastoma

what is the one mixed benign odontogenic tumor discussed?

odontoma

what is the second most common odontogenic tumor, and most common epithelial?

ameloblastoma

which pattern of ameloblastoma: 75-86%

conventional ameloblastoma

which pattern of ameloblastoma: 13-21%

unicystic ameloblastoma

which pattern of ameloblastoma: 1-4%

peripheral ameloblastoma

soft tissue ameloblastoma

peripheral ameloblastoma

ameloblastomas are typically found in

> 80% mandible usually M (35 years, no gender)

ameloblastoma recurrence rate and treatment

• Simple enucleation to en bloc resection

• Curettage recurrence rate= 50-90%

• Marginal resection recurrence rate= 15%

• optimal tx controversial

unicystic ameloblastoma age and location predilection

50% ages 10-20 and posterior mandible

unicystic ameloblastoma often mimic

dentigerous cyst

what are the three types of unicystic ameloblastoma

• luminal

• intraluminal

• mural

recurrence and treatment of unicystic ameloblastoma

mural debatable but intra/luminal enucleation and follow-up; recurrence 10-20%

• Painless, non-ulcerated gingival nodule

• Resembles pyogenic granuloma or fibroma

• Usually < 1.5cm

• Average age = 52

• Mandibular predilection

• Superficial alveolar bone may be eroded

peripheral ameloblastoma

recurrence and tx of peripheral ameloblastoma

15-20% recur but further excision often curative, behaves better than its ameloblast counterparts

adenomatoid odontogenic tumor age, location, MF predilection

70% 10-20 years, 70% maxilla - 90% anterior, F>M

treatment for AOT

benign, enucleates easy from bone but rare occurrence

which rare peripheral tumor, <1% of odontogenic tumors?

CEOT

CEOT age and jaw predilection

8-92 yo mean 36 and mandible

Liesegang rings

CEOT

CEOT treatment and recurrence

15% recur, good prognosis conservative resection recommended, less aggressive than ameloblastoma

age, gender, jaw predilection odontogenic myxoma

25-30, no gender, posterior mandible

tennis racket/soap bubble

odontogenic myxoma

recurrence and tx of odontogenic myxoma

small curettage and follow up, large are resected

25% recur bc complete removal hard

egg-white consistency makes complete removal difficult

odontogenic myxoma

gender and age predilection cementoblastoma

equal gender; <20 (75% before 30)

mass on 1st mandibular M roots, halo continuity w PDL

cementoblastoma

number one most common odontogenic tumor/hamartoma, 74% of odontogenic tumors in US

odontoma

denticles

compound odontoma

ghost cells

odontoma and calcifying odontogenic cyst

odontoma treatment and prognosis

conservative enucleation and excellent prognosis

• Multiple osteomas, multiple dense bone islands

• multiple unerupted supernumerary and permanent teeth

• epidermoid cysts, subcutaneous dermoid tumors

• multiple polyps of small and large intestines; strong predilection for malignant transformation

Gardner’s syndrome

CGCG predilection and recurrence

<20 yo and mandible, thorough curettage, recur 15-20%

aggressive? tx w corticosteroids, calcitonin, INF-⍺

cherubism predilections

posterior mandible early childhood

cherubism treatment

most regress after puberty, observe vs surgery debatable