Odontogenic Tumours

Question 1

how are odontogenic tumours usually discovered

Answer 1

non-eruption of teeth/late stage bony expansion or other imaging

Question 2

what is the classification of odontogenic tumours

Answer 2

epithelial
mesenchymal
mixed

Question 3

what are the odontogenic sources of epithelium

Answer 3

rests of malassez
rests of serres
reduce enamel epithelium

Question 4

name 3 epithelial tumours

Answer 4

ameloblastoma
adenomatoid odontogenic tumour
calcifying epithelial odontogenic tumour

Question 5

name a mesenchymal tumour

Answer 5

odontogenic myxoma

Question 6

name a mixed tumour

Answer 6

odontoma

Question 7

where do ameloblastomas usually occur

Answer 7

posterior mandible

Question 8

what is the radiological appearance of ameloblastomas

Answer 8

multicystic
(can be unicystic in young patients)
well-defined corticated margins
potentially scalloped margins
thick curved septa giving soap bubble appearance
radiolucent

Question 9

what happens to the adjacent structures with an ameloblastoma

Answer 9

displacement
thinning of bony cortices
knife edge external root resorption

Question 10

what is the histology of a follicular ameloblastoma

Answer 10

islands present within fibrous tissue background
islands have ameloblast like cells surrounding them
tissue in middle of follicles
cystic changes within follicles
no connective tissue

Question 11

what is the histology of plexiform ameloblastoma

Answer 11

ameloblastoma like cells arranged in strands
stellate reticulum
fibrous tissue
no connective tissue

Question 12

how does the lack of connective tissue in ameloblastomas impact prognosis

Answer 12

means it can easily grow and infiltrate into the jaw causing high recurrence rate

Question 13

what is the management of ameloblastomas

Answer 13

surgically resect with 1cm margin

Question 14

if an ameloblastoma turns malignant what is it then called

Answer 14

ameloblastic carcinoma

Question 15

who usually gets an adenomatoid odontogenic tumour

Answer 15

teenagers

Question 16

where do adenomatoid odontogenic tumours occur

Answer 16

anterior maxilla

Question 17

what is an adenomatoid odontogenic tumour associated with

Answer 17

unerupted tooth
(maxillary canine)

Question 18

what is the appearance of an adenomatoid odontogenic tumour

Answer 18

unilocular radiolucency with internal calcifications around crown of unerupted tooth
well defined corticated margins

Question 19

what is the histology of an adenomatoid odontogenic tumour

Answer 19

epithelium in duct like structures
degree of calcification reflected in radiological appearance
fibrous tissue capsule

Question 20

what does the presence of a fibrous tissue capsule in adenomatoid odontogenic tumours mean for prognosis

Answer 20

lower risk of recurrence and easier removal

Question 21

where do calcifying epithelial odontogenic tumours occur

Answer 21

posterior mandible

Question 22

what is the presentation of a calcifying epithelial odontogenic tumour

Answer 22

slow growing but large
radiolucency with internal radiopacities
multi or unilocular
well or poorly defined margins
potential internal septa

Question 23

where do odontogenic myxomas commonly occur

Answer 23

mandible

Question 24

what is the presentation of an odontogenic myxoma

Answer 24

well-defined radiolucency and thin corticated margin
slow growth along bone
scallops between teeth

Question 25

what is the histology of an odontogenic myxoma

Answer 25

loose myxoid tissue with stellate cells
islands of inactive odontogenic epithelium
no capsule so is locally invasive

Question 26

how do you manage an odontogenic myxoma

Answer 26

curettage or resection

Question 27

what is an odontoma

Answer 27

malformation of a dental tissue similar to teeth

Question 28

what are the 2 types of odontoma

Answer 28

compound
complex

Question 29

what is a compound odontoma

Answer 29

ordered dental structures (multiple mini teeth)
anterior maxilla usually

Question 30

what is a complex odontoma

Answer 30

disorganised mass of dental tissues
more common in posterior mandible

Question 31

what is the histology of an odontoma

Answer 31

dentine
soft tissue resembling tooth germ
maybe some enamel if it is not fully calcified