Odontogenic Neoplasms

Question 1

3 Tumors of odontogenic epithelium

Answer 1

1. Ameloblastoma
2. Adenoid Odontogenic Tumor (AOT)
3. Calcifying Epithelial Odontogenic Tumor (CEOT)

Question 2

3 Mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme

Answer 2

1. Ameloblastic fibroma
2. Ameloblastic fibro-odontoma
3. Odontoma

Question 3

2 Tumors of odontogenic mesenchyme

Answer 3

1. Odontogenic myxoma

2. Cementoblastoma

Question 4

The frequency of this tumor is equal to the combined frequency of all other odontogenic tumors

Answer 4

Ameloblastoma

Question 5

What feature of an ameloblastoma can be dramatic?

Answer 5

Expansion

Question 6

Most common area for ameloblastoma?

Answer 6

Posterior mandible (molar/ramus region)

Question 7

What is the radiographic appearance of ameloblastoma?

Answer 7

“Soap bubble or honeycomb”

Question 8

Do the lesional cells of an ameloblastoma make enamel?

Answer 8

No

Question 9

2 Most common histological patterns of ameloblastoma?

Answer 9

1. Follicular

2. Plexiform

Question 10

What do you see in the histology of an ameloblastoma?

Answer 10

Tumor islands

Question 11

What type of cells are at the periphery of tumor islands in an ameloblastoma? Are the nuclei polarized toward or away from the basement membrane?

Answer 11

Cuboidal or columnar cells

Away from

Question 12

Ameloblastoma insinuates through _____. This is the reason for an ___ ___ ____

Answer 12

Trabeculae

En bloc resection

Question 13

Why do maxillary ameloblastomas have to be treated more aggressively?

Answer 13

Because of anatomic location (vital structures)

Question 14

Prognosis for ameloblastoma?

Answer 14

Guarded

Question 15

When is an ameloblastoma more likely to be fatal?

Answer 15

When it is in the maxilla

Question 16

What is the soft tissue variant of an ameloblastoma?

Answer 16

Peripheral ameloblastoma

Question 17

What is the histological difference between an ameloblastoma and a peripheral ameloblastoma?

Answer 17

The peripheral is located under the surface epithelium

Question 18

Treatment for a peripheral ameloblastoma

Answer 18

The biopsy is often curative

Question 19

Are most patients with Adenomatoid Odontogenic Tumor (AOT) old or young?

Answer 19

Young

Question 20

AOTs have a ____ predilection, are mostly in the ____ (anterior/posterior) ______ (maxilla/mandible), and are often associated with ____

Answer 20

Female
Anterior
Maxilla
Impacted teeth

Question 21

AOTs often cause _____ of roots

Answer 21

Divergence

Question 22

An AOT has a well defined ____

Answer 22

Capsule

Question 23

Which stratum layer will you find a Calcifying Epithelial Odontogenic Tumor (CEOT) in?

Answer 23

Stratum intermedium

Question 24

CEOTs are often in the ____ (anterior/posterior) _____ (maxilla/mandible)

Answer 24

Posterior mandible

Question 25

Radiographically, a CEOT is often ________ when small and _____ when large

Answer 25

Well-circumscribed | Multilocular

Question 26

What type of radiographic pattern is seen with a CEOT?

Answer 26

"Driven snow"

Question 27

The calcifications associated with a CEOT are called ___ ___

Answer 27

Liesegang rings (lamellated)

Question 28

Is radical surgery warranted for a CEOT?

Answer 28

No

Question 29

When the epithelial and ectomesenchymal cells are both neoplastic

Answer 29

Ameloblastic fibroma

Question 30

Ameloblastic fibromas are typically seen in _____ (older/younger) patients, and are often seen in the _____ (anterior/posterior) ____ (maxilla/mandible)

Answer 30

Younger | Posterior mandible

Question 31

The epithelial proliferation of ameloblastic fibromas resembles ____ ____

Answer 31

Dental papilla

Question 32

The myxoid connective tissue of an ameloblastic fibroma contains strands and islands of odontogenic epithelium resembling ___ ____

Answer 32

Dental lamina

Question 33

An ameloblastic fibro-odontoma is often seen in ____ (older/younger) patients. Where is it often seen?

Answer 33

Younger | Equal frequency in the mandible and maxilla

Question 34

An ameloblastic fibro-odontoma often overlies a(n) ____ ____

Answer 34

Impacted tooth

Question 35

The histology of an ameloblastic fibro-odontoma is the same as:

Answer 35

An ameloblastic fibroma with an odontoma

Question 36

What type of odontoma is usually associated with an ameloblastic fibro-odontoma?

Answer 36

The complex type

Question 37

2 forms of an odontoma and where they're located

Answer 37

1. Compound (usually anterior) | 2. Complex (usually posterior)

Question 38

An odontoma is probably a(n) ____ ____ rather than a true neoplasm

Answer 38

Odontogenic hamartoma

Question 39

Odontomas are typically seen in ____ (older/younger) patients and are slightly more frequent in the _____ (maxilla/mandible)

Answer 39

Younger | Maxilla

Question 40

Radiographically, a compound odontoma is a collection of

Answer 40

Small malformed teeth surrounded by a radiolucent rim

Question 41

Radiographically, a complex odontoma is:

Answer 41

A calcified mass with the same density of tooth structure (if it is fully formed)

Question 42

Histologically, what is seen in a complex odontoma?

Answer 42

A mix of dentin, enamel matrix, cementum, odontogenic epithelium and dental papilla

Question 43

Benign neoplasm assumed to be of odontogenic origin because it only affects the jaw bones as a central lesion - no other bones

Answer 43

Odontogenic myxoma

Question 44

Odontogenic myxomas are slightly more common in the ____ (maxilla/mandible)

Answer 44

Mandible

Question 45

Odontogenic myxomas have a ____ ____ appearance

Answer 45

Soap bubble

Question 46

What is unique about odontogenic myxomas on a radiograph?

Answer 46

There are thin, wispy trabeculae of residual bone, often at right angles

Question 47

Treatment for an odontogenic myxoma if it is small? If it is large?

Answer 47

Small - curettage | Large - en bloc or segmental resection

Question 48

What contributes to the recurrence rate of an odontogenic myxoma?

Answer 48

Infiltration

Question 49

Cementoblastomas are usually seen in the _______ region

Answer 49

Mandibular molar (usually 1st molar)

Question 50

Cementoblastomas are often associated with ___ and ___

Answer 50

Pain and swelling

Question 51

Cementoblastomas often obscur the _______

Answer 51

Outline of the root

Question 52

What is a distinguishing histological feature of a cementoblastoma?

Answer 52

It is fused to the root

Question 53

Treatment for cementoblastoma

Answer 53

Surgically extract the involved tooth and enucleate the lesion (or endo, enucleation, and root amputation)