Odontogenic Tumors and Cysts

Question 1

In Tjepkema JVD 2020, what is the most common location for conventional ameloblastoma?
A) Caudal MX
B) Rostral MX
C) Caudal MN
D) Rostral MN

Answer 1

Found mostly in region of canines and premolars of the maxilla - B

Question 2

In Tjepkema JVD 2020, the percentage of intraosseous lesions of conventional ameloblastoma was \_\_\_, compared to \_\_\_ were extraosseous in CAA?
A) 67%, 95%
B) 33%, 67%
C) 95%, 67%
D) 95%, 33%

Answer 2

C)

CAA mostly extraosseous and most intraosseous are cystic.

Lower recurrence with conservative margins, margins of 1cm may not be necessary

Question 3

In Fiani, odontogenic tumors and FFH, what were the most common lesions?
A) FFH
B) CAA
C) POF
D) APOT

Answer 3

B) CAA 45%>POF 31%>FFH 16%>APOT

Question 4

In Fiani, odontogenic tumors and FFH, CAA was most common in the \_\_\_ and POF/FFH were most common in the \_\_\_? BONUS if you can state the ratio
A) Rostral MX, Caudal MN
B) Rostral MN, Caudal MX
C) Rostral MX, Rostral MN
D) Rostral MN, Rostral MX

Answer 4

D) CAA rostral MN (2.3:1)

POF/FFH rostral MX - POF (1.7:1)

Question 5

According to Fiani, odontogenic tumors and FFH, which of the following is false?
A) Goldens, Akitas, Cockers and Shelties over-rep CAA
B) CAA equal between males and females.
C) FFH more common in mix breeds
D) APOT more common in the rostral MX

Answer 5

D) APOT in rostral MN

Neutered males over-rep in POF

Question 6

Comparing Bellei and Babbitt, what are the percentage of DTC in their respective studies?
A) 29%, 44%
B) 39%, 77%
C) 44%, 29%
D) 77%, 39%

Answer 6

C) 44% Bellei, 29% Babbitt

Question 7

Comparing Bellei and Babbitt, what are the percentage of unerupted teeth were PM1 in their respective studies?
A) 78%, 68%
B) 90%, 71%
C) 68%, 78%
D) 71%, 90%

Answer 7

A) Bellei 78% were PM1, 48.8% were cystic

Babbitt 68% were PM1, 29.4% were cystic

Question 8

In Bellei, of the 10 teeth submitted for histo that were negative or equivocal for cystic lesions on rads, which of the following are true?
A) 4 lesions had pericoronal radiolucency that was <3x the width of the PDL and were DTC on histo.
B) 3 lesions had pericoronal radiolucency that was 3x the width of the PDL and were DTC on histo.
C) 3 lesions had pericoronal radiolucency that was <3x the width of the PDL and were not DTC on histo
D) All of the above.

Answer 8

D)

The point is that Babbitt said if the pericoronal lucency was greater than or equal to 3x the PDL you should extract because its likely a cyst. Bellei is saying they have several that are less than 3x that are still cystic so they are debunking this statement.

Question 9

According to Babbitt, what breeds are over-represented in unerupted teeth?

Answer 9

Brachycephalics over-represented, Boxers, Bostons, Shih Tzu and Pug most common.

Bellei was Boxer and Lab

Question 10

According to Babbitt, what was the percentage of histo diagnosed DTC's that were present in the 4 most common breeds?
A) 85%
B) 65%
C) 45%
D) 25%

Answer 10

A) 85% present in Boxers, Bostons, Shih Tzus and Pugs.

Question 11

In Velasquez-Urgel, Maxillary and Mandibular POF in a cat, which of the following is false?
A) Odontogenic tumors represent 0.33% of oral tumors of the cat in one study, POF represented 7.8% of all oral tumors in another study,
B)Proliferative PDL stroma found as sole component in 16% of POF, while other POF contain odontogenic epithelium and/or foci of dentinoid, cementum or osteoid material
C) APOT originates with odontogenic epithelium with extracellular amyloid.
D) FIOT originates within the supportive CT with fibroblasts CT associated with islands of odontogenic epithelium and is noted most commonly in the rostral mandible.

Answer 11

D) FIOT, rostral maxilla

Question 12

In Hodesson, features of squamous odontogenic tumor (SOT), which of the following were part of the defining features of the lesion?
A) Lack of differentiated ameloblasts
B) Squamous cell morphology
C) Lack of signs of malignancy
D) All of the above

Answer 12

D) is the answer

Lack of differentiated ameloblasts and signs of malignancy differentiate the lesion from ameloblastoma and SCC.

This case rostral mandible

Question 13

According to Malmberg, AA with atypical foci in 5 dogs, which of the following is true?
A) Ancillary treatment was advocated
B) The atypical foci were associated with metaplasia and poorer prognosis relative to AA
C) No age, breed or sex predilection
D) Atypical cells were pleiomorphic with low mitotic rate.

Answer 13

C is true

No ancillary treatment was performed

The atypical foci were NOT associated with metaplasia or poorer prognosis relative to AA

Atypical cells had a high mitotic rate

Question 14

According to Goldschmidt, clinical characterization of CAA in 263 dogs, which of the following is false?
A) CAA is typically found in middle aged-to geriatric dogs and Goldens have an increased propensity.
B) No difference noted between male and female patients
C) When narrown dirty margins encountered, revision surgery is warranted.
D) Intra-op margins of 1cm may be acceptable and margins for prevention of local recurrence may be as small as 5mm.

Answer 14

C) is false, when dirty margins are encountered, medical surveillance rather than revision surgery or radiation therapy may be clinically appropriate.

Question 15

According to Goldschmidt, clinical characterization of CAA in 263 dogs, what was the most common location of CAA and what was its prevalence?
A) Rostral MX, 21.5% 
B) Cadual MN, 21.5% 
C) Rostral MN 51% 
D) Caudal MX 51%

Answer 15

C) Rostral MN 51%

Question 16

According to Tjepkema, suspected LPC in concurrently with CAA in a 2yo Std Poodle, which of the following is false?
A) LPCs are inflammatory cysts
B) LPCs are non-keratinized and associated with vital teeth.
C) Anatomically both LPC and CAA arise in the gingiva and periodontium expanding (LPC) or invading (CAA) along the affected tooth root while sparing the apex
D) LPCs present as a unilocular lucency with well defined corticated borders.

Answer 16

A) is False

LPCs are non-inflammatory, non-keratinized, developmental cysts that are associated with vital teeth lateral to a tooth root with absence of pulpitis, typically tear dropped shape

C) Describes possible association between LPC and CAA which may explain their existing together.

Question 17

According to Tjepkema, suspected LPC in concurrently with CAA in a 2yo Std Poodle, LPC is assumed to originate from one of the following except?
A) Reduced enamel epithelium
B) Remnants of dental lamina
C) Rests of Malassez
D) Stellate reticulum

Answer 17

D) is false

Question 18

According to Scott, Odontogenic fibromyxoma in the cat, where do these lesions originate from?

Answer 18

Originate from odontogenic ectomesenchyme, arise from connective tissue within tooth bearing regions.

Question 19

According to Hoyer, Extensive Maxillary Odontomas in 2 dogs, odontomas which of the following is false?
A) Benign neoplasm
B) Comprised of mixed odontogenic epithelium and odontogenic ectomesenchyme
C) Never includes dental hard tissue
D) Hyperactivity of the dental lamina may be partially responsible for formation

Answer 19

C) is false in that these may or may not include dental hard tissue.

May be considered Hamartoma

Denticles pathognomonic for compound odontomas

Question 20

According to Hiscox regarding peripheral giant cell tumor, which of the following is false?
A) Rostral maxilla is the classic location
B) Classically there is evidence of PDL
C) It is considered a reactive epulide
D) CT revealed expansile mass with osteolysis and periosteal reaction

Answer 20

B is false

Classically there is numerous GC, stellate mesenchymal cells with regularly spaced blood vessels and no evidence of PDL, which is a classic sign of a POF.

Question 21

According to Honzelka, what modified conservative treatment was used on and extensive DTC?

Answer 21

Decompression by marsupialization by suturing cyst wall to oral mucosa, suture skin to any soft tissue around cyst and excision/enucleation at a later date.

Question 22

According to Soukup and Bell's classification paper, which of the following are only present in animals?
A) CAA
B) APOT
C) FIOT
D) fibromatous epulides of PDL

Answer 22

All of them

Question 23

According to Soukup and Bell’s classification paper, which of the following is true?
A) FFH is over exuberant repair of fibrous CT secondary to chronic gingival trauma and irritation
B) Most cases of CEOT analogous to humans
C) POF should be considered an inflammatory lesion of odontogenic mesenchyme
D) Amyloid in APOT is derived from odontoblasts

Answer 23

A is true

Most cases of CEOT not analogous to humans - APOT

POF should be considered a neoplastic lesion of odontogenic mesenchyme

Amyloid in APOT from ameloblasts

Question 24

According to Svendius, oral path in Swedish dogs, which category of lesions was most common?
A) Reactive
B) Benign
C) Malignant
D) Unknown

Answer 24

Reactive at 39%, followed by Benign 24%, and malignant at 15%

Question 25

``` According to Svendius, oral path in Swedish dogs, which lesion was most common? A) CAA B) POF C) FFH D) OMM ```

Answer 25

FFH was most common at 24%, followed by POF, then OMM Purebred more prone, Dachshund predilection for malignancies SCC lower than previous studies at 1.4% Highest number of malignancies in Goldens, Labs and Dachshunds, Highest number of reactive lesions and benign in Goldens and Boxers (Boxers were biopsied most) 3 amelogenesis imperfecta Std Poodles identified.

Question 26

According to LaDouceur regarding OKCs, which of the following is false? A) OKCs are derived from odontogenic epithelium B) They contain abundant orthokeratin and parakeratin C) They are chronic inflammatory process that stimulate the rests of Malassez D) Contain all characteristics of human OKCs except for microcyst formation.

Answer 26

C is false, its Rest of Serres (Dental Lamina Remnants)

Question 27

According to Amory, CT characteristics of Odontogenic Neoplasms in Dogs, which are the following are associated with odontogenic tumors? A) Displaced teeth B) Cyst like structures C) variable soft tissue and mineral attenuation D) bone lysis and enhanced contrast

Answer 27

All of them

Question 28

``` According to Amory, which of the following is best detected by dental radiology? A) keratinizing ameloblastoma B) conventional ameloblastoma C) CAA D) fibromatous epulides of PDL origin ```

Answer 28

D) These are the only oral canine epulis recognized by WHO

Question 29

``` According to Amory, CT characteristics of Odontogenic Neoplasms in Dogs, 52% of the maxillary masses had extraoral involvement, what structures was most commonly involved? A) nasal cavity B) orbit C) nasopharynx D) Vomer ```

Answer 29

A) Nasal Cavity 91% 53% of CAA cases in this study in rostral Maxilla Rostral maxilla most common in all the cases (48.3%) APOT 2/3rd rostral mandible

Question 30

What are the four possible reasons deciduous teeth do not exfoliate (in McGee's Bilateral DTC paper so that's why its here)?

Answer 30

absent adult tooth Ankylosis of deciduous tooth hormonal influences failure of permanent crown to contact deciduous root during eruption.

Question 31

``` According to McGee, what tissue does a DTC arise from? A) enamel epithelium of a tooth crown B) epithelial rests of Malassez C) dental lamina remnants D) reduced enamel epithelium ```

Answer 31

D) REE

Question 32

``` According to Verstraete Clinical and histo findings in dogs with odontogenic cysts, what percentage of lesions were DTC? A) 45% B) 71% C) 32% D) 16% ```

Answer 32

B) 29/41 dogs 71%, 36 cysts total 30 of 36 were PM1 Brachycephalics over-rep

Question 33

According to Verstraete Clinical and histo findings in dogs with odontogenic cysts, 9/41 lesions resembled OKC with some but not all of the histo features to make diagnosis of OKC in humans. What breeds were over-represented in these lesions and what were they named?

Answer 33

Canine odontogenic parakeratinizing cyst Over-represented by Min Schnauzer and Springer Spaniel OKCs are developmental COPC lack hyperchromatic, palisading basal cell layer and keratincious debris commonly found in OKC

Question 34

According to Arzi, expression of cytokeratins in epithelium of canine odontogenic tumors, which of the following is true? A) CK 8/18 expressed by CAA and POF but not normal tissue B) Complex and compound odontomas had different expression than the tooth germ C) Typical expression patterns of odontogenic epithelium and gingiva of dogs was CK 7, 8, 18 and 20 D) Dogs and man exhibit different expression in the odontogenic epithelium

Answer 34

A) is true B) Compound and complex odontomas have nearly the same expression as the tooth germ C) Typical expression patterns are CK 14 and CK 5/6. CK 7, 8, 18 and 20 were generally absent D) Dogs and man exhibit similar expression in the odontogenic epithelium

Question 35

In Bock, Oral masses in 2 cats (APOT), which of the follwoing is false? A) One APOT was ODAM (+) and one was ODAM (-) suggesting the amyloid in these lesions are of different origin B) Amyloid in CEOT of humans associated with ODAM a unique odontogenic amyloid. C) APOT differs from ameloblastoma because of stellate reticulum in APOT D) APOT is a rare, benign, rapidly growing tumor

Answer 35

D) APOT is slow growing

Question 36

According to Kelly, AA in dogs treated with intralesional bleomycin, which if the following is false? A) All dogs had lesion decrease by 25% after the 1st injection. B) Bleomycin causes vacuolar degeneration and tumor cell necrosis C) Pulmonary fibrosis is a possible side effect of bleomycin and it was noted in 2/7 dogs D) Complete response in 30-91 days in 6/7 dogs.

Answer 36

C is false, no dogs showed clinical signs of pulmonary fibrosis. 1/7 dogs was palliative and had ~25% decrease in tumor volume within 14 days.

Question 37

``` According to Bell and Soukup regarding canine furcational cyst, which of the following were proposed mechanisms of inflammation? A) pericoronitis B) periodontitis C) trauma D) Developmental defects ```

Answer 37

All of them

Question 38

According to Bell and Soukup regarding canine furcational cyst, which of the following was not a consistent radiographic feature? A) Corticated border combined with a central area of increased radiolucency B) Radiolucency of the furcation isolated within interradicular area between mesial and distal roots. C) Expansion of cortical bone generally not seen D) Evidence of endodontic disease

Answer 38

D no evidence of endodontic disease, impacted teeth, No obvious underlying causes for the cysts were identified. TR in 4 of 20 (20%)

Question 39

According to Bell and Soukup regarding canine furcational cyst, which of the following is false in regards to histologic findings? A) Immature bone present in 65% of samples B) Granulation tissue in 45%, present in all nine dogs that had attenuation or loss of the lining epithelium. C) Inflammation ranged from minimal 15%, to moderate 25%, and was most commonly mild (60%). D) Majority were non-viable teeth with evidence of pulpitis

Answer 39

D is false, vital tooth, no pulpitis

Question 40

According to Bell and Soukup regarding canine furcational cyst, what was the most common skull type presented?

Answer 40

Mesaticephalic 70%, brachycephalic 25%, dolicocephalic 5%