Odontomes and Odontogenic Tumours

Question 1

What is a a tumour?

Answer 1

a swelling or excessive growth of tissue

Question 2

what is a neoplasm?

Answer 2

new growth occuring outside of normal homeostatic mechanisms (may be histologically/cytologiaclly immature or abnormal cells

Question 3

what is a hamartoma?

Answer 3

mass of disorganised tissue native to the anatomical location (eg: lung hamartoma in the lung, odontomes in the mouth)

Question 4

what are odontomes?

Answer 4

abnormal growth of tooth forming tissue

Question 5

what are the 5 types of odontoma?

Answer 5

invaginated odontome (more severe called dens-in-dente)
evaginated odontome
enamel pearl
complex odontoma
compound odontoma

Question 6

what can you apply to a deep cingulum pit caused by invaginated odontome?

Answer 6

fissure sealant

Question 7

what is an evaginated odontome?

Answer 7

little bit of extra enamel or dentine on the crown of the tooth

Question 8

what are evaginated odontomes sometimes called when they get a bit bigger?

Answer 8

talon cusp

Question 9

which teeth are invaginated/evaginated odontomes more common in?

Answer 9

maxillary teeth (most commonly lateral incisors)

Question 10

how is an enamel pearl formed?

Answer 10

disruption of the enamel follicle (forms a little pearl of enamel usually at the furcation of a multi-rooted tooth)

Question 11

what is the difference between compound and complex odontome?

Answer 11

they both have all the tooth tissue (enamel, dentinea nd cementum in the correct relationship) but complex odontomes are not organised

Question 12

what age can odontomes occur?

Answer 12

any age but more common in teens

Question 13

what are odontomes usually associated with?

Answer 13

failure to erupt or missing teeth

Question 14

what is the treatment for odontomes?

Answer 14

removal

Question 15

what is an ameloblastoma?

Answer 15

presented as a tumour

Question 16

are ameloblastomas painful

Answer 16

no

Question 17

are ameloblastomas likely to metastisize?

Answer 17

very rarely but can still cause disruption to quality of live

Question 18

what do they typically present as radiographically? what do they appear similar to?

Answer 18

multi-locular radiolucency
odontogenic keratocyst

Question 19

how can you distinguish between keratocyst and ameloblastoma?

Answer 19

ameloblastoma tends to cause significant expansion of the bone (whereas keratoyst doesn’t) and will also cause external resorption of a number of teeth (OKC less likely to do so)

Question 20

how do ameloblastomas present clincially?

Answer 20

slow growing, painless, expansile lesion

Question 21

what does the management of periapical cysts, OKC, ameloblastoma and oral cancer depend on?

Answer 21

the aggressiveness and severity

Question 22

what is the recurrence rate for the following: periapical cysts, OKC, ameloblastoma and oral cancer

Answer 22

periapical cysts - (if treated properly)
OKC +
ameloblastoma ++
oral cancer +++

Question 23

what is the treatment for periapical cysts?

Answer 23

enucleate it or RCT or XLA

Question 24

what is the management for keratocyst?

Answer 24

enucleation w curettage (gold standard)/ Carnay’s (solution which fixes the tissue, kills the cells and makes them easier to remove)

Question 25

why are keratocysts a bit more complex than periapical cysts to manage?

Answer 25

they are multilocular so it can be difficult to get all the bits of tissue out and the cyst lining is very delicate which is easy to leave behind

Question 26

what is the management for ameloblastoma?

Answer 26

local resection (remove the tumour with a margin of normal bone either side) +/- reconstruction

Question 27

what kind of tumour is an ameloblastoma?

Answer 27

neoplasm

Question 28

what is the management for oral cancer?

Answer 28

wide excision with a good margin of tissue, reconstruction, radiotherapy

Question 29

what can happen if oral cancer is not treated properly?

Answer 29

it is highly likely to reoccur

Question 30

why it is important to consider treating the lymph nodes with radiotherapy?

Answer 30

because it is cancer it has the potential to metastasize

Question 31

what might you reconstruct an area with?

Answer 31

fibula bone graft and denta implants

Question 32

what are examples of other odontogenic tumours

Answer 32

cementoma, cemtnal dysplasia, cemento-osseous dysplsia