Surgical Mgmnt of Odontogenic tumors

Question 1

What is the biologic classification of the following tumors?
* Adenomatoid odontogenic tumor
* Squamous odontogenic tumor
* Cementoblastoma
* Periapical cemento-osseous dysplasia
* Odontoma

Answer 1

BENIGN, NO RECURRENCE POTENTIAL

Question 2

What is the biologic classification of the following tumors?
* Cystic ameloblastoma (unicystic)
* Calcifying epithelial odontogenic tumor
* Central odontogenic fibroma
* Florid cementoosseous dysplasia
* Ameloblastic fibroma and fibroodontoma

Answer 2

Benign (some recurrence potential)

Question 3

What is the biologic classification of the following tumors?
 Ameloblastoma(Multicystic/Solid)
 Clear cell odontogenic tumor (some consider this a carcinoma)
 Odontogenic ghost cell tumor (COC, solid type)
 Odontogenic myxoma
 Odontoameloblastoma

Answer 3

Benign aggressive

Question 4

Does paresthesia more commonly occur w tumors or cytic lesions?

Answer 4

Tumors

Question 5

Local removal of tumor by appropriate instrumentation in direct
contact with the lesion: used for very benign types of lesions.

Answer 5

Enucleation

Question 6

Do you aspirate a lesion before or after obtaining a CT scan of the area?

Answer 6

Aspirate after

Question 7

• Removal of a tumor by incising through uninvolved tissues
  around the tumor, thus delivering the tumor without direct
  contact during instrumentation (

Answer 7

Surgical resection

Question 8

• Resection of a tumor without disruption of the continuity of the bone.

Answer 8

Marginal (Segmental) resection

Question 9

Resection of a tumor by removing full-thickness portion of the
jaw.
* In the mandible, this can vary from a small continuity defect to
a hemimandibulectomy.
* Jaw continuity is disrupted.

Answer 9

Partial resection

Question 10

• Resection of a tumor by removal of the involved bone.

Answer 10

Total resection

Question 11

• Resection of tumor with bone, adjacent soft tissues and contiguous
  lymph node channels (This is an ablative procedure used most
  commonly malignant tumors)

Answer 11

Composite resection

Question 12

What type of reconstruction graft is done for smaller defects?

Answer 12

Free bone graft

Question 13

What type of reconstruction graft is done for larger defects?

Answer 13

Vascularized bone graft

Question 14

• Benign, but locally invasive (Except for the Malignant variant).
• It is unencapsulated and infiltrates surrounding bone marrow.
• Even though they are locally infiltrative, they do not metastasize
  (Except for the Malignant variant).
• Occasionally arise from dentigerous cysts.

Answer 14

Ameloblastoma

Question 15

HOw are unicystic ameloblastomas treated?

Answer 15

Ennucleation w/ peripheral ostectomy

Question 16

How do you treat solid ameloblastomas?

Answer 16

Resection 1.5 cm beyond tumor margins

Question 17

• It occurs chiefly in middle age people long after odontogenesis
  has ceased.
• They may occur in any part of both jaws but most are in the
  middle and posterior regions of the mandible.
• They may be unilocular but frequently become multilocular as they
  increase in size.
• The unilocular lesion is indistinguishable from an odontogenic cyst.
• Well-circumscribed, “soap- bubble appearance” (Multicystic or Solid
  variant).

Answer 17

Ameloblastoma

Question 18

• This is a tumor that is commonly found in teenagers.
• It occurs in the middle and anterior portions of the jaws
• Commonly associated with the crown of an impacted anterior tooth.
• Two-thirds occur in the maxilla and it is more common in females.
• The maxillary incisor-cuspids are common sites.
• Painless expansion is often the chief complaint.

Answer 18

Adenomatoid odontogenic tumor

Question 19

The radiographic appearance is a unilocular radiolucency, often around
the crown of an unerupted tooth in which case they resemble a
dentigerous cyst.

Answer 19

Adenomatoid odontogenic tumor

Question 20

How do you treat an AOT?

Answer 20

Enucleation

Question 21

What are the most common type of odontogenic tumors seen in OS clinic?

Answer 21

Odontomas

Question 22

The tumors in which odontogenic differentiation is fully expressed
are the ______

In these tumors, the epithelium and ectomesenchyme realize their  potential and make enamel and dentin respectively. 
 
 As a result, these tumors are mostly radiodense.

Answer 22

odontomas.

Question 23

In the ______ odontoma, there is little or no tendency to form
tooth-like structures.

• The dentin and enamel are entwined in a mass that bears no
  resemblance to teeth.

Answer 23

Complex odontoma

Question 24

In the _____ odontoma, multiple small and malformed tooth-
like structures are formed creating a “bag of marbles” radiographic
appearance.

Answer 24

compound odontoma

Question 25

Is compound or complex odontoma more found in anterior jaw?

Answer 25

Compound

Question 26

Is compound or complex odontoma more found in posterior jaw?

Answer 26

Complex

Question 27

What is tx for odontomas?

Answer 27

Elective surgery

Question 28

* True benign neoplasm of cementoblasts * This tumor typically occurs around the roots of the lower posterior teeth (First Mandibular molars) * Cortex expanded without pain * Involved tooth ankylosed. Radiographically it appears as a ball of dense material attached to the end of the root.

Answer 28

Cementoblastoma

Question 29

What is tx for cementoblastoma

Answer 29

Complete excision of the lesion along with extraction of the involved tooth.

Question 30

What are ameloblastomas and AOTs derived from?

Answer 30

Odontogenic epithelium

Question 31

What are complex and compound odontomas classified as?

Answer 31

Mixed tumors

Question 32

What are cementoblastomas derived from?

Answer 32

Cementoblastoma