Wide age range, most over 50 yrs gender =

80% in mandible

Some asymptomatic, others pain and bony swelling, 60% have soft tissue

Radiographic: unilocular or multilocular radiolucencies, margins often ill-defined or irregular

One or more of 3 patterns: 1. Biphasic mixed w/ more eosinophilic polygonal epithelial cells; 2. monophasic w/ clear cells arranged in nests and cords separated by thin strands of hyalinized connective tissue, 3. Pattern resembling ameloblastoma w/ clear cells at periphery of islands showing palisading

Pleomorphism, mitoses and necrosis rare

Tx: wide surgical resection

Px: guarded, metastasis to regional lymph nodes reported 25% of cases to lungs

Mostly younger pts, 2/3rds 10-19; F>M (2:1), strong predilection for anterior portion of jaws

Max>mandible (2:1); occasional extraosseous cases reported; size most are small not over 3 cm in diameter

S&S: most often asympatomic, discovered at routing radiographic exam investigate unerupted tooth

75% circumscribed unilocular lucency involving crown of unerupted tooth, most often canine mimicking dentigerous cyst; often radiolucency extends apically along root past CEJ

Less often presents as well-delineated unilocular radiolucency not related to unerupted tooth but b/t roots of erupted teeth

Tx: enucleation usually sufficient due to encapsulation

Px: good - seldom if ever recurs, no reports of malignant change or metastasis

Wide age range most often between 30-50 yrs; gender =; site 2/3rds in mandible mostly posterior; S&S: most commonly painless, slowling growing swelling

Radiographic: unilocular or multilocular radiolucency w/ unilocular more common in maxilla (scalloped margins, usually contains calcified foci of varying size and density; often assoc with impacted tooth, usually mandibular molar

Islands, stands or sheets of polyhedral epi cells in fibrous stroma; epi cellular outlines distinct; intercellular bridges seen

Large areas of amorphous, eosinophilic hyalinized extracellular material often present, freq enclosed by tumor islands and is thought to represent amyloid or an amyloid-like material (calcifications can dev w/in material in form of rings)

Tx: conservative local resection to include narrow rim of surrounding bone, although lesions in posterior in maxilla should be treated more aggressively.

Px: Good but recurrence rate of 15% (highest recurrence rate)

Wide age range, avg age 38 yrs; anywhere in jaws, max = mandibular; may be multiple and may occur in more than one member of a fmaily

S&S: painless or mildly painful gingival swelling, often assoc w/ mobility of teeth in area, 25% no S&S

Tx: conservative local excision and curettage

Px: good - little tendency to recur, but more in maxilla than mandible

Unilocular (small lesions) or multilocular radiolucency, well-defined, sometimes sclerotic border; 75% assoc w/ unerupted tooth

Can grow to large size, mandibular lesions sometimes involving much of the body and ramus

Tx: complete but conservative surgical excision

Px: good but follow-up imperative to detect recurrence

Tx: conservative curettage; usually separates easily from surrounding bone

Px: excellent, recurrence uncommon, dev of malignancy rare

Hamartoma (malformation rather than true neoplasm) of odontogenic tissues containing enamel, dentin and varying amounts of pulp, cementum, odontogenic epi and mesenchyme

Commonest of odontogenic tumors w/ a prevalence exceeding that of all the other odontogenic tumors combined

Compound - multiple small malformed teeth, entire mass being surrounded by narrow radiolucent rim

Complex - irregular radiopaque mass, also surrounded by narrow radiolucent rim

Both types often assoc w/ unerupted teeth, eruption of which they are preventing; developing odontomas may show minimal mineralization but still show radiolucent rim

Compound - multiple malformed tooth-like structures

Complex - disorganized mass of dental tissues w/ no resemblance to teeth

Tx: simple surgical excision

Px: excellent

Wide age range mean 40 yrs; F>M; 45% in maxilla - most anterior to 1st molar, rest in mandible, half posterior to 1st molar, 1/3 assoc w/ unerupted tooth

S&S: small lesions usually asympatomatic, larger lesions can produce swelling and loosening of teeth

Smaller lesions well-defined, unilocular assoc. w/ periradicular area of erupted teeth

Larger lesions tends to be multilocular

Many lesions have sclerotic borders and root resorption of assoc teeth; root divergence of adj teeth also common; occasional radiopaque flecks can be noted

Simple type: sheets of stellate fibroblasts, often arranged in a whorled pattern w/ fine collagen fibrils and abundant ground substance; occas foci of calcification

World health organization type: cellular fibrosis CT w/ collagen fibers arranged in interlacing bundles; strands and nests of odontogenic epi throughout the lesion; calcinations composed of cementum-like or dentinoid material

Tx: simple enucleation and curettage

Px: good, few recurrences reported

range 2nd to 7th decade; gingiva, most often mandible, facial

S&S: well-circumscribed nodule clinically similar to other epulide lesions (pyogenic granuloma, PGCG, peripheral ossifying fibroma); may be minute calcifications which are radiographically detectable even though it is outside of bone

Tx: local surgical excision

Px: excellent, but recurrence has been reported so pt should be followed and aware of this possibility

Unilocular or multilocular radiolucency may displace teeth or resorb teeth in area; margin of lucency often irregular or scalloped

Lucent area may contain thin, wispy trabeculae of residual bone; often at right angles to each other

Esp mandibular lesions may show prominent "soap bubble" pattern closely resembling ameloblastoma

Irregularly arranged stellate, spindle-shaped & round cells in an abundant, loose myxoid stroma containing few collagen fibrils; composed glycosaminoglycan, mainly hyaluronic acid and chondroitin sulfate

Myxoma cells contain vimentin and some muscle-specific actin

Tx: curettage may be adequate for small lesions but larger lesions require resection w/ margin of uninvolved bone

Px: good but avg 25% recurrence rate; malignant transformation rare if it ever occurs

Uncommon condition; 75% in mandible, 90% in molar/premolar area; 50% involve first permanent molar

mostly children and young adults; pain and swelling in 2/3 in pts; usually slow growing or static, occas more aggressive, locally destructive

Radiopaque mass fused to one or more tooth roots and surrounded by a thin radiolucent rim

Outline of root or roots of involved tooth usually obscured as result of root resorption and fusion of tumor w/ tooth

Tx: surgical extraction of mass and attached tooth; endodontic treatment and root amputation may be considered

Px: good; complete healing expected w/ most studies relating little tendency to recur