Ameloblastic fibroma

Ameloblastic fibro-odontoma

Ameloblastic fibrosarcoma

Odontoameloblastoma

Odontoma

(1)  Neoplasm of both odontogenic epithelium and mesenchymal tissues.

(2)  Tend to occur in the first two decades of life

(3)  70% in the posterior mandible

(1)  Well-defined unilocular or multilocular radiolucency; 1/2 associated with impacted tooth.

(2)  Homogeneous myxoid connective tissue is cords and strands of odontogenic epithelium.

(3)  20% recurrence rate after conservative removal.

(1)  Malignant counterpart of ameloblastic fibroma

(2)  Average age is 26

(3)  75% in mandible

(4)  Twice as common in males

Ameloblastic Fibrosarcoma

(1)  radiographic presentation

(2)  histologic presentation

(3)  treatment

(4)  recurrence rate

(1)  ill-defined destructive radiolucent lesion.

(2)  atypical mesenchymal cells with increased cellularity and increased mitosis.

(3)  radical surgical excision; guarded prognosis.

(4)  50% of cases represent recurrence of a previously diagnosed ameloblastic fibroma.

(1)  is it a developing odontoma or a separate odontogenic neoplasm?

(2)  Average age is 10 yrs.

(3)  Equal frequency in Mx and Mn, usually associated with impacted tooth.

Ameloblastic Fibro-odontoma

(1)  radiographic presentation

(2)  histologic presentation

(3)  treatment

(1)  well-circumscribed unilocular (rarely multilocular) radiolucency with variable calcifications.

(2)  Microscopically looks like AF with dental hard tissue.

(3)  Conservative curettage with excellent prognosis.

Odontomas

(1)  % of odontogenic tumors

(2)  average age of pts

(3)  definition

(4)  clinical presentation

(5)  List types

(1)  Most common type of odontogenic tumors.

(2)  Avg age is 14.

(3)  Odontomas are considered to be hamartomas rather than true neoplasms.

(4)  Often associated with an impacted tooth and is asymptomatic.

(5)  Complex & Compound

Compound Odontoma

(1)  description

(2)  location

(3)  radiographic presentation

(4)  histologic presentation

(5)  treatment

(1)  composed of multiple small tooth-like structures.

(2)  More often seen in the anterior maxilla.

(3)  radiographic features are usually diagnostic and consists of a clump of "toothlets."

(4)  Decalcified sections show all the dental tissues in proper orientation.

(5)  Treated with simple local excision.

Complex Odontoma

(1)  description

(2)  location

(3)  radiographic presentation

(4)  histologic presentation

(5)  treatment

(1)  Composed of all of the dental tissue, which are arranged in a disorganized mix.

(2)  Occur more often in the molar region of either jaw.

(3)  Presents as a radiopaque mass with a narrow radiolucent rim.

(4)  Decalcified sections show all the dental tissues in an disorganized pattern.

(5)  Treated with simple local excision, dentigerous cyst may develop.

(1)  Extremely rare.  Features of both ameloblastoma and odontoma.

(2)  More often in younger people and in the mandible.

(3)  Destructive radiolucency w/ radiopaque features of an odontoma.

(4)  Recurs like ameloblastoma and should be treated accordingly.

-Odontogenic fibroma

-Granular cell odontogenic fibroma

-Peripheral odontogenic fibroma

-Myxoma

-Cementoblastoma

(1)  Unusual odontogenic lesion, 40, 7.4:1 female.

(2)  Most common in anterior Mx & posterior Mn.

(3)  Unilocular or multilocular radiolucency, root resorption is common.

(4)  May have "simple" pattern or the WHO pattern.

(5)  treated with enucleation and curettage with few recurrences and very good prognosis.

(1)  very rare tumor.  avg age is 40.

(2)  Tends to occur in molar areas.

(3)  Composed of large eosinophilic granular cells similar to those seen in granular cell ameloblastomas; may see small calcifications.

(4)  Responds well to curettage.

(1)  Soft tissue counterpart of the WHO type central odontogenic fibroma. 

Slow-growing, sessile, gingival mass.

(2)  Usually facial gingiva of the mandible and normal colored.

(3)  Fibrous tissue with islands or strands of odontogenic epithelium and scattered calcifications.

(4)  Treated with local excision with little chance of recurrence.

(1)  Neoplasm believed to be derived from odontogenic ectomesenchyme.

Avg age is between 20-30 years.

(2)  Slightly more common in mandible.

(3)  Multilocular (tennis racquet) or unilocular radiolucency (often w/ scalloped border).

(4)  Loose, myxoid connective tissue with little collagen.

*dental papilla from a developing tooth may be confused with myxoma.

(5)  Recurrence is common (25% w/curettage).

(1)  Neoplasm of cementoblasts closely related to osteoblastoma.  Usually under the age of 25.

(2)  Most commonly associated with roots of mandibular 1st molar.

(3)  Well circumscribed calcified mass w/ peripheral lucent line and resorption of associated roots.

(4)  Sheets of thick trabeculae w/ reversal lines surfaced by numerous cementoblasts

*May be confused w/ osteosarcoma

(5)  Treat by extraction of the involved tooth and removal of the mass; excellent prognosis.