O. Path 2 Spring Final

Front 1

Most common odontogenic neoplasm

Back 1

Ameloblastoma

Front 2

Origin of ameloblastoma?

Back 2

Dental lamina, REE

Front 3

How would you diagnose ameloblastoma clinically?

Back 3

Asymptomatic painless swelling
Slow growing, locally invasive process
Tendency for recurrence

Front 4

Where is the usual spot for ameloblastoma?

Back 4

Posterior mandible

Front 5

Radiographic symptoms of ameloblastoma?

Back 5

Unilocular R/L when small

Honeycomb or multilocular as it grows larger

Front 6

T/F Radiographically you can see resorption of adjacent tooth roots or displacement of teeth in ameloblastoma.

Back 6

TRUE

Front 7

Two histological types of ameloblastoma

Back 7

1. Folicular: tumor islands w/peripheral reverse nuclear polarity and central stellate reticulum-like areas

2. Plexiform: interconnected strands of epithelium

Front 8

Trx of ameloblastoma?

Back 8

Complete surgical excision

En bloc or segmental resection if large

Front 9

Prognosis of ameloblastoma?

Back 9

Guarded w/10-15% recurrence. varies w/type of trx, lesional size, and length of follow-up

Front 10

Another name for calcifying epithelial odontogenic tumor

Back 10

Pindborg tumor

Front 11

Origin of calcifying epithelial odontogenic tumor?

Back 11

Probably stratum intermedium origin

Front 12

How would you clinically see calcifying epithelial odontogenic tumor?

Back 12

Adults (40)
Painless swelling
Often associated w/impacted tooth

Front 13

T/F Ameloblastoma is often associated w/an impacted tooth

Back 13

TRUE

Front 14

Location of calcifying epithelial odontogenic tumor?

Back 14

Posterior mandible

Front 15

Radiographic features of Pindborg tumor?

Back 15

R/L uni/multilocular or honeycomb pattern
Variable amts of calcified material
"Driven snow radiopacities"

Front 16

Histological features of Pindborg tumor?

Back 16

Bizarre polygonal cells
Amyloid (polygonal epithelial cells w/variable pleomorphism but w/o mitotic figures
LIESEGANG calcifications (concentric lamellar pattern)

Front 17

Liesegang

Back 17

Calcifying epithelial odontogenic tumor

Front 18

Trx of calcifying epithelial odontogenic tumor?

Back 18

Conservative excision

Front 19

Prognosis of Pindborg tumor?

Back 19

Good
Lesions trxed by curettage have greatest tendency to recur

Front 20

Stratum intermedium origin

Back 20

Pindborg tumor

Front 21

Name 3 epithelial origin odontogenic neoplasms

Back 21

1. Ameloblastoma
2. Calcifying epithelial odontogenic tumor
3. Adenomatoid odontogenic tumor

Front 22

Origin of adenomatoid odontogenic tumor

Back 22

Enamel organ origin or dental lamina

Front 23

Who (males or females and what age) is most likely to have an adenomatoid odontogenic tumor?

Back 23

Females (2:1)

10-19 years old

Front 24

Where is an adenomatoid odontogenic tumor most likely to occur?

Back 24

Anterior MAXILLA and mandible

Front 25

What is a unique radiographic feature of adenomatoid odontogenic tumor?

Back 25

When associated w/impated teeth, tendency for radiolucent margin to extend apically past the CEJ

Front 26

Radiographic features of adenomatoid odontogenic tumor?

Back 26

Unilocular R/L
Ofent w/impated tooth (esp max K9)
May develop radiopaque flecks

Front 27

Histologic features of adenomatoid odontogenic tumor?

Back 27

Encapsulated, duct-like (glandular) structures
Calcifications

Front 28

Trx of adenomatoid odontogenic tumor?

Prognosis?

Back 28

Enucleation

Excellent

Front 29

What are the three types of mixed origin odontogenic neoplasms?

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1. Ameloblastic fibroma
2. Odontoma
3. Ameloblastic fibro-odontoma

Front 30

Origin of ameloblastic fibroma?

Back 30

Dental lamina and dental papilla-like tissues intermingled

Front 31

Mean age for people w/ameloblastic fibroma?

Back 31

12 (1st-2nd decades)

Front 32

Usual location of ameloblastic fibroma?

Back 32

Posterior mandible

Front 33

Radiographic characteristics of ameloblastic fibroma?

Back 33

Unilocular R/L
50% w/impation
May be multilocular

Front 34

Histology of ameloblastic fibroma?

Back 34

Narrow strands of odontogenic epithelium
Loose mesenchymal tissue (resemblins primitive dental pulp)

Front 35

Narrow strands of odontogenic epithelium with loose mesenchymal tissue

Back 35

Ameloblastic fibroma

Front 36

Trx of ameloblastic fibroma?

Back 36

Initial conservative excision

Front 37

Prognosis of ameloblastic fibroma?

Back 37

Good

Recurrence uncommon but sarcomatous transformation can occue

Front 38

Origin of odontoma?

Back 38

Probably hamartoma of odontogenic organ (dental follicle)

Front 39

Age of occurence of odontoma?

Back 39

14 (1st-2nd decades

Front 40

Two types of odontomas and where are they located in the jaw?

Back 40

1. Anterior jaw: compound
2. Posterior jaw: complex

Front 41

Compound vs complex odontoma?

Back 41

Compound: tooth-like arrangements of dental hard tissues

Complex: haphazard mixture of dental hard tissues

Front 42

Radiographic features of odontoma?

Back 42

Well demarcated R/L rim surrounding a central zone of variable opacities

Front 43

Histology of odontoma?

Back 43

Compound: looks like small teeth

Complex: disorganized mixture of dentin, cementum, and enamel

Front 44

Trx of odontoma?

Prognosis?

Back 44

Enucleation

Excellent

Front 45

Origin of ameloblastic fibro-odontoma?

Back 45

Ameloblastic fibroma w/additional development of odontoma

Front 46

Age of ameloblastic fibro-odontoma?

Back 46

10 (1st-2nd decades)

Front 47

Clinical features of ameloblastic fibro-odontoma?

Back 47

Same as ameloblastic fibroma

Post mandible usually associated w/impacted tooth

Front 48

Histological features of ameloblastic fibro-odontoma?

Back 48

Ameloblastic fibroma with formation of dental hard tissues

Front 49

Radiographic features of ameloblastic fibro-odontoma?

Back 49

Well defined R/L w/variable r/o component

Front 50

Trx of ameloblastic fibro-odontoma?

Prognosis?

Back 50

Conservative excision

Excellent prognosis

Front 51

Name three types of odontogenic neoplasms from mesenchymal origin

Back 51

1. Central odontogenic fibroma
2. Odontogenic Myxoma
3. Cementoblastoma (true cementoma)

Front 52

Origin of central odontogenic fibroma?

Back 52

Dental follicle or dental papilla, possibly PDL

Front 53

Male or female and age of central odontogenic fibroma?

Back 53

Femal, 40

Front 54

Clinical features of central odontogenic fibroma?

Back 54

Rare
Painless bony expansion

Front 55

Where in the jaw would you normally see central odontogenic fibroma?

Back 55

Ant maxilla and post mandible
Max lesions may demonstrate palatal depression

Front 56

Radiographic features of central odontogenic fibroma?

Back 56

Well demarcated uni/multilocular R/L
Root resorption of adjacent teeth may be seen

Front 57

Histologic features of central odontogenic fibroma?

Back 57

Collagenous connective tissue
Long strands or small nests of odontogenic epithelium
Possible scattered calcifications

Front 58

Trx of central odontogenic fibroma?

Prognosis?

Back 58

Conservative excision

Good prognosis- routine follow-up recommended

Front 59

Origin of odontogenic myxoma?

Back 59

Dental papilla (primitive dental pulp)

Front 60

Normal age of odontogenic myxoma?

Back 60

Young adult (30)

Front 61

Clinical features of odontogenic myxoma?

Back 61

Mandible slightly more affected than max
Asymptomatic bony swelling

Front 62

Radiographic features of odontogenic myxoma?

Back 62

Uni/multilocular R/L
Honeycomb or soap-bubble appearance
Root displacement/resorption

Front 63

Histologic features of odontogenic myxoma?

Back 63

Loos stellate to spindle-shaped cells
Acellular myxomatous tissue
Infiltrates host cancellous bone

Front 64

Trx of odontogenic myxoma?


Prognosis?

Back 64

Trx as ameloblastoma
Small lesions: aggressive curettage
Large lesions: marginal or en bloc resection
Max lesions more aggressive so less worry about recurrence

Good prognosis but up to 25% recurrence rate reported

Front 65

Origin of cementoblastoma?

Back 65

PDL

Front 66

Age of pts w/cementoblastoma?

Back 66

Teens-20s

Front 67

Majority of cementoblastoma occur in which part of jaw?

Back 67

Post mand - 75% esp. 1st permanent molar

Front 68

Clinical appearance of cementoblastoma?

Back 68

SLow bony expansion
May be symptomatic/painful (66%)

Front 69

Radiographic characteristics of cementoblastoma?

Back 69

R/O mass w/R/L border fused to root
Root may appear replaced

Front 70

R/O mass w/R/L border fused to root

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Cementoblastoma

Front 71

Histological features of cementoblastoma?

Back 71

cellular cementum
Active cementoblasts
May mimic osteosarcoma

Front 72

Trx of cementoblastoma?

Prognosis?

Back 72

Conservative excision - remove lesion w/tooth, or root amputation w/endo

Good prognosis

Front 73

Dif b/t cementoblastoma and hypercementosis?

Back 73

Hypercementosis is deposition of cementum around apical region of tooth PDL is INTACT
No radiolucent component

Front 74

Dif b/t cementoblastoma and periapical cemental dysplasia?

Back 74

Periapical cemental dysplasia:
Mand ant region
Middle-aged black females
R/L w/varying degrees of central radiopacity
NO FUSION TO TOOTH
PDL still seen