2988
The WHO Histological Typing of
Odontogenic Tumours
A Commentary on the Second Edition
Ivor R. H. Kramer, M.D.S., F.R.C.Path.,* Jens J. Pindborg, D.D.S., Dr.Odonf.,t
and Mervyn Shear, D.Sc.(Dent), M.D.S., F.R.C.Path.$
This article introduces the revised World Health Organi-
zation (WHO) classification of odontogenic tumors and
jaw cysts and certain bone lesions that either are peculiar
to the jaws or have distinctive features in that location.
The new and revised classification is compared with the
previous version, the reasons for the changes are out-
lined, and reference is made to a number of newly char-
acterized lesions that have been included. Cancer 1992;
70:2988-94.
Key words: odontogenic tumors, WHO classification, jaw
cysts, bone lesions.
The first World Health Organization (WHO) Hisfologi-
cal Typing of Odontogenic Turnours, Jaw Cysts and Allied
Lesions,' published in 1971, was the result of 5 years of
From the *Department of Oral Pathology, Institute of Dental
Surgery, University of London, England; the tWorld Health Organi-
zation Collaborating Centre for the Histological Classification of
Odontogenic Tumours, Royal Dental College, Copenhagen, Den-
mark; and the +Department of Oral Pathology, University of the Wit-
watersrand, Johannesburg, South Africa.
Consultants during the preparation of the revised classification
were: Dr. A. Abrams, Department of Oral Pathology, University of
Southern California, Los Angeles, California; Dr. A. Buchner, Depart-
ment of Oral Pathology, School of Dental Medicine, University of Tel
Aviv, Israel; Dr. K. Donath, Institute of Pathology, University of
Hamburg, Germany; Dr. A. Esguep, Department of Oral Pathology,
Faculty of Odontology, University of Chile, Chile; Dr. L. Hansen,
Department of Oral Medicine and Hospital Dentistry, University of
California, San Francisco, California; Dr. H. Nikai, Department of
Oral Pathology, Hiroshima University, Hiroshima, Japan; and Dr. 8.
Radden, Department of Dental Medicine and Surgery, University of
Melbourne, Melbourne, Australia.
The referees who commented on the revised classification and
text were: Dr. G. Rick, Oral Pathology Service, La Jolla, California;
Dr. K. W. Lee, Department of Oral Pathology, Institute of Dental
Surgery, University of London, England; and Dr. I van der Waal,
Department of Oral Pathology, Academic Hospital, Free University,
Amsterdam, Netherlands.
Address for reprints: Ivor R. H. Kramer, M.D.S., F.R.C.Path.,
Department of Oral Pathology, Institute of Dental Surgery, Eastman
Dental Hospital, 256 Gray's Inn Road, London WClX 8LD, United
Kingdom.
Accepted for publication May 22, 1992.
work by an international group, primarily oral patholo-
gists, but also including bone pathologists and patholo-
gists with other special interests. Initially, the publica-
tion was intended to describe only odontogenic tumors
and tumor-like lesions, but it soon became clear that it
would be helpful to include jaw cysts and certain bone
lesions that either are peculiar to the jaws or have dis-
tinctive features when they occur in that location. Al-
though the title of the second edition refers only to
"Odontogenic Tumours," the scope remains the same
as that of the First Edition.
For the Second Edition,2 the original two authors
were joined by a third, and over an extended period a
new draft was written that incorporated advances that
had occurred in the intervening years and the com-
ments and advice solicited from an international panel
of colleagues. The draft was submitted to three addi-
tional independent referees who had not been involved
in the earlier stages; their suggestions and criticisms
paved the way for the preparation of the final Classifica-
tion and text.
The Classifications used in the first and second edi-
tions are set out in Tables 1 and 2. The basic framework
essentially is unchanged, with the same three main di-
visions: "Neoplasms and Other Tumours Related to the
Odontogenic Apparatus," "Neoplasms and Other Le-
sions Related to Bone," and "Epithelial Cysts." How-
ever, within that framework there are substantial dif-
ferences in format and in the entities identified.
'Neoplasms and Other Tumours Related to the
Odontogenic Apparatus'
Throughout the years there have been many attempts
to produce a "logical" classification of these lesions.
Recent advances in our understanding of the origins
and the interactions of the odontogenic tissues have
provided a better scientific basis, but uncertainties re-
main. The classification used in the Second Edition (as
in the First Edition) is based first on behavior, with a
WHO Typing of Odontogenic Tumours/Kramer et a2.
Table 1. WHO Histological Typing of Odontogenic Turnours, Jaw Cysts and Allied
Lesions, From the First Edition, 1971
I. Neoplasms and other tumours related to the odontogenic
apparatus
A. Benign
1. Ameloblastoma
2. Calcifying epithelial odontogenic tumour
3. Ameloblastic fibroma
4. Adenomatoid odontogenic tumor (adeno-
ameloblastoma)
5. Calcifying odontogenic cyst
6 . Dentinoma
7. Ameloblastic fibro-odontoma
8. Odonto-ameloblastoma
9. Complex odontoma
10. Compound odontoma
11. Fibroma (odontogenic fibroma)
12. Myxoma (myxofibroma)
13. Cementomas
a. Benign cementoblastoma (true cementoma)
b. Cementifying fibroma
c. Periapical cementa1 dysplasia (periapical fibrous
dysplasia)
d. Gigantiform cementoma (familial multiple
cementomas)
14. Melanotic neuro-ectodermal tumour of infancy
(melanotic progonoma, melano-ameloblastoma)
B. Malignant
1 , Odontogenic carcinomas
a. Malignant ameloblastoma
b. Primarv intra-osseous carcinoma
broad division into lesions generally regarded as "be-
nign'' or "malignant," and the benign category includes
a number of entities that are probably or certainly non-
neoplastic.
In the Second Edition, the benign category is subdi-
vided into three groups: lesions in which there is odon-
togenic epithelium without (morphologically identifi-
able) odontogenic ectomesenchyme; lesions in which
both of these elements are identifiable (some lesions in
this group show inductive changes leading to the for-
mation of one or more of the dental hard tissues); and
lesions in which odontogenic ectomesenchyme appears
to predominate, although, in some instances, odonto-
genic epithelium may be included. Here, the term "in-
cluded'' is intended to indicate that, although epithe-
lium may be present, it sometimes appears to be present
by chance, rather than playing an essential role in the
pathogenesis of the lesion.
In addition to the regrouping based on these subdi-
visions of the benign odontogenic tumors, some newly
recognized odontogenic tumors have been added.
There also are substantial changesin the section on ame-
loblastomas, while some lesions designated in the First
2989
c. Other carcinomas arising from odontogenic
epithelium, including those arising from
odontogenic cysts
2. Odontogenic sarcomas
a. Ameloblastic fibrosarcoma (ameloblastic sarcoma)
b. Ameloblastic odontosarcoma
11. Neoplasms and other tumours related to bone
A. Osteogenic neoplasms
1. Ossifying fibroma (fibro-osteoma)
B. Non-neoplastic bone lesions
1. Fibrous dysplasia
2. Cherubism
3. Central giant cell granuloma (giant cell reparative
granuloma)
4. Aneurysmal bone cyst
5. Simple bone cyst (traumatic, haemorrhagic bone cyst)
111. Epithelial cysts
A. Developmental
1. Odontogenic
a. Primordial cyst (keratocyst)
b. Gingival cyst
c. Eruption cyst
d. Dentigerous (follicular)cyst
2. Non-odontogenic
a. Naso-palatine duct (incisive canal) cyst
b. Globulo-maxillary cyst
c. Naso-labial (naso-alveolar) cyst
B. Inflammatory
1. Radicular cyst
IV. Unclassified lesions
Edition have been moved to another part of the Classifi-
cation or merged into different subgroups.
Among the ameloblastomas, the unicystic varieties
have attracted considerable and it is im-
portant that they should be identified accurately be-
cause the surgical management and the prognosis often
are significantly different from that of other ameloblast-
omas. Other variations discussed in the Second Edition
include the desmoplastic arnel~blastoma~*~ and the ker-
atoameloblastoma.'
The squamous odontogenic tumor was first de-
scribed in 1975.9Since then it has become accepted that
this is a distinctive lesion, rather than a variant of the
ameloblastoma.'O~" Although it is an infiltrative
growth, most examples respond to curettage, and recur-
rence is rare.
The other lesion added to the group of benign le-
sions of the odontogenic apparatus is the clear cell
odontogenic tumor." This too is a locally invasive neo-
plasm, and although few examples have been reported,
there is some evidence that it may be more aggressive
than the ameloblastoma. Some examples may be
frankly malignant (clear cell odontogenic ~arcinoma)'~
2990 CANCER December 15,1992, Volume 70, No. 12

Table 2. WHO Histological Typing of Odontogenic Tumours, From the Second Edition, 1992
~~

1 Neoplasms and other tumours related to the odontogenic apparatus

1.1 Benign
1.1.1 Odontogenic epithelium without odontogenic ectomesenchyme
1.1.1.1 Ameloblastoma 9310/0*
1.1.1.2 Squamous odontogenic tumour 9312/0
1.1.1.3 Calcifying epithelial odontogenic tumour (Pindborg tumour) 9340/0
1.1.1.4 Clear cell odontogenic tumour 9270/0
1.1.2 Odontogenic epithelium with odontogenic ectomesenchyme, with or without dental hard tissue formation
1.1.2.1 Ameloblastic fibroma 9330/0
1.1.2.2 Ameloblastic fibrodentinoma (dentinoma) and ameloblastic fibro-odontoma 9290/0
1.1.2.3 Odontoamelobldstoma 9311/0
1.1.2.4 Adenomatoid odontogenic tumour 9300/0
1.1.2.5 Calcifying odontogenic cyst 9301/0
1.1.2.6 Complex odontoma 9282/0
1.1.2.7 Compound odontoma 9281/0
1.1.3 Odontogenic ectomesenchyme with or without included odontogenic epithelium
1.1.3.1 Odontogenic fibroma t
1.1.3.2 Myxoma (odontogenic myxoma, myxofibroma) 9320/0
1.1.3.3 Benign cementoblastoma (cementoblastoma, true cementoma) 9273/0
1.2 Malignant
1.2.1 Odontogenic carcinomas
1.2.1.1 Malignant ameloblastoma 9310/3
1.2.1.2 Primary intraosseous carcinoma 9270/3
1.2.1.3 Malignant variants of other odontogenic epithelial tumours +
I

1.2.1.4 Malignant changes in odontogenic cysts 9270/3

1.2.2 Odontogenic sarcomas
1.2.2.1 Ameloblastic fibrosarcoma (ameloblastic sarcoma) 9330/3
1.2.2.2 Ameloblastic fibrodentinosarcoma and ameloblastic fibro-odontosarcoma 9290/3
1.2.3 Odontogenic carcinosarcoma 8980/3
2 Neoplasms and other lesions related to bone
2.1 Osteogenic neoplasms
2.1.1 Cemento-ossifying fibroma (cementifying fibroma, ossifying fibroma) §
2.2 Non-neoplastic bone lesions
2.2.1 Fibrous dysplasia of the jaws 74910
2.2.2 Cemento-osseous dysplasias
2.2.2.1 Periapical cementa1 dysplasia (periapical fibrous dysplasia) 92?2/0
2.2.2.2 Florid cemento-osseous dysplasia (gigantiform cementoma, familial multiple cementomas) 9275/0
2.2.2.3 Other cemento-osseous dysplasias
2.2.3 Cherubism (familial multilocular cystic disease of the jaws) 70980
2.2.4 Central giant cell granuloma 44130
2.2.5 Aneurysmal bone cyst 33640
2.2.6 Solitary bone cyst (traumatic, simple, haemorrhagic bone cyst) 33404
2.3 Other tumours
2.3.1 Melanotic neuroectodermal tumour of infancy (melanotic progonoma) 9363/0
3 Epithelial cysts
3.1 Developmental
3.1.1 Odontogenic
3.1.1.1 ”Gingival cyst” of infants (Epstein pearls) 26540
3.1.1.2 Odontogenic keratocyst (primordial cyst) 26530
3.1.1.3 Dentigerous (follicular) cyst 26560
3.1.1.4 Eruption cyst 26550
3.1.1.5 Lateral periodontal cyst 26520
3.1.1.6 Gingival cyst in adults 26540
3.1.1.7 Glandular odontogenic cyst; sialo-odontogenic cyst 26520
3.1.2 Nonodontogenic
3.1.2.1 Nasopalatine duct (incisive canal) cyst 26600
3.1.2.2 Nasolabial (nasoalveolar) cyst 26500
WHO Typing of Odontogenic Tumours/Kramer et al.
Table 2. (Continuedl
3.2 Inflammatory
3.2.1 Radicular cyst
3.2.1.1 Apical and lateral radicular cyst
3.2.1.2 Residual radicular cyst
3.2.2 Paradental (inflammatory collateral, mandibular infected buccal) cyst
* Morphology code of the International Classification of Diseases for Oncology (ICD-0) and the Systematized Nomenclature of Medicine (SNOMED).
t Central odontogenic fibroma 9321/0, peripheral odontogenic fibroma 9322/0.
Use appropriate tumour coding from 1.1 above, with behavior code /3.
5 Ossifying fibroma 9262/0, cementifying fibroma 9274/0. 9262/0 is recommended for cemento-ossifying fibroma.
Reprinted with permission from the WHO Histological Typing of Odontogenic Tumours Second Edition. Heidelberg: Springer-Verlag, 1992.
and are classified with the malignant variants of other
odontogenic tumors.
Jaw lesions of proliferating odontogenic epithelium
embedded in a cellular ectomesenchymal tissue that re-
sembles the dental papilla present considerable prob-
lems in classification and in diagnosi~.'~,'~ The prob-
lems are compounded by several of these lesions show-
ing varying degrees of inductive change, leading to the
deposition of dentin, enamel, or both.
The compound and complex odontoma clearly are
developmental anomalies, and in their later stages they
produce increasing amounts of the dental hard tissues
until the growth of the lesion is completed. However,
before this final stage is reached, it may be difficult to
distinguish the odontoma from other lesions that have
the capacity for continued growth.
It is believed that the ameloblastic fibroma may be a
true mixed tumor, in which the epithelial and the ecto-
mesenchymal elements are neoplastic. Lesions com-
posed of similar elements, but in which inductive
changes have resulted in the deposition of dentin alone
or dentin plus enamel, are termed "ameloblastic fibro-
dentinoma" ("dentinoma" in the previous Classifica-
tion) and "ameloblastic fibro-odontoma," respectively.
It is unclear whether the ameloblastic fibroma, amelo-
blastic fibrodentinoma, and ameloblastic fibro-odon-
toma are to be regarded as separate entities or as stages
in the evolution of a single type of lesion. All are rare,
and it is suggested that there may be merit in identify-
ing their differing histologic patterns until more experi-
ence of their behavior has been accumulated.
The odontoameloblastoma,'6 another rare tumor,
has a structure and behavior like that of the ameloblast-
oma but also has an odontoma-like element: clearly it is
important (and sometimes difficult) to distinguish this
neoplasm from an odontoma that has been excised,
whereas active (but not neoplastic) odontogenic epithe-
lium is still relatively abundant.
In the years since the publication of the First Edi-
tion, large numbers of calcifying odontogenic cysts
have been st~died,'~,''and it is clear that the lesions of
this group can show considerable diversity in structure
2991
43800
26520
and behavior. Some, which correspond most closely to
the original description," appear to be non-neoplastic,
but others (some of which are termed "dentinogenic,"
or "odontogenic," ghost cell tumor)" may have an in-
filtrative pattern of growth. Although in the current
Classification, they remain under the heading of "calci-
fying odontogenic cyst," more experience may provide
reliable criteria for their reclassification.
Among the dental hard tissues, dentin and enamel
are entirely distinctive (at least in their normal forms:
dysplastic dentin or enamel can be more difficult to
identify). However, cementum is associated with
greater identification problems. The normal cementum
that covers the root of the tooth is formed by cells of, or
derived from, the dental follicle, as is the bundle bone
that lines the tooth socket. Both the cementum and the
bundle bone of the socket provide attachment for the
periodontal ligament that anchors the tooth to the bone.
Apart from their different locations, the extent to which
cementum and the adjacent bundle bone are different
tissues is debatable; certainly they show considerable
histologic similarities. It should also be noted that,
within the normal periodontal ligament, it is common
to find rounded basophilic masses, sometimes lying
free in the ligament and sometimes fused to the cemen-
tum. These rounded masses appear to be composed of
cementum and are called "cementicles."
There is a variety of jaw lesions that may include a
hard tissue that resembles cementum, either in the form
of rounded masses like "cementicles," or in some other
form. Some of these jaw lesions are clearly neoplastic,
some are clearly non-neoplastic, and some are of less
certain status. However, terminology and classification
are complicated by two additional factors. First, the ce-
mentum-like tissue often is accompanied by varying
amounts of tissue that resembles either ordinary woven
bone or metaplastic bone similar to that found typically
in fibrous dysplasia. Second, characteristic cementum-
like tissue sometimes is found in lesions of other parts
of the skeleton, where it could not possibly be derived
from the odontogenic apparatus. Thus, the problems
are to decide what is cemental, what is osseous, and
2992 CANCER December 15,2992, Volume 70, No. 12
how valid is the distinction between the two (always
accepting that cementum on the root of the tooth is
distinctive and recognizable, if only because of its loca-
tion).
Against this background, it is understandable that a
historical review of the development of oral pathology
would show much grappling with these problems, and
it would be premature to suggest that they have been
resolved. However, it seems that the picture is becom-
ing clearer, and the new Classification reflects substan-
tial changes in our views of the cementum-containing
lesions.
The benign c e r n e n t ~ b l a s t o m a ~is~a- ~benign
~ neo-
plasm; almost always it has a close relationship to the
root of a tooth; and in the new classification, it remains
under the main heading of "Tumours and Other Le-
sions Related to the Odontogenic Apparatus." All of the
other cementum-containing lesions (periapical cemen-
tal dysplasia, florid cemento-osseous dysplasia or gi-
gantiform cementoma, and certain other less well-de-
fined entities) that formerly were grouped with the
benign cementoblastoma under the heading "Cemen-
tomas" have been transferred to the category of "Non-
neoplastic Bone Lesions."
The myxoma of the jaws (odontogenic myxoma) is
a neoplasm that appears to have no counterpart else-
where in the skeleton, thus supporting the view that it is
derived from the odontogenic mesoderm (ectomesen-
chyme). It usualy presents little difficulty in histologic
diagnosis, but in the Second Edition, attention is drawn
to a particular and common diagnostic trap. If a tooth
does not erupt, or if eruption is delayed, it is sometimes
found that the crown is surrounded by an area of radio-
lucency wider than that shown by the normal dental
follicle. If this area is explored surgically (often on a
provisional diagnosis of dentigerous cyst), a soft and
slightly mucinous tissue may be found that histologi-
cally resembles the myxoma. However, almost always,
tissue with these features and in this particular location
represents thickened dental follicle that has undergone
a myxoid (but not a neoplastic) change.
The part of the Classification relating to odonto-
genic carcinomas and sarcomas remains largely un-
changed, but a separate category has been introduced
for malignant variants of "other" odontogenic epithe-
lial t ~ m o r s ~ *(other
* * ~ than malignant ameloblastoma
and primary intraosseous carcinoma).26A new category
has been introduced for the very rare odontogenic car-
cinosar~oma.~'
'Neoplasms and Other Lesions Related to Bone'
Reference was made earlier to the presence within cer-
tain lesions of both cementum-like tissue and other
hard tissue recognizable as woven or metaplastic bone.
In the jaws, there are rare encapsulated (or at least de-
marcated) fibroblastic tumors that contain cementum-
like material, metaplastic bone such as that seen in fi-
brous dysplasia, or any combination of the two. Unlike
the lesions of fibrous dysplasia, these tumors continue
to grow until they are removed, and at operation they
can often be enucleated. Thus, they appear to be benign
neoplasms of bone, and they have been placed in this
category. It is generally now accepted that the examples
of these tumors in which the mineralized component is
preponderantly cementum-like (the "cementifying fi-
bromas") and those in which the main mineralized com-
ponent is bone (the "ossifying fibromas") simply repre-
sent the ends of a continuous spectrum. The differences
in the hard tissue pattern do not seem to be reflected in
differences in behavior, and in the Second Edition these
tumors are placed together in the category "cemento-
ossifying f i b r ~ r n a . ' " ~ -These
~ ~ are distinctive jaw le-
sions that should not be confused (although they often
are) with lesions termed "ossifying fibroma" and occur-
ring in other parts of the skeleton.
Unlike the cemento-ossifying fibroma, fibrous dys-
plasia of the jaws is a nondemarcated lesion, and it is
self-limiting. However, after the active phase of the le-
sion has passed, in many instances the affected bone
never returns to normal, either radiographically or histo-
logically. Thus, an old area of fibrous dysplasia some-
times is explored surgically, and the tissue shows a
rather characteristic appearance (sometimes referred to
as "osseous kel~id").~' The metaplastic bone of the ac-
tive lesion has been replaced by lamellar bone, but the
trabeculae, lying in a fibrous tissue that remains moder-
ately cellular, tend to run parallel to one another and to
be close together. In the Second Edition, this distinctive
appearance is described and illustrated.
In the group of non-neoplastic bone lesions, fibrous
dysplasia of the jaws, cherubism, central giant cell
granuloma, aneurysmal bone cyst, and solitary bone
cyst are joined by a number of the cementum-contain-
ing lesions that previously were classified differently. It
used to be thought that periapical fibrous dysplasia,
florid cemento-osseous dysplasia (gigantiform cemen-
toma), and some other cementa1 lesions were separate
entities. However, as a reflection of the growing belief
that they may represent parts of a single ~pectrum,~'
they now are grouped as "cemento-osseous dyspla-
sias"a1though the named clinicopathologic presenta-
tions mentioned above are still listed.
'Epithelial Cysts'
In the category of "developmental odontogenic
~ y s t s , " ~there
~ " ~ are several changes in the Second Edi-
tion: the lesions are placed in a more logical order;
odontogenic kerat~cyst~~"" is given as the preferred
WHO Typing of Odontogenic Tumours/Kramer et al.
name for the lesion that also is referred to as the ”pri-
mordial cyst” (the concept that these are two different
entities is not supported); there are additional subdivi-
sions, and new entities have been added. The group of
gingival cysts is divided into those of infants41 and
those of adults.42The developmental lateral periodon-
tal ~ y s tis~added
~ , ~to ~the Classification, and reference
is made to its variant, the “botryoid odontogenic
~ y s t . ”Another
~ ~ , ~ ~addition is the ”glandular odonto-
genic cyst” or “sialo-odontogenic cyst” (both names are
given because this distinctive lesion has been character-
ized only recently, and there is no consensus on the
preferred termin~logy).~’-~~ This lesion has a lining that
may be partly squamous and without distinctive fea-
tures. However, in other areas the stratified epithelium
has a surface layer of acidophilic cuboidal or columnar
cells, and often there are papillary projections into the
cyst cavity together with crypts or cyst-like spaces
within the thickness of the epithelium. The surface cells
and those lining the crypts include a variable number
that are ciliated or mucous-producing. (However, it is
emphasized that many jaw cysts have ciliated and mu-
cous cells, and these features alone do not justify the
diagnosis of glandular odontogenic cyst.) The nature of
these lesions remains somewhat uncertain, but experi-
ence shows that they may grow to a considerable size,
and the larger examples may show a tendency to recur.
Within the group of ”developmental nonodonto-
genic cysts,” only the nasopalatine (incisive anal)^',^^
and the nasolabial (nas~alveolar)~~ cysts are included in
the formal Classification. The concept of side-to-side
fusion of the embryonic facial processes has been
largely discarded35(although the palatal processes join
in this way), and it is now accepted that the so-called
fissural cysts, which supposedly arise from epithelium
trapped in the lines of fusion, are cysts that can be as-
signed to other categories. Thus, in the Second Edition,
lesions that used to be regarded as “fissural” cysts are
mentioned in the text but not listed in the Classification.
Finally, in the category of “inflammatory cysts,”
the Classification in the Second Edition makes provi-
sion for the paradental (inflammatory collateral, man-
dibular infected buccal) ~ y s t . These
~ ~ - lesions
~ ~ arise ei-
ther from reduced enamel epithelium or from the odon-
togenic epithelial rests lying in the gingiva or superficial
part of the periodontal ligament; the epithelial prolifera-
tion and cyst formation result from gingival inflamma-
tion.
This commentary has referred only to the principal
changes that have been introduced in the Second Edi-
tion.
In an article that introduced another volume in the
series of WHO “blue books,”56 the authors said that
“Any workable classification of tumors is necessarily a
compromise between lumpers and splitters and be-
2993
tween those who lay emphasis on features of diagnostic
importance and those who consider histogenesis or pos-
sible epidemiological use of greater value.”
The authors of the WHO Histological Typing of
Odontogenic Turnouvs believe that the classification pre-
sented in the Second Edition provides a workable basis
and one that reflects current opinion and current uncer-
tainty. The revised format of the Classification repre-
sents an attempt to group the lesions (and especially
those of the odontogenic apparatus) on a more logical
basis. Although immunohistochemical and other tech-
niques have enhanced our understanding of the patho-
genesis of odontogenic tumors, throughout this text the
emphasis is on features that are of diagnostic value and
observable by routine and conventional histologic tech-
niques that are widely available.
Although it is now WHO policy that volumes in
this series should contain only a limited number of color
illustrations (so that a reasonable sales price can be
maintained), generous financial support from a number
of donors has made it possible for all of the photomi-
crographs in this edition to be in color. Also, as in the
First Edition, the illustrations include reproductions of
clinical radiographs where these show distinctive fea-
tures.
References
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of tumours: No. 5. histological typing of odontogenic tumours,
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2. Kramer IRH, Pindborg JJ, Shear M. International histological
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