1. List the important causes of tumours (swellings) of the jaws.

● Odontogenic tumours - tumours that arise from dental tissues, such as

ameloblastoma or odontoma.
● Non-odontogenic tumours - tumours that arise from non-dental tissues, such as
fibroma or lipoma.
● Benign and malignant bone tumours - such as osteoma, osteosarcoma,
chondroma or chondrosarcoma.
● Metastatic tumours - tumours that spread to the jawbone from other parts of the
body, such as the breast, lung or prostate.
● Lymphoma - a type of cancer that affects the lymphatic system, and can present
as a swelling in the jaw.
● Salivary gland tumours - tumours that arise from the salivary glands, such as
mucoepidermoid carcinoma or adenoid cystic carcinoma.
● Inflammatory or infectious conditions - such as osteomyelitis, periodontitis or
abscess.
● Developmental or congenital abnormalities - such as dentigerous cyst or
ameloblastic fibroma

2. Classify the important types of odontogenic tumours according to their tissue

components.
● Epithelial odontogenic tumours: These tumours arise from epithelial cells of the
tooth-forming tissues. Examples of epithelial odontogenic tumours include
ameloblastoma, calcifying epithelial odontogenic tumour, adenomatoid
odontogenic tumour, and squamous odontogenic tumour. [1]
● Mixed odontogenic tumours: These tumours arise from both epithelial and
mesenchymal cells of the tooth-forming tissues. Examples of mixed odontogenic
tumours include ameloblastic fibroma and odontogenic fibroma. [1]
● Mesenchymal odontogenic tumours: These tumours arise from mesenchymal
cells of the tooth-forming tissues. Examples of mesenchymal odontogenic
tumours include cementifying fibroma and ossifying fibroma. [1]
● Odontogenic tumours with specialised tissues: These tumours arise from
odontogenic tissues that undergo differentiation into specialised tissues.
Examples of odontogenic tumours with specialised tissues include ameloblastic
fibro-odontoma and odontoma

3. Explain the role of induction in the formation of dental hard tissues in the mixed
epithelial and connective tissue neoplasms.
● formation of tooth germs from dental lamina through induction
4. List the key features of the ameloblastoma.
● Derived from ameloblasts lining the tooth follicle
● Most commonly occurs in the posterior mandible
● Can reach large proportions and cause facial deformity
● Has various subtypes including conventional, unicystic, peripheral/extraosseous,
adenomatoid, and desmoplastic
 ● Radiologically seen as large multilocular areas causing root resorption and
expansion of the jaw in adult types, and as a single lucent locule in unicystic
types
● Histological patterns include follicular, plexiform, acanthomatous, granular cell,
basal cell, and desmoplastic
● Can metastasize to the lungs in rare cases.

5. Describe the common clinical and radiological features of the ameloblastoma.

● Clinically, ameloblastoma can present as a painless swelling or mass in the jaw
[1][3].
● Radiologically, ameloblastoma can appear as a well-defined, often multilocular
radiolucent lesion with scalloped borders and expansion of the surrounding bone
[2]. However, ameloblastoma can also appear as a unilocular radiolucent lesion
or a mixed radiolucent-radiopaque lesion [1]. In some cases, there may be tooth
displacement or resorption, but this is not a consistent feature
6. Describe in detail the histological features and main patterns of the solid and
multicystic ameloblastoma and recognise these in images.
● Histologically, the solid/multicystic ameloblastoma consists of a fibrous
connective tissue stroma with epithelial cells that resemble the cells of the
enamel organ. The cells are arranged in nests or cords, and there may be areas
of cystic degeneration within the tumour. The cells exhibit peripheral palisading
and reverse polarity, with the nuclei being located away from the stroma [1].
● Radiologically, the solid/multicystic ameloblastoma presents as a radiolucent
lesion with areas of radiopacity due to the presence of calcifications. The tumour
may appear as a multilocular lesion with well-defined borders or as a unilocular
lesion with ill-defined borders. There may also be expansion of the cortical bone
and root resorption of adjacent teeth
● https://radiopaedia.org/articles/ameloblastoma
7. Describe the different histological types of the unicystic ameloblastomas and
recognise these in images.
● In terms of histology, there are two types of unicystic ameloblastomas: luminal
and intraluminal. Luminal unicystic ameloblastomas have a single layer of
ameloblastic epithelium that lines the cyst cavity. Intraluminal unicystic
ameloblastomas, on the other hand, have tumour growth that extends into the
lumen [3].
● Recognition of unicystic ameloblastomas in images can be challenging, but
certain features may be helpful. Unicystic ameloblastomas may appear as a
well-circumscribed radiolucency on radiographs, with a corticated margin. The
cyst may have a smooth or lobulated contour and may contain areas of
calcification. In histological images, the characteristic features of unicystic
ameloblastomas include a single layer of ameloblastic epithelium lining the cyst
cavity in luminal type, while intraluminal type has tumour growth extending into
the lumen
8. Correlate the different histological types of the unicystic ameloblastomas with the
management / treatment modalities.
● The most common treatment approach is surgery, which may involve
enucleation, curettage, or resection depending on the size, location, and type of
tumour. It also notes that radiation therapy and chemotherapy may be used in
certain cases, such as when the tumour is unresectable or recurrent. Treatment
decisions are typically made on a case-by-case basis by a multidisciplinary team
of healthcare professionals

9. Explain the key elements of the metastasizing ameloblastoma and ameloblastic

carcinoma.
● The malignant forms of ameloblastoma include ameloblastic carcinoma and
metastasizing ameloblastoma. Some benign neoplastic ameloblastoma cells can
reach the lungs via blood vessels, especially during surgery of the jaw where a
scalpel implants cells in vessels, or when a patient aspirates some tumour cells.
This process can lead to the development of metastasizing ameloblastoma,
which is a rare but potentially malignant variant of the tumour that can spread to
other parts of the body. However, it is important to note that the vast majority of
ameloblastomas are benign and do not metastasize.
10. List the key features of the adenomatoid odontogenic tumour.
● Adenomatoid odontogenic tumour (AOT) is a rare benign odontogenic tumour
that is often found in the maxilla and more frequently in females in the second
decade of life
● the adenomatoid odontogenic tumour is a rare, slow-growing, benign
odontogenic tumour
● presents as a radiolucency around an unerupted tooth extending past the
cementoenamel junction
● Despite being known to pathologists for over a century, the histogenesis and
histopathologic designation of AOT remain controversial.
11. Describe the common clinical and radiological features of the adenomatoid
odontogenic tumour.
● Clinically, AOTs may present as asymptomatic swellings or as painless, slowly
expanding masses [1].
● Radiographically, AOTs are characterised by a well-circumscribed, unilocular
radiolucency with a corticated margin [2]. The radiolucent lesion is usually
associated with an impacted tooth, and the lesion can extend apically beyond the
cementoenamel junction
● AOTs may contain punctate calcifications that are distributed throughout the
tumour
12. Describe the main histological features of the adenomatoid odontogenic tumour
and identify these in images.
● The adenomatoid odontogenic tumour is a well-circumscribed lesion that
surrounds the crown of an unerupted or impacted tooth. It is composed of a
mixture of epithelial and mesenchymal tissues. The epithelial component forms
 glandular or tubular structures with a layer of columnar cells that resemble the
inner and outer enamel epithelium. The mesenchymal component consists of
spindle-shaped cells that resemble dental papilla cells. These spindle cells are
often arranged in a concentric pattern around the epithelial structures, forming
the characteristic "rosette-like" structures seen in this tumour.
● In addition, according to [3], the epithelial cells in adenomatoid odontogenic
tumours can show varying degrees of proliferation and can form cyst-like
structures, which are often filled with eosinophilic material. Calcifications may
also be present within the tumour.
● Overall, the histological features of adenomatoid odontogenic tumour include
glandular or tubular structures, spindle-shaped cells, and rosette-like structures.
These features can be identified through examination of tissue samples under a
microscope.

13. List the key features of the calcifying epithelial odontogenic tumour.
● Characterised by sheets, islands, nests, or cords of epithelial cells surrounded by
a mature fibrous connective stroma [2]
● Eosinophilic and polyhedral epithelial cells with sharply defined borders and
distinct intercellular bridging [2]
● May contain calcifications in the form of amyloid or psammoma bodies [3]
● May be associated with impacted teeth, and often involves the mandible,
particularly in the premolar-molar region

14. Describe the common clinical and radiological features of the adenomatoid
odontogenic tumour.
● Radiographically, AOT presents as an expansile radiolucency with
well-circumscribed margins, often around an unerupted or impacted tooth, most
commonly in the maxilla. It may also contain a variable amount of punctate
calcifications [1]. The most common site for AOT is the anterior maxilla,
particularly around an unerupted canine tooth, in teenage females
15. Describe the main histological features of the adenomatoid odontogenic tumour
and identify these in images.
● The main histological features of AOT include a well-circumscribed central
proliferation of ductlike epithelium surrounding small foci of calcification. The
epithelium may have rosettes, trabecular or cribriform patterns, and
columnar-type cells with basal nuclei and clear cytoplasm, which may resemble
pre-ameloblasts
● https://www.pathologyoutlines.com/topic/mandiblemaxillaadenomatoid.html
16. Explain the key elements of the clear cell odontogenic carcinoma.
● Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic
tumour that was first described by Hansen in 1985.
● It is the fifth most common malignant odontogenic tumour and is characterised by
clear cells, which have a cytoplasmic accumulation of water, glycogen,
 mucopolysaccharides, mucin, lipids, or other material that is not stained by
Haematoxylin or Eosin [3].
● CCOC can be challenging to diagnose and may present with a range of
symptoms, such as pain, swelling, or an asymptomatic mass in the jaw [1].
● The tumour typically affects middle-aged adults, and it has a slightly higher
prevalence in females than males.
● The most common location for the tumour is the mandible, particularly in the
molar region
17. List the key features of the calcifying (ghost cell) odontogenic cyst/tumour.
● Calcifying odontogenic cyst (COC) and dentinogenic ghost cell tumour (DGCT)
are two different entities that can present ghost cells as a characteristic feature.
Ghost cell odontogenic carcinoma (GCOC) is a malignant epithelial tumours that
exhibits similar features to COC or DGCT
● COC is classified into three types based on histological features [3]. Type 1A
COC presents ghost cells and dentinoid, Type 1B shows calcified tissues in the
cyst wall with dystrophic calcification, and Type 1C shows features similar to an
ameloblastic fibroma
● DGCT presents ghost cells, dysplastic dentin, and dentinoid as its main features
● GCOC is classified as an odontogenic carcinoma with features of COC or DGCT
18. Describe the common clinical and radiological features of the calcifying (ghost
cell) odontogenic cyst/tumour.
● Clinically, these lesions may present as a painless swelling or an asymptomatic
finding on radiographic examination.
● Radiographically, the lesion may present as a well-defined unilocular or
multilocular radiolucency with or without calcifications, which may exhibit a
characteristic "honeycomb" or "soap bubble" appearance. These calcifications
may appear as curvilinear or globular radiopacities
19. Describe the main histological features of the calcifying (ghost cell) odontogenic
cyst/tumour and identify these in images.
● COC is characterised by the presence of ghost cells, which are eosinophilic cells
that lack nuclei and contain areas of calcification. The cyst wall is composed of
connective tissue that may contain varying amounts of fibrous tissue, hyalinized
material, and occasional odontogenic epithelial rests [1]. DGCT is a rare
odontogenic tumour with ghost cells, which is composed of epithelial cells
resembling ameloblasts and dentinogenic cells, along with ghost cells, which are
formed due to keratinization of epithelial cells [3].
● GCOC is a neoplastic condition that has features of COC or DGCT but exhibits
malignant behaviour. The ghost cells in GCOC are pleomorphic and irregular in
shape, often forming clusters, and they exhibit bizarre nuclei. The tumour exhibits
a highly infiltrative growth pattern with varying amounts of dysplastic odontogenic
epithelium and calcification
● https://radiopaedia.org/articles/dentinogenic-ghost-cell-tumour
● https://www.pathologyoutlines.com/topic/mandiblemaxillaghostcellodontogeniccar
cinoma.html
20. Explain the key elements of the squamous odontogenic tumour.
● Squamous odontogenic tumour (SOT) is a rare, benign odontogenic tumour of
the jawbones that is locally infiltrative and has been known to exhibit histologic
overlap with other pathologic entities such as ameloblastomas and squamous
cell carcinomas.
● SOT is composed of islands of well-differentiated squamous epithelium of varying
shape and size and is believed to originate from the rests of Malassez
● SOTs are generally reported in adults, but cases have been observed in
individuals of all ages, including children
21. List the key features of the ameloblastic fibroma
● Ameloblastic fibroma is a benign mixed odontogenic tumours of odontogenic
epithelium and mesenchymal tissue that arises from dental tissues that grow into
teeth.
● It is characterised by the proliferation of both odontogenic epithelium and
mesenchymal tissue without the formation of enamel or dentin [1].
● The neoplastic epithelium is arranged in small islands and long, narrow,
anastomosing cords, and includes a peripheral layer of columnar cells and a
central zone of loosely arranged, stellate reticulum-like cells [3].
● Ameloblastic fibroma is generally considered to be less aggressive than
ameloblastoma
22. Describe the common clinical and radiological features of the ameloblastic
fibroma without or with formation of calcifying dental tissues.
● When the AF does not produce dental tissue, it presents as an unilocular lucent
mandibular lesion, commonly in the posterior mandible, associated with impacted
teeth and centred on the unerupted crown. It is painless and leads to delayed
tooth eruption in the affected region. It has a prevalence of 0-3.4% among
odontogenic tumours in different regions [2].
● On the other hand, if AF produces calcifying dental tissue, it is referred to as an
ameloblastic fibro-odontoma (AFO). AFO is characterised by the formation of
calcified dental tissue, and it is also usually associated with impacted teeth.
● Radiographically, it presents as a mixed radiolucent-radiopaque lesion, and it
may cause facial asymmetry and delayed eruption of the associated tooth
23. Explain the relationship between the ameloblastic fibroma and the ameloblastic
fibro-dentinoma and the ameloblastic fibro-odontoma.
● Ameloblastic fibroma (AF), ameloblastic fibro-dentinoma (AFD), and ameloblastic
fibro-odontoma (AFO) are three related benign mixed odontogenic tumours [1].
AFD and AFO were previously considered separate entities from AF, but recent
changes in the World Health Organization classification system have placed
them all under the same heading of AF [3].

● AF and AFD are similar in that they are both composed of odontogenic
epithelium and mesenchymal tissue, but AFD additionally contains mineralized
dental tissues such as dentin and enamel [1]. On the other hand, AFO is a more
 complex lesion that is composed of all the components of AFD plus additional
dental tissues such as enamel and cementum [3].

● Despite the similarities, there are some differences in their clinical and
radiographic features. AF typically presents as a unilocular radiolucency in the
mandible, usually associated with impacted teeth and embryonic connective
tissue [1]. AFD presents similarly but is often associated with the formation of
dental hard tissues [1]. AFO is characterised by a radiolucent area with varying
amounts of radio-opaque material, representing dental tissues such as enamel,
dentin, and cementum

24. Describe the main histological features of the ameloblastic fibroma without or with
formation of calcifying dental tissues (ameloblastic fibro-dentinoma and the
ameloblastic fibro-odontoma) and identify these in images.
● Ameloblastic fibroma (AF) is a benign neoplasm of odontogenic origin that is
composed of epithelium and mesenchyme. The lesion appears radiolucent and
can be unilocular or multilocular, usually with a sclerotic rim [1]. Histologically, AF
consists of small islands and cords of markedly attenuated ameloblastic
epithelium that are two cells thick within dense collagenous stroma that is often
immature. There may be occasional dentin or cementum production and stellate
reticulum, and also a granular cell variant. These histological features can be
visualised through microscopic images [2].
● Ameloblastic fibro-dentinoma (AFD) and ameloblastic fibro-odontoma (AFO) are
also benign mixed odontogenic tumours, but with the formation of calcifying
dental tissues. AFD is a rare tumour that is mostly seen in children and young
adults. The histology of AFD is similar to that of AF, with the addition of
dentin-like calcifications in the stroma, and the presence of cuboidal to columnar
odontogenic epithelium with a palisaded basal cell layer [1]. In AFO, the tumour
can develop into a fully formed odontoma when dental hard tissues form

25. Explain the nature of the ameloblastic sarcoma.

● an ameloblastic sarcoma is a rapidly growing, painful, and destructive
odontogenic tumour that arises through malignant change in the mesenchymal
and epithelial tissue component of a preexisting ameloblastic fibroma. It is
considered the malignant counterpart of ameloblastic fibroma, which is a benign
mixed odontogenic tumour [2]. The tumour is characterised by the presence of
both an ameloblastic epithelial component and a malignant mesenchymal
stroma. Ameloblastic sarcoma occurs without the formation of dentin or enamel
and is an exceedingly rare condition [2]. It is a highly aggressive neoplasm with a
high rate of recurrence and metastasis, making early diagnosis and treatment
crucial for better outcomes
26. List the key features of the odontogenic myxoma
 ● Epidemiology: Odontogenic myxoma is typically seen in the second to third
decades of life, slightly earlier than ameloblastomas. It is a rare tumour that
accounts for 3-6% of odontogenic tumours. [1]
● Pathology: The odontogenic myxoma arises from embryonic connective tissue
associated with tooth formation. It consists mainly of spindle-shaped cells and
scattered collagen fibres distributed through a loose, mucoid material. [2]
● Signs and symptoms: Odontogenic myxoma is usually painless and may grow
slowly. The tumour can be large and aggressively invade the jaw and
surrounding tissue, and displace teeth

27. Describe the common clinical and radiological features of the odontogenic
myxoma.
● Odontogenic myxomas are rare tumours that usually involve the mandible or
maxilla and account for 3-6% of odontogenic tumours. They are typically seen in
the 2nd to 3rd decades of life, slightly earlier than ameloblastomas, and are
usually not painful [1].
● In terms of radiographic features, odontogenic myxomas are described as
well-circumscribed, multilocular, and often expansile lesions that can cause
resorption of adjacent teeth or roots. They are characterised by a radiolucent or
mixed radiolucent-radiopaque appearance and have been likened to a soap
bubble or honeycomb appearance. The cortical bone surrounding the lesion may
also appear thinned or expanded [1, 2].
● Clinical and radiographic features of odontogenic myxomas may overlap with
those of other odontogenic tumours, making diagnosis challenging

28. Describe the histological features of the odontogenic myxoma and identify these
in images. Explain why the myxoma requires aggressive treatment.
● Histologically, the tumour is characterised by a myxoid or fibromyxoid stroma with
spindled cells and clusters of odontogenic epithelium [1]. Radiographically, OM
appears as a well-defined, multilocular or unilocular radiolucency with a thin or
expanded cortex. The lesion is often described as having a "soap bubble" or
"tennis racquet strings" appearance [2][3].
● The reason why OM requires aggressive treatment is that although it is a benign
tumour, it has the potential for local invasiveness and destruction of bone. OM
can cause significant facial deformity and functional impairment, particularly
when it affects the mandible. In addition, the recurrence rate of OM is relatively
high, ranging from 10% to 30%, even after complete surgical removal. Therefore,
treatment usually involves complete surgical excision of the tumour with a margin
of healthy tissue, followed by long-term follow-up

29. Explain the nature of the odontogenic fibroma.

● Odontogenic fibroma is a rare benign mesenchymal odontogenic tumour that
arises from dental mesenchyme and is composed of varying amounts of fibrous
connective tissue [3]. There are two types of odontogenic fibromas: central
 odontogenic fibroma (COF) and peripheral odontogenic fibroma (POF). COF is a
non-encapsulated, slow-growing tumour that occurs in the mandible or maxilla,
while POF is a relatively common reactive lesion that arises from periodontal
ligament fibres, gingival connective tissue, or alveolar mucosa
● It occurs mostly in adults and is often associated with chronic irritation or trauma,
but it can also occur in children. The histological appearance of odontogenic
fibroma can vary, but it is typically characterised by the presence of
spindle-shaped fibroblastic cells in a collagenous stroma [2]. Odontogenic
fibromas are treated with complete surgical excision, and the prognosis is
excellent, as recurrence is rare
30. List the key features of the cementoblastoma.
● Location: Cementoblastomas are exclusively found in the tooth-bearing regions
of the jaws, usually in the mandible.
● Pain: Pain is a common symptom of cementoblastoma, and it may be
accompanied by swelling.
● Radiographic features: The tumour is radiopaque on radiographs, with a
well-defined radiolucent zone surrounding it.
● Histopathology: The tumour is characterised by a mass of cementum-like tissue
attached to the root of a tooth, with the presence of cementoblasts in the tumour
tissue.
● Treatment: Treatment involves complete surgical excision of the tumour along
with the associated tooth, followed by monitoring for recurrence
31. Describe the common clinical and radiological features of the cementoblastoma.
● Clinical features:
○ Asymptomatic swelling or a palpable mass in the jaw
○ Pain or discomfort in the affected area, especially during chewing or biting
○ Expansion of the jawbone
○ Displacement or loosening of teeth adjacent to the tumour

● Radiological features:
○ Well-circumscribed, radiopaque lesion with a radiolucent halo surrounding
it
○ Sclerotic border with a "target-like" appearance on radiographs
○ Root resorption or displacement of the adjacent teeth
○ Surrounding bone is not destroyed and the tooth socket is expanded
○ Tooth is fused with the tumour, and the roots are not clearly visible
○ May have a radiopaque line between the tumour and tooth, which
represents the cemental layer that separates the tumour from the tooth
32. Describe the histological features of the cementoblastoma and identify these in
images.
● Histologically, it is characterised by a well-circumscribed mass of cementum-like
tissue surrounded by a layer of fibrous connective tissue. The tumour mass
shows hyperplasia of cementoblasts with a uniform population of cells and is
separated from the surrounding bone by a thin layer of connective tissue. The
 cementoblasts are arranged in cords, trabeculae, and irregular masses, and are
surrounded by a fibrous stroma containing blood vessels and osteoclast-like giant
cells. The cementoblasts may exhibit varying degrees of mineralization, with
some cells producing a more basophilic, immature matrix and others producing a
more eosinophilic, mature matrix. Osteoid or bone formation may also be seen
within the tumour mass
33. Explain the hamartomatous nature of the odontomes.
● They are developmental anomalies that result in the formation of an irregular
mixture of normal dental tissues that have failed to develop properly. Odontoma
may be composed of a disorganised mass of enamel, dentin, cementum, and
pulp tissue, which are the normal constituents of teeth. They arise from the
proliferation of remnants of dental epithelium and/or mesenchyme that remain
active in the jaw after tooth formation has been completed. The exact cause of
odontoma is not fully understood, but it is thought to be related to genetic factors,
environmental factors, or a combination of both.
34. List the key features of the odontomes.
● Odontoma are considered hamartomas, which means they are developmental
malformations rather than true neoplasms.
● They are composed of normal dental tissues, such as enamel, dentin, cementum,
and pulp.
● Odontoma can be classified into two types: compound and complex.
● Compound odontoma consist of many small tooth-like structures, while complex
odontoma are irregular masses of dental tissues.
● They usually occur in the maxilla and can cause delayed eruption of adjacent
teeth.
● Odontoma can be asymptomatic and are often discovered on routine
radiographs.
● Treatment involves surgical excision of the lesion, followed by management of
any associated dental anomalies

35. Describe and explain the differences between the compound and complex
odontomes, common clinical and radiological features and he macroscopic and
histological features
 Feature Compound Complex

Appearance Multiple, small, tooth-like Irregular mass of dental

structures in a cluster tissue

Size Usually smaller (less than Often larger (up to several

1 cm) centimetres)

Composition Resemble normal teeth, Disorganised mass of

contain pulp and dentin dental tissue with no
recognizable tooth
structures

Clinical presentation Often asymptomatic, may May cause pain or

interfere with tooth swelling due to pressure
eruption on surrounding structures

Radiographic Radiopaque with a Radiopaque with a

appearance well-defined border less-defined border

location More common in anterior More common in

maxilla posterior mandible

Aetiology Thought to result from May result from trauma or

abnormal proliferation of infection during tooth
dental tissue during tooth development
development

Treatment Generally requires Generally requires

surgical removal surgical removal

36. Explain the relationship between the dilated and invaginated odontome and the
compound and complex odontomes respectively.
● Dilated odontomas are a type of odontoma that occur infrequently and
can affect any area of the dental arches. They are characterised by a
cystic expansion of the enamel organ, which results in the formation of a
large, thin-walled cavity that is filled with fluid and may contain small
amounts of calcified material.
● Dens invaginatus, also known as dens in dente, is another developmental
anomaly that occurs during odontogenesis. It results from the
invagination of a portion of the dental crown within the enamel organ,
leading to the formation of a deep, enamel-lined pit. Dens invaginatus can
be classified into three types based on the depth of the invagination and
the extent of the deformity
37. Explain the relationship of the complex (“gestant”) odontome and the
dens-in-dente.
● Dens-in-dente, also known as dens invaginatus, is a developmental anomaly
resulting from invagination of a portion of crown forming within the enamel organ
during odontogenesis.