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Odontomes

&
Odontogenic tumors


LAB 3


Dr. Tahani Abualteen
BDS, MFD
• 20 years old female attended the dental
clinic for routine dental examination, her
lower left 2
nd
molar wasn’t there and a
panoramic radiograph was suggested to
investigate about this tooth and this
incidental radiographic appearance was
discovered in association with the
unerupted lower left 2
nd
molar
The patient is unaware of this lesion

1- What do we call this lesion and how can
we reach the definitive diagnosis?!

2- What type is this?!

3- Describe the usual radiographic
appearance?!

4- What are the clinical features of this
lesion?!

5- What are the histopathological features
of this lesion?!

Complex Odontome: Radiographic Features
• 20 years old female attended the dental
clinic for routine dental examination, her
upper right central incisor wasn’t there
and a panoramic radiograph was
suggested to investigate about this tooth
and this incidental radiographic
appearance was discovered in
association with the unerupted upper
right central incisor
The patient is unaware of this lesion

1- What do we call this lesion and how can
we reach the definitive diagnosis?!

2- What type is this?!

3- Describe the usual radiographic
appearance?!

4- What are the clinical features of this
lesion?!

5- What are the histopathological features
of this lesion?!

Compound Odontome: Radiographic Features
Compound Odontome: Radiographic Features
 Benign odontogenic tumors:
1) Odontogenic epithelium with mature, fibrous stroma, without
odontogenic ectomesenchyme:

•Ameloblastoma
•Sequamous odontogenic tumor
•Calcifying epithelial odontogenic tumor
•Adenomatoid odontogenic tumor
•Keratocystic odontogenic tumor (OKC previously)

Odontogenic epithelium is neoplastic BUT ectomesenchyme isn’t
Classification of odontogenic tumors:
Classification of odontogenic tumors:
Benign odontogenic tumors:
2) Odontogenic epithelium with odontogenic ectomesenchyme, with or without
hard tissue formation:

•Ameloblastic fibroma
•Ameloblastic fibro-dentinoma
•Ameloblastic fibro-odontoma
•Odontoma, complex type (considered as hamartoma)
•Odontoma, compound type (considered as hamartoma)
•Odonto-ameloblastoma
•Calcifying cystic odontogenic tumor (calcifying odontogenic cyst previously)
•Dentinogenic ghost cell tumor

BOTH of Odontogenic epithelium & ectomesenchyme are neoplastic



Classification of odontogenic tumors:
Benign odontogenic tumors:
3) Mesenchyme and/or odontogenic ectomesenchyme with or without
odontogenic epithelium:

•Odontogenic fibroma
•Odontogenic myxoma/myxofibroma
Cementoblastoma

Ectomesenchyme is neoplastic BUT Odontogenic epithelium isn’t

Malignant odontogenic tumors:

1) Odontogenic carcinomas:

•Metastasizing (malignant) ameloblastoma
•Ameloblastic carcinoma – Primary type
•Ameloblastic carcinoma – Secondary type (de-differentiated), intra-osseous
•Ameloblastic carcinoma – Secondary type (de-differentiated), peripheral
•Primary intra-osseous Sequamous cell carcinoma – solid type
•Primary intra-osseous Sequamous cell carcinoma derived from keratocystic
odontogenic tumor
•Primary intra-osseous Sequamous cell carcinoma derived from odontogenic
cysts
•Clear cell odontogenic carcinoma
•Ghost cell odontogenic carcinoma

2) Odontogenic Sarcomas:
•Ameloblastic fibrosarcoma
•Ameloblastic fibro-dentino and fibro-odontosarcoma
Classification of odontogenic tumors:
Other tumors of debatable origin:

•Melanotic neuro-ectodermal tumor of infancy
•Congenital gingival granular cell tumor (congenital epulis)
Classification of odontogenic tumors:
• 30 years old male attended the dental clinic
to consult about this facial swelling on the
right side of his face
The patient stated that the lesion is
asymptomatic and facial deformity is bony-
hard & non-tender & gradually increasing in
size with time
Upon intraoral examination, teeth at the
affected site are loose
This is the radiographic appearance
discovered

1- What is the most likely diagnosis?! and how can
we confirm it?!

2- What clinical variety is this?! What is the other
clinical variety?!

3- Whom are usually affected?!

4- Describe the usual radiographic appearance?!

5- What are the clinical features of this lesion?!

6- What histopathological variety is this?! What is
the other variety?!

• 30 years old male attended the dental clinic
to consult about this facial swelling on the
right side of his face
The patient stated that the lesion is
asymptomatic and facial deformity is bony-
hard & non-tender & gradually increasing in
size with time
Upon intraoral examination, teeth at the
affected site are loose
This is the radiographic appearance discovered

7- What are the differences between the two
histopathological varieties?!?!

8- What are the different sources of origin for this
lesion?!

9- Does any of the dental hard tissues exist within this
lesion?!

10- Describe the usual behavior of such lesions?!

11- What is the usual treatment for such lesion?!

12- What are the differences between the two clinical
varieties of this lesion?!


Ameloblastoma
Follicular Pattern
Follicular Pattern
Follicular Pattern
Unicystic ameloblastoma
Peripheral (Extra-osseous) Ameloblastoma
• 20 years old male attended the dental
clinic to consult about the mobility he
encountered recently in his upper left
canine and first premolars
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?! and how
can we confirm it?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What is the proposed origin of this lesion?!

5- What is the usual treatment for this lesion?!

Sequamous Odontogenic Tumor
• 40 years old male attended the dental
clinic for routine dental examination
and on radiography we discovered this
appearance and we asked for biopsy
and here are the radiographic and
histopathological appearances
discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this lesion?!


Calcifying Epithelial Odontogenic Tumor
Calcifying Epithelial Odontogenic Tumor
Calcifying Epithelial Odontogenic Tumor
Calcifying Epithelial Odontogenic Tumor
• 13 years old male attended the
dental clinic to consult about this
swelling at the upper right canine
area (which isn’t erupted yet)
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this
lesion?!

5- What is the usual treatment for this
lesion?!

Adenomatoid Odontogenic Tumor
Adenomatoid Odontogenic Tumor
• 25 years old male attended the
dental clinic for routine dental
examination
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this
lesion?!

5- What are the differences between this
lesion and ameloblastoma?!

6- What is the usual treatment for this
lesion?!

Ameloblastic Fibroma
Ameloblastic Fibroma
Ameloblastic Fibroma
Ameloblastic Fibro-odontoma
• 35 years old female attended the
dental clinic for routine dental
examination
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this
lesion?!

5- What is the usual treatment for this
lesion?!

6- Formerly, certain tumor was considered
the solid variant of this lesion, what was
it?! And what are its features?!

Calcifying Cystic Odontogenic Tumor
Calcifying Cystic Odontogenic Tumor
• 20 years old female attended the
dental clinic to consult about this
swelling taking the place of the
extracted lower left 1
st
molar
This is the histological appearance
discovered

1- What is the most likely diagnosis?!

2- Describe the usual histopathological
appearance?!

3- What are the clinical features of this
lesion?!

4- What is the origin of this lesion?!

5- What is the usual treatment for this
lesion?!

Odontogenic Fibroma
• 30 years old male attended the
dental clinic for routine dental
examination
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this
lesion?!

5- What is the usual behavior for this
lesion?!


• 18 years old female attended the
dental clinic for routine dental
examination
This is the radiographic & histological
appearances discovered

1- What is the most likely diagnosis?!

2- Describe the usual radiographic
appearance?!

3- Describe the usual histopathological
appearance?!

4- What are the clinical features of this
lesion?!

5- What is the only difference between this
lesion and Osteoblastoma?!



• 5 months old child was presented to
the dental clinic to consult about a
swelling on the gum pads
This is the histological appearance
discovered

1- What is the most likely diagnosis?!

2- What are the clinical features of this
lesion?!

3- What is the possible origin for this
lesion?!

4- What is the usual treatment for this
lesion?!



Melanotic Neuro ectodermal Tumor of
Infancy
• 5 months old child was presented to
the dental clinic to consult about a
swelling on the gum pads
This is the histological appearance
discovered

1- What is the most likely diagnosis?!

2- What are the clinical features of this
lesion?!

3- What is the usual treatment for this
lesion?!



Congenital Epulis
Congenital Epulis