Odontogenic Cysts and Tumors

Odontogenic Cysts and Tumors
Presentation lecture by:Michael Underbrink, MD
Anna Pou, MD

Introduction
* Variety of cysts and tumors
* Uniquely derived from tissues of developing teeth
* May present to otolaryngologist

Odontogenesis
* Projections of dental lamina into ectomesenchyme
* Layered cap (inner/outer enamel epithelium, stratum intermedium, stellate reticulum)
* Odontoblasts secrete dentin ameloblasts (from IEE) enamel
* Cementoblasts cementum
* Fibroblasts periodontal membrane

Diagnosis
* Complete history
o Pain, loose teeth, occlusion, swellings, dysthesias, delayed tooth eruption
* Thorough physical examination
o Inspection, palpation, percussion, auscultation
* Plain radiographs
o Panorex, dental radiographs
* CT for larger, aggressive lesions

Diagnosis
* Differential diagnosis
* Obtain tissue
o FNA – r/o vascular lesions, inflammatory
o Excisional biopsy – smaller cysts, unilocular tumors
o Incisional biopsy – larger lesions prior to definitive therapy
Odontogenic Cysts
* Inflammatory
o Radicular
o Paradental
* Developmental
o Dentigerous
o Developmental lateral periodontal
o Odontogenic keratocyst
o Glandular odontogenic

Radicular (Periapical) Cyst
* Most common (65%)
* Epithelial cell rests of Malassez
* Response to inflammation
* Radiographic findings
o Pulpless, nonvital tooth
o Small well-defined periapical radiolucency
* Histology
* Treatment – extraction, root canal

Radicular Cyst
Residual Cyst
Paradental Cyst
* Associated with partially impacted 3rd molars
* Result of inflammation of the gingiva over an erupting molar
* 0.5 to 4% of cysts
* Radiology – radiolucency in apical portion of the root
* Treatment – enucleation

Dentigerous (follicular) Cyst
* Most common developmental cyst (24%)
* Fluid between reduced enamel epithelium and tooth crown
* Radiographic findings
o Unilocular radiolucency with well-defined sclerotic margins
* Histology
o Nonkeratinizing squamous epithelium
* Treatment – enucleation, decompression

Dentigerous Cyst
Developmental Lateral Periodontal Cyst
Odontogenic Keratocyst
Treatment of OKC
Glandular Odontogenic Cyst
Treatment of GOC
Nonodontogenic Cysts
Incisive Canal Cyst
Stafne Bone Cyst
Traumatic Bone Cyst
Surgical Ciliated Cyst
Odontogenic Tumors
Ameloblastoma
Treatment of Ameloblastoma
Calcifying Epithelial Odontogenic Tumor
Treatment of CEOT
Adenomatoid Odontogenic Tumor
Squamous Odontogenic Tumor
Calcifying Odontogenic Cyst
Mesenchymal Odontogenic Tumors
Odontogenic Myxoma
Cementoblastoma
Mixed Odontogenic Tumors
Related Jaw Lesions
Central Giant Cell Granuloma
Brown Tumor
Aneurysmal Bone Cyst
Fibrous Dysplasia
Ossifying Fibroma
Condensing Osteitis
Conclusion
Case Presentation
Physical Examination
Radiographs
Pathology
Treatment

Odontogenic Cysts and Tumors.ppt