neo: new; plasia: formation. a neoplasm is defined as an uncoordinated proliferation of tissue, the...
TRANSCRIPT
Neo: new; Plasia: formation. A neoplasm is defined as an uncoordinated proliferation of tissue, the growth of which
persists in a potentially unlimited fashion, even after cessation of the stimulus which evoked the change.
CLASSIFICATIONCLASSIFICATION
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumors Non-odontogenic tumorsNon-odontogenic tumorsA. Epithelial origin
1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor
B Mixed origin 1. Ameloblastic fibroma
2. OdontomesC Mesodermal origin
1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Epithelial origin1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor
B Mixed origin 1. Ameloblastic fibroma
2. OdontomesC Mesodermal origin
1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Hyperplastic lesions1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
A. Hyperplastic lesions1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
C. Mesenchymal2. Muscle tissue origina. Leiomyomab. Rhabdomyomac. Granular cell myoblastoma3. Nerve tissue origina. Neurofibromab. Neurilemmomac. Melanotic progonoma
C. Mesenchymal2. Muscle tissue origina. Leiomyomab. Rhabdomyomac. Granular cell myoblastoma3. Nerve tissue origina. Neurofibromab. Neurilemmomac. Melanotic progonoma
Common Clinical Features
Common Clinical Features
Age of occurrence: Varies with each tumorAge of occurrence: Varies with each tumor
Sex predilection: Varies with each tumor
Sex predilection: Varies with each tumor
Symptoms: Most of the tumors present as a painless, gradually / rapidly enlarging swelling. If infected, pain may be present. Other symptoms include facial deformity, mobility in teeth, numbness.
Symptoms: Most of the tumors present as a painless, gradually / rapidly enlarging swelling. If infected, pain may be present. Other symptoms include facial deformity, mobility in teeth, numbness.
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Common Clinical Features
Common Clinical Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Signs: The swelling has the following features:Inspection: usually single, round or oval, well-
defined boundaries, smooth or nodular surface, normal overlying skin or mucosa, expansion of jaw bone, obliteration of vestibule
Palpation: Normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage), teeth mobility, paraesthesia
Additional features: missing tooth or normal dentition, displacement of teeth, pathological jaw fracture, signs of inflammation if tumor is infected
Signs: The swelling has the following features:Inspection: usually single, round or oval, well-
defined boundaries, smooth or nodular surface, normal overlying skin or mucosa, expansion of jaw bone, obliteration of vestibule
Palpation: Normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage), teeth mobility, paraesthesia
Additional features: missing tooth or normal dentition, displacement of teeth, pathological jaw fracture, signs of inflammation if tumor is infected
Common Radiographic Features
Common Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Common Radiographic Features
Common Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Common Radiographic Features
Common Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumorsA. Epithelial origin
1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Epithelial origin1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
Non-odontogenic tumorsNon-odontogenic tumors
Pathogenesis: Proliferation of tissues differentiated from dental lamina. Stimulus for this proliferation not known.
CLASSIFICATIONCLASSIFICATION
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Age of occurrence: mostly between 20 to 50 years of age, peak frequency at 33 years of age
Age of occurrence: mostly between 20 to 50 years of age, peak frequency at 33 years of ageSex predilection: males slightly more commonly affected than females
Sex predilection: males slightly more commonly affected than females
Symptoms: Most of the tumors present as a painless, gradually / rapidly enlarging swelling. If infected, pain may be present. Other symptoms include facial deformity, mobility in teeth, numbness
Symptoms: Most of the tumors present as a painless, gradually / rapidly enlarging swelling. If infected, pain may be present. Other symptoms include facial deformity, mobility in teeth, numbness
Site: 80% of tumors in mandible, in mandible 3rd molar-ramus region more affected
Site: 80% of tumors in mandible, in mandible 3rd molar-ramus region more affected
Ameloblastoma(‘locally malignant’)
Ameloblastoma(‘locally malignant’)
Clinical Features
Clinical Features
Signs: The swelling has the following features:
Inspection: single, round or oval, well-defined boundaries,
smooth or lobulated, normal overlying skin or mucosa
(ulcerated if large), expansion of jaw bone in all the 3
planes, obliteration of vestibule
Palpation: normal temperature of the overlying skin or
mucosa, non-tender, consistency is bony hard (if
entirely within bone); ‘egg-shell crackling’ (if overlying
bone is thin); firm (if no bone coverage) or soft (if
unicystic), teeth mobility, paraesthesia
Additional features: missing tooth or normal dentition,
displacement of teeth, pathological jaw fracture, thin
straw colored fluid on aspiration (unicystic variety)
signs of inflammation if tumor is infecte
Signs: The swelling has the following features:
Inspection: single, round or oval, well-defined boundaries,
smooth or lobulated, normal overlying skin or mucosa
(ulcerated if large), expansion of jaw bone in all the 3
planes, obliteration of vestibule
Palpation: normal temperature of the overlying skin or
mucosa, non-tender, consistency is bony hard (if
entirely within bone); ‘egg-shell crackling’ (if overlying
bone is thin); firm (if no bone coverage) or soft (if
unicystic), teeth mobility, paraesthesia
Additional features: missing tooth or normal dentition,
displacement of teeth, pathological jaw fracture, thin
straw colored fluid on aspiration (unicystic variety)
signs of inflammation if tumor is infecte
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Ameloblastoma(‘locally malignant’)
Ameloblastoma(‘locally malignant’)
Clinical Features
Clinical Features
Image: Lucas’s Pathology of Tumors of the Oral Tissues, 5 th edition
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Type of lesion: radiolucentSite: usually mandibular 3rd molar-ramus regionSize: large lesionShape: unilocular (round or oval), multilocular (‘soap
bubble’, ‘honeycomb’) with locules separated by bony septae
Number: singleOutline: regular or scallopedBorder: well-defined hyperostotic (‘partially hyperostotic’)Contents: homogenous radiolucencyAdditional features: impaction of tooth with displacement
deep in the jaw, expansion of jaw bone bucco-lingually, antero-posteriorly and vertically, displacement & resorption of roots, displacement of inferior alveolar canal, obliteration of maxillary antrum, thinning of cortical plates, thinning of inferior border of mandible, ‘cyst-in-cyst’ appearance, pathological jaw fracture
Type of lesion: radiolucentSite: usually mandibular 3rd molar-ramus regionSize: large lesionShape: unilocular (round or oval), multilocular (‘soap
bubble’, ‘honeycomb’) with locules separated by bony septae
Number: singleOutline: regular or scallopedBorder: well-defined hyperostotic (‘partially hyperostotic’)Contents: homogenous radiolucencyAdditional features: impaction of tooth with displacement
deep in the jaw, expansion of jaw bone bucco-lingually, antero-posteriorly and vertically, displacement & resorption of roots, displacement of inferior alveolar canal, obliteration of maxillary antrum, thinning of cortical plates, thinning of inferior border of mandible, ‘cyst-in-cyst’ appearance, pathological jaw fracture
Ameloblastoma(‘locally malignant’)
Ameloblastoma(‘locally malignant’)
Radiographic Features
Radiographic Features
Ameloblastoma(‘locally malignant’)
Ameloblastoma(‘locally malignant’)
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Images: Atlas of Oral Diagnostic Imaging by Higashi
Differential Diagnosis:Unilocular - other odontogenic tumors (except
radiopaque) and cystsMultilocular - ameloblastic fibroma, myxoma,
haemangioma, central giant cell granuloma, early stages of fibro-osseous lesions, odontogenic keratocyst
Differential Diagnosis:Unilocular - other odontogenic tumors (except
radiopaque) and cystsMultilocular - ameloblastic fibroma, myxoma,
haemangioma, central giant cell granuloma, early stages of fibro-osseous lesions, odontogenic keratocyst
Ameloblastoma(‘locally malignant’)
Ameloblastoma(‘locally malignant’)
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Management: wide surgical excision to avoid recurrence, bone grafts
Management: wide surgical excision to avoid recurrence, bone grafts
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumorsA. Epithelial origin
1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Epithelial origin1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
Non-odontogenic tumorsNon-odontogenic tumors
CLASSIFICATIONCLASSIFICATION
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Adenomatoid Odontogenic Tumor(‘AOT’)
Adenomatoid Odontogenic Tumor(‘AOT’)
Clinical Features
Clinical Features
Signs: The swelling has the following features:Inspection: single, round or oval, well-defined
boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone, obliteration of vestibule
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage)
Additional features: normal dentition, displacement of teeth
Signs: The swelling has the following features:Inspection: single, round or oval, well-defined
boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone, obliteration of vestibule
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage)
Additional features: normal dentition, displacement of teeth
Age of occurrence: mostly in 2nd & 3rd decades of life
Age of occurrence: mostly in 2nd & 3rd decades of life
Sex predilection: females slightly more commonly affected than males
Sex predilection: females slightly more commonly affected than males
Symptoms: Most of the tumors present as a painless, gradually enlarging swelling. Sometimes asymptomatic, being discovered radiographically.
Symptoms: Most of the tumors present as a painless, gradually enlarging swelling. Sometimes asymptomatic, being discovered radiographically.
Site: almost all cases involve maxillary anterior teeth
Site: almost all cases involve maxillary anterior teeth
Type of lesion: predominantly radiolucent (‘mixed’)
Site: maxillary anterior regionSize: about 3 cms in diameterShape: unilocular (round or oval)Number: singleOutline: regularBorder: well-defined hyperostoticContents: homogenous radiolucency interspersed
with radiopaque foci (‘driven snow’ appearance)
Additional features: sometimes impaction of tooth, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Type of lesion: predominantly radiolucent (‘mixed’)
Site: maxillary anterior regionSize: about 3 cms in diameterShape: unilocular (round or oval)Number: singleOutline: regularBorder: well-defined hyperostoticContents: homogenous radiolucency interspersed
with radiopaque foci (‘driven snow’ appearance)
Additional features: sometimes impaction of tooth, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Radiographic Features
Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Adenomatoid Odontogenic Tumor(‘AOT’)
Adenomatoid Odontogenic Tumor(‘AOT’)
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Adenomatoid Odontogenic Tumor(‘AOT’)
Adenomatoid Odontogenic Tumor(‘AOT’)
Differential Diagnosis:No radiopaque foci – ameloblastoma,
ameloblastic fibroma, odontogenic fibroma, primordial cyst, lateral periodontal cyst
Radiopaque foci – CEOC, CEOT
Differential Diagnosis:No radiopaque foci – ameloblastoma,
ameloblastic fibroma, odontogenic fibroma, primordial cyst, lateral periodontal cyst
Radiopaque foci – CEOC, CEOT
Management: surgical enucleationManagement: surgical enucleation
Image: Atlas of Oral Diagnostic Imaging by Higashi
Age of occurrence: mostly in middle aged patients
Age of occurrence: mostly in middle aged patients
Sex predilection: females equally affected as males
Sex predilection: females equally affected as males
Symptoms: Most of the tumors present as a painless, gradually enlarging swelling. Sometimes non-eruption of tooth / asymptomatic, being discovered radiographically.
Symptoms: Most of the tumors present as a painless, gradually enlarging swelling. Sometimes non-eruption of tooth / asymptomatic, being discovered radiographically.
Site: majority in mandibular premolar-molar region
Site: majority in mandibular premolar-molar region
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
Clinical Features
Clinical Features
Signs: The swelling has the following features:Inspection: single, round or oval, well-defined
boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone, obliteration of vestibule
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage)
Additional features: missing tooth, displacement of teeth
Signs: The swelling has the following features:Inspection: single, round or oval, well-defined
boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone, obliteration of vestibule
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); ‘egg-shell crackling’ (if overlying bone is thin); firm (if no bone coverage)
Additional features: missing tooth, displacement of teeth
Type of lesion: predominantly radiolucent (‘mixed’)
Site: mandibular premolar-molar regionSize: about 3 cms in diameterShape: somewhat irregularNumber: singleOutline: somewhat irregularBorder: well-defined, at times diffuseContents: homogenous radiolucency interspersed
with diffuse radiopacitiesAdditional features: impaction of tooth is
common, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Type of lesion: predominantly radiolucent (‘mixed’)
Site: mandibular premolar-molar regionSize: about 3 cms in diameterShape: somewhat irregularNumber: singleOutline: somewhat irregularBorder: well-defined, at times diffuseContents: homogenous radiolucency interspersed
with diffuse radiopacitiesAdditional features: impaction of tooth is
common, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Radiographic Features
Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
Calcifying Epithelial Odontogenic Tumor(‘CEOT’, Pindborg tumor)
Differential Diagnosis: CEOC, AOT, intermediate stages of fibro-osseous lesions
Differential Diagnosis: CEOC, AOT, intermediate stages of fibro-osseous lesions
Management: wide surgical excision to avoid recurrence
Management: wide surgical excision to avoid recurrence
Image: Lucas’s Pathology of Tumors of the Oral Tissues, 5 th edition
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumorsA. Epithelial origin
1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Epithelial origin1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
Non-odontogenic tumorsNon-odontogenic tumors
CLASSIFICATIONCLASSIFICATION
Age of occurrence: mostly in young adultsAge of occurrence: mostly in young adults
Sex predilection: males more frequently affected
Sex predilection: males more frequently affected
Symptoms: mostly asymptomatic, being discovered radiographically for non-eruption of tooth, sometimes slowly enlarging swelling
Symptoms: mostly asymptomatic, being discovered radiographically for non-eruption of tooth, sometimes slowly enlarging swelling
Site: complex more common in mandibular premolar-molar region, compound more common in maxillary anterior region
Site: complex more common in mandibular premolar-molar region, compound more common in maxillary anterior region
Signs: If present, the swelling has the following features:
Inspection: single, round or oval, well-defined boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone,
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); firm or hard (if no bone coverage)
Additional features: missing tooth
Signs: If present, the swelling has the following features:
Inspection: single, round or oval, well-defined boundaries, smooth, normal overlying skin or mucosa, little expansion of jaw bone,
Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); firm or hard (if no bone coverage)
Additional features: missing tooth
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Odontome(‘complex/compound composite odontome’, Odontoma)
Odontome(‘complex/compound composite odontome’, Odontoma)
Clinical Features
Clinical Features
Type of lesion: radiopaque mass surrounded by a radiolucent line and further by a radiopaque line, ‘mixed’ in early stages
Site: mandibular premolar-molar region / maxillary anterior region
Size: complex can be large, compound usually smallShape: round or ovalNumber: singleOutline: regularBorder: well-defined hyperostoticContents: radiopacities of varying densities interspersed
with tiny radiolucencies, radiopacities arranged in haphazard manner (‘complex’) or in anatomical relation forming several small teeth ‘denticles’ (‘compound’)
Additional features: associated with supernumerary tooth, impaction of tooth, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Type of lesion: radiopaque mass surrounded by a radiolucent line and further by a radiopaque line, ‘mixed’ in early stages
Site: mandibular premolar-molar region / maxillary anterior region
Size: complex can be large, compound usually smallShape: round or ovalNumber: singleOutline: regularBorder: well-defined hyperostoticContents: radiopacities of varying densities interspersed
with tiny radiolucencies, radiopacities arranged in haphazard manner (‘complex’) or in anatomical relation forming several small teeth ‘denticles’ (‘compound’)
Additional features: associated with supernumerary tooth, impaction of tooth, little expansion of jaw bone, displacement & resorption of roots, thinning of cortical plates
Radiographic Features
Radiographic Features
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Odontome(‘complex/compound composite odontome’, Odontoma)
Odontome(‘complex/compound composite odontome’, Odontoma)
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Odontome(‘complex/compound composite odontome’, Odontoma)
Odontome(‘complex/compound composite odontome’, Odontoma)
Images: Atlas of Oral Diagnostic Imaging by Higashi
Differential Diagnosis:in the early stage: CEOC, AOT,
intermediate stage of fibro-osseous lesions
in the mature stage: mature stage of fibro-osseous lesions, osteoma
Differential Diagnosis:in the early stage: CEOC, AOT,
intermediate stage of fibro-osseous lesions
in the mature stage: mature stage of fibro-osseous lesions, osteoma
Management: surgical removal to allow eruption of impacted tooth and avoid cystic changes
Management: surgical removal to allow eruption of impacted tooth and avoid cystic changes
ODONTOGENIC TUMORSODONTOGENIC TUMORS
Odontome(‘complex/compound composite odontome’, Odontoma)
Odontome(‘complex/compound composite odontome’, Odontoma)
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumorsA. Epithelial origin
1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
A. Epithelial origin1. Ameloblastoma2. Adenomatoid odontogenic tumor3. Calcifying epithelial odontogenic tumor4. Squamous odontogenic tumor5. Ameloblastic fibroma6. Odontomes
B. Mesodermal origin1. Myxoma & Myxofibroma2. Odontogenic fibroma3. Cementifying fibroma4. Periapical cemental dysplasia5. Benign cementoblastoma6. Familial multiple cementoma
Non-odontogenic tumorsNon-odontogenic tumors
Fibro-osseous lesions
Fibro-osseous lesions
CLASSIFICATIONCLASSIFICATION
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumors Non-odontogenic tumorsNon-odontogenic tumorsA. Hyperplastic lesions
1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
A. Hyperplastic lesions1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
CLASSIFICATIONCLASSIFICATION
NON-ODONTOGENIC TUMORSNON-ODONTOGENIC TUMORS
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Pathogenesis: excessive reparative response to an irritant (trauma, infection)
Clinical Features
Age of occurrence: central variety occurs in young adults especially below 30 years of age, peripheral variety usually in adults
Sex predilection: both varieties more common in femalesSite: the region of the jaws anterior to molars involved by the central variety , the peripheral variety involves only gingiva / alveolar mucosa
Radiographic FeaturesType of lesion: radiolucentSite: usually anterior to mandibular 1st molarSize: medium sized lesionShape: unilocular (round or oval), multilocular
(‘soap bubble’) with locules separated by thin bony septae
Number: singleOutline: regular or scallopedBorder: well-defined hyperostoticContents: homogenous radiolucencyAdditional features: expansion of jaw bone bucco-
lingually and vertically, displacement of developing teeth, thinning of cortical plates, thinning of inferior border of mandible
Radiographic FeaturesType of lesion: radiolucentSite: usually anterior to mandibular 1st molarSize: medium sized lesionShape: unilocular (round or oval), multilocular
(‘soap bubble’) with locules separated by thin bony septae
Number: singleOutline: regular or scallopedBorder: well-defined hyperostoticContents: homogenous radiolucencyAdditional features: expansion of jaw bone bucco-
lingually and vertically, displacement of developing teeth, thinning of cortical plates, thinning of inferior border of mandible
NON-ODONTOGENIC TUMORSNON-ODONTOGENIC TUMORS
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Symptoms: mostly slowly enlarging swelling, sometimes mobility in teethSymptoms: mostly slowly enlarging swelling, sometimes mobility in teeth
Clinical FeaturesClinical Features
Signs: the swelling has the following features:Inspection: single, round or oval, well-defined boundaries, smooth, normal overlying mucosa, bluish discoloration of mucosa if cortex is perforated, expansion of jaw bone,Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); soft (if no bone coverage)Additional features: displacement / mobility in teeth
Signs: the swelling has the following features:Inspection: single, round or oval, well-defined boundaries, smooth, normal overlying mucosa, bluish discoloration of mucosa if cortex is perforated, expansion of jaw bone,Palpation: normal temperature of the overlying skin or mucosa, non-tender, consistency is bony hard (if entirely within bone); soft (if no bone coverage)Additional features: displacement / mobility in teeth
NON-ODONTOGENIC TUMORSNON-ODONTOGENIC TUMORS
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Giant Cell Granuloma(‘central/peripheral’, reparative/hyperplastic giant cell lesion’ )
Radiographic Features
Radiographic Features
Differential Diagnosis: from other multilocular lesions like ameloblastoma, hemangioma, myxoma and early fibro-osseous lesions
Differential Diagnosis: from other multilocular lesions like ameloblastoma, hemangioma, myxoma and early fibro-osseous lesions
Image: Lucas’s Pathology of Tumors of the Oral Tissues, 5 th edition
Management: surgical removal with adequate margins to avoid recurrence, screening for hyperparathyroidism
Management: surgical removal with adequate margins to avoid recurrence, screening for hyperparathyroidism
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumors Non-odontogenic tumorsNon-odontogenic tumorsA. Hyperplastic lesions
1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
A. Hyperplastic lesions1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
CLASSIFICATIONCLASSIFICATION
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumors Non-odontogenic tumorsNon-odontogenic tumorsA. Hyperplastic lesions
1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
A. Hyperplastic lesions1. Polyp2. Epulis3. Giant cell granuloma
B. Epithelial origin1. Papilloma2. Adenoma3. Pigmented nevus4. Keratoacanthoma
C. Mesenchymal1. Connective tissue origina. Fibromab. Lipoma / Fibrolipomac. Haemangiomad. Lymphangiomae. Chondromaf. Osteoma
CLASSIFICATIONCLASSIFICATION
OsteomasOsteomas
NON-ODONTOGENIC TUMORSNON-ODONTOGENIC TUMORS
OsteomasOsteomas
NON-ODONTOGENIC TUMORSNON-ODONTOGENIC TUMORS
C. Mesenchymal2. Muscle tissue origina. Leiomyomab. Rhabdomyomac. Granular cell myoblastoma3. Nerve tissue origina. Neurofibromab. Neurilemmomac. Melanotic progonoma
C. Mesenchymal2. Muscle tissue origina. Leiomyomab. Rhabdomyomac. Granular cell myoblastoma3. Nerve tissue origina. Neurofibromab. Neurilemmomac. Melanotic progonoma
BENIGN NEOPLASMSBENIGN NEOPLASMS
Odontogenic tumorsOdontogenic tumors Non-odontogenic tumorsNon-odontogenic tumors
CLASSIFICATIONCLASSIFICATION
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