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Odontogenic tumours 牙源性瘤 Benigns, the odontogenesis is an embryonic…

- - - - compound odontoma: tumor mass with multiple structures that resemble teeth => maxilla
      - complex odontoma: irregular mass of calcified material (enamel, dentin, cement) together with connective tissue => mandible
    - - children & adolescents
      - asymptomatic/ accidental xray for retention of temporary teeth/ absence of definitive or displacement
    - - complex: irregular dense radiopaque area
      - compound: opacities resembling teeth, more or less trained and with variable number
      - thin radiolucent rim
    - - complex: disorganized mass of enamel/ dentin/ cement and pulp
      - compound: odontogenic tissues showing a more regular provision. cystic peripheral capsule
    - - surgery
      - rare recurrence
  - - - epithelial islets of cuboid cells with areas of starry lattice (ameloblastoma)
      - scattered in an embryonic connective tissue, with minimum collagen formation and marked cellularity
    - - resection and curettage of the underlying tissue
      - 18% recurrence
    - - Affects young patients 15 years
      - most common in the mandible
      - It is a true mixed tumour in which the epithelial tissue and pulp are both neoplastic.
      - painless jaw swelling in premolar region
      - slow growth, deformed bone, expands and moves cortices (does not invade or infiltrates)
- - - - island of polyhedral epithelial cells in a fibrous stroma
    - - Lucent area with well or poorly defined
      - multilocular with diffuse radiopacities within the lesion
    - - 30-50 years, no sex predilection
      - painless slow growing swelling
      - 1% odontogenic tumours/ 6% extra-osseous 骨外的
      - Location: mandible, posterior area/ incisor: PM region (extra-osseous)
    - - total resection of the lesion
      - 20% recurrence/ 15% clear cell variant
  - - - the MOST COMMON odontogenic tumours
      - Locally aggressive growth & high rate of recurrence/ slow growth
      - between 20-40ys
      - 80% third molar area of either jaw/ 20% are associated with an impacted tooth.
      - 75% mandible/ 25% maxilla
      - hard swelling/ tooth mobility/ asymptomatic deformity by bone expansion
    - - unicystic: variable epithelial lining, plexiform or follicular with ameloblastoma cells in the basal layer.
      - desmoplasic
        
        clinic:
        
        maxilla=mandible
        
        anterior and PM region
        
        slow painless growing
        
        xray
        
        not defined margins
      - solid or multicystic
        
        follicular
        
        island of epithelial cells In a connective tissue stroma/ columnar cells reverse nuclear polarity
        
        Island: polygonal or angular cells, stellated reticulum, surrounded by a single layer of ameloblast-like cells with reverse nuclear polarity
        
        plexiform
        
        stroma loose, vascular, sparsely cellular connective tissue
        
        microcyte formations
        
        Thin trabecular of epithelium bordered by flatter cells
      - peripheral
        
        extraosseus ameloblastoma
        
        clinic
        
        fibrous nodules
        
        superficial to the alveolar ridge
        
        65% incisor to PM region
        
        slow growing with little or non bone erosion
    - - teeth roots with varying degrees of resorption
      - can be associated a non erupted tooth
      - well-defined margins (not preserved)
      - uni or multilocular radiolucency in " soap bubbles" "honeycomb" lesion
    - - Trabecular of epithelial cells in a connective tissue stroma.
      - Cyst formation in the epithelial island
    - - Wide excision
      - 20% recurrence
  - - - 10-20 years female predilection
      - hamartoma 错构瘤; 下丘脑; 缺陷瘤/ asymptomatic slow growing mass
      - 3% odontogenic tumour/ 75% impacted tooth
      - Anterior area
  - - - tooth displacement
      - no root resorption
      - may expand cortices
      - no tooth inclusion, except third molars
      - uni/ multilocular radiolucency
    - - no inflammatory infiltrate
      - keratin
      - keratinized squamous epithelium with cuboidal cells
    - - Location: mandible, posterior area
      - slow growth/ isolated lesions
      - 20-30 years males
      - recurrent rate: 20-56%
    - - chemical products: Carney solution
      - marsupializatio: big lesions
      - surgical excision with curettage of the underlying bone
      - Hight recurrence rate
- - - - root resorption
      - tooth mobility
      - slow growing painless, swelling of the jaw