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Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms A. Ruprecht D.D.S., M.Sc.D., F.R.C.D.(C,), Dip. A.B.O.M.R. Professor and Director of.

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Presentation on theme: "Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms A. Ruprecht D.D.S., M.Sc.D., F.R.C.D.(C,), Dip. A.B.O.M.R. Professor and Director of."— Presentation transcript:

1 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms A. Ruprecht D.D.S., M.Sc.D., F.R.C.D.(C,), Dip. A.B.O.M.R. Professor and Director of Oral and Maxillofacial Radiology Professor of Radiology Professor of Anatomy and Cell Biology The University of Iowa

2 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures

3 Copyright © 2004 by A. Ruprecht l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

4 Copyright © 2004 by A. Ruprecht Poorly DefinedWell Defined

5 Copyright © 2004 by A. Ruprecht l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

6 Copyright © 2004 by A. Ruprecht Corticated

7 Copyright © 2004 by A. Ruprecht l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

8 Copyright © 2004 by A. Ruprecht Space Occupying vs. Non-Space Occupying

9 Copyright © 2004 by A. Ruprecht Space Occupying

10 Copyright © 2004 by A. Ruprecht l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

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16 l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

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22 l Well defined l Corticated l Space occupying l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

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28 l Displacement of teeth l Directional resorption of teeth l Displacement of anatomical structures The Radiology of Benign Neoplasms

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34 l Displacement of periosteum l Internal structure: trabeculae & calcification l Unilocular / multilocular The Radiology of Benign Neoplasms

35 Copyright © 2004 by A. Ruprecht l Displacement of periosteum l Internal structure: trabeculae & calcification l Unilocular / multilocular The Radiology of Benign Neoplasms

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41 l Displacement of periosteum l Internal structure: trabeculae & calcification l Unilocular / multilocular The Radiology of Benign Neoplasms

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45 l Displacement of periosteum l Internal structure: trabeculae & calcification l Unilocular / multilocular The Radiology of Benign Neoplasms

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47 Cyst or Benign Neoplasm Malignant Neoplasm The Radiology of Benign Neoplasms

48 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms I. Odontogenic

49 Copyright © 2004 by A. Ruprecht Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal The Radiology of Benign Neoplasms Odontogenic Odontogenic

50 Copyright © 2004 by A. Ruprecht Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal Odontogenic Odontogenic The Radiology of Benign Neoplasms

51 Copyright © 2004 by A. Ruprecht Dental Lamina Ameloblastoma Enamel organ Adenomatoid Odontogenic Tumor Root sheath of Hertwig Ameloblastic fibroma Dental Lamina Odontoma

52 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

53 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

54 Copyright © 2004 by A. Ruprecht Ameloblastoma Age: years (predominantly 30s and 40s) Mandible:Maxilla = 85:15 60% mandibular molar-ramus area The Radiology of Benign Neoplasms

55 Copyright © 2004 by A. Ruprecht Ameloblastoma 10% 3%2% 15%60%

56 Copyright © 2004 by A. Ruprecht Ameloblastoma Unilocular Multilocular (coarse septa) Soap bubble Honeycomb The Radiology of Benign Neoplasms

57 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

58 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

59 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

60 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

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62 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

63 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

64 Copyright © 2004 by A. Ruprecht Ameloblastoma Displacement or resorption of teeth Extends beyond radiographic limits Superior aspect often lost The Radiology of Benign Neoplasms

65 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

66 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

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70 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

71 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

72 Copyright © 2004 by A. Ruprecht Keratocyst -> Ameloblastoma The Radiology of Benign Neoplasms

73 Copyright © 2004 by A. Ruprecht July 26, 1973 The Radiology of Benign Neoplasms

74 Copyright © 2004 by A. Ruprecht March 8, 1974 The Radiology of Benign Neoplasms

75 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

76 Copyright © 2004 by A. Ruprecht Simple Bone Cyst -> Ameloblastoma The Radiology of Benign Neoplasms

77 Copyright © 2004 by A. Ruprecht February 5, 1966 The Radiology of Benign Neoplasms

78 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

79 Copyright © 2004 by A. Ruprecht December 29, 1967 The Radiology of Benign Neoplasms

80 Copyright © 2004 by A. Ruprecht July 19, 1968 The Radiology of Benign Neoplasms

81 Copyright © 2004 by A. Ruprecht January 11, 1969 The Radiology of Benign Neoplasms

82 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

83 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

84 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

85 Copyright © 2004 by A. Ruprecht July 14, 1969 The Radiology of Benign Neoplasms

86 Copyright © 2004 by A. Ruprecht Recurrent Ameloblastoma The Radiology of Benign Neoplasms

87 Copyright © 2004 by A. Ruprecht Recurrent Ameloblastoma radiolucent areas circular pattern The Radiology of Benign Neoplasms

88 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

89 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

90 Copyright © 2004 by A. Ruprecht Squamous odontogenic tumor (SOT) The Radiology of Benign Neoplasms

91 Copyright © 2004 by A. Ruprecht Squamous odontogenic tumor (SOT) Age: 10s - 60s years (mean of 40) Mandible:Maxilla = 1:1 alveolar process area from rests of Malassez? The Radiology of Benign Neoplasms

92 Copyright © 2004 by A. Ruprecht radiolucent well-circumscribed semilunar associated with roots of teeth Squamous odontogenic tumor (SOT) The Radiology of Benign Neoplasms

93 Copyright © 2004 by A. Ruprecht locally invasive recur with conservative treatment excision is treatment of choice Squamous odontogenic tumor (SOT) The Radiology of Benign Neoplasms

94 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

95 Copyright © 2004 by A. Ruprecht Adenomatoid odontogenic tumor (AOT) The Radiology of Benign Neoplasms

96 Copyright © 2004 by A. Ruprecht Adenomatoid odontogenic tumor (AOT) (18 years of age) anterior maxilla or mandible radiolucent or with radiopaque foci may mimic dentigerous cyst The Radiology of Benign Neoplasms

97 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

98 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

99 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

100 Copyright © 2004 by A. Ruprecht Calcifying epithelial odontogenic tumor (CEOT) The Radiology of Benign Neoplasms

101 Copyright © 2004 by A. Ruprecht Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) (mean 40) maxilla:mandible = 1:2 ramus-molar region The Radiology of Benign Neoplasms

102 Copyright © 2004 by A. Ruprecht Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) usually associated with impacted teeth unilocular or multilocular radiolucent or with radiopaque foci The Radiology of Benign Neoplasms

103 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

104 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

105 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

106 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

107 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

108 Copyright © 2004 by A. Ruprecht Clear cell odontogenic tumor The Radiology of Benign Neoplasms

109 Copyright © 2004 by A. Ruprecht Clear cell odontogenic tumor rare 60 years of age females maxilla or mandible The Radiology of Benign Neoplasms

110 Copyright © 2004 by A. Ruprecht Clear cell odontogenic tumor radiolucent poorly circumscribed locally aggressive The Radiology of Benign Neoplasms

111 Copyright © 2004 by A. Ruprecht Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy] Odontogenic Odontogenic The Radiology of Benign Neoplasms

112 Copyright © 2004 by A. Ruprecht Melanotic neuroectodermal tumor of infancy The Radiology of Benign Neoplasms

113 Copyright © 2004 by A. Ruprecht Melanotic neuroectodermal tumor of infancy (MNTI) rare young, usually first year of life anterior maxilla moderately well circumscribed, around apical area of roots The Radiology of Benign Neoplasms

114 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

115 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

116 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

117 Copyright © 2004 by A. Ruprecht Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal Odontogenic Odontogenic The Radiology of Benign Neoplasms

118 Copyright © 2004 by A. Ruprecht Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal Odontogenic Odontogenic The Radiology of Benign Neoplasms

119 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

120 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

121 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

122 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

123 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

124 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

125 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

126 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

127 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

128 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

129 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

130 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

131 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

132 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

133 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Compound odontoma Complex odontoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

134 Copyright © 2004 by A. Ruprecht Ameloblastic fibroma Ameloblastic fibro-odontoma Compound odontoma Complex odontoma The Radiology of Benign Neoplasms

135 Copyright © 2004 by A. Ruprecht –>Compound Odontoma Ameloblastic Fibroma–>Ameloblastic Fibro-odontoma –>Complex Odontoma The Radiology of Benign Neoplasms

136 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

137 Copyright © 2004 by A. Ruprecht Ameloblastic Fibroma l primitive myxoid connective tissue l resemblance to dental pulp l strands of odontogenic epithelium 2 cells wide Ameloblastic Fibro-odontoma l primitive myxoid connective tissue l resemblance to dental pulp l strands of odontogenic epithelium 2 cells wide l cells differentiate to produce enamel and dentin The Radiology of Benign Neoplasms

138 Copyright © 2004 by A. Ruprecht Ameloblastic Fibro- odontoma l prominent enamel matrix often seen before final maturation of hard tissue l enamel and dentin in the form of compound or complex odontoma Compound Odontoma Complex odontoma l prominent enamel matrix often seen before final maturation of hard tissue l enamel and dentin in the form of compound or complex odontoma The Radiology of Benign Neoplasms

139 Copyright © 2004 by A. Ruprecht Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma Odontogenic Odontogenic The Radiology of Benign Neoplasms

140 Copyright © 2004 by A. Ruprecht Odonto-ameloblastoma The Radiology of Benign Neoplasms

141 Copyright © 2004 by A. Ruprecht Odonto-ameloblastoma rare young, first decade ameloblastoma component odontoma component The Radiology of Benign Neoplasms

142 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

143 Copyright © 2004 by A. Ruprecht Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal Odontogenic Odontogenic The Radiology of Benign Neoplasms

144 Copyright © 2004 by A. Ruprecht Mesenchymal Odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma Odontogenic Odontogenic The Radiology of Benign Neoplasms

145 Copyright © 2004 by A. Ruprecht Mesenchymal Odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma Odontogenic Odontogenic The Radiology of Benign Neoplasms

146 Copyright © 2004 by A. Ruprecht Odontogenic fibroma Central odontogenic fibroma Central odontogenic fibroma Peripheral odontogenic fibroma Peripheral odontogenic fibroma The Radiology of Benign Neoplasms

147 Copyright © 2004 by A. Ruprecht Central odontogenic fibroma The Radiology of Benign Neoplasms

148 Copyright © 2004 by A. Ruprecht Central odontogenic fibroma rare all age groups radiolucent usually unilocular The Radiology of Benign Neoplasms

149 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

150 Copyright © 2004 by A. Ruprecht Peripheral odontogenic fibroma The Radiology of Benign Neoplasms

151 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

152 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

153 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

154 Copyright © 2004 by A. Ruprecht Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma Odontogenic Odontogenic The Radiology of Benign Neoplasms

155 Copyright © 2004 by A. Ruprecht Odontogenic myxoma The Radiology of Benign Neoplasms

156 Copyright © 2004 by A. Ruprecht Odontogenic myxoma years (15-35, mean 30) maxilla:mandible 1:1 may be infiltrative and aggressive The Radiology of Benign Neoplasms

157 Copyright © 2004 by A. Ruprecht Odontogenic myxoma “tennis racket” appearance (neither coarse nor fine septa) cortical expansion root displacement rather than resorption The Radiology of Benign Neoplasms

158 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

159 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

160 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

161 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

162 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

163 Copyright © 2004 by A. Ruprecht Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma Odontogenic Odontogenic The Radiology of Benign Neoplasms

164 Copyright © 2004 by A. Ruprecht Benign cementoblastoma The Radiology of Benign Neoplasms

165 Copyright © 2004 by A. Ruprecht Benign cementoblastoma second or third decade, usually before 25 continuous with root, which is resorbed pulp vitality unrelated The Radiology of Benign Neoplasms

166 Copyright © 2004 by A. Ruprecht Benign cementoblastoma radiopaque mass surrounded by radiolucent line surrounded by radiopaque line The Radiology of Benign Neoplasms

167 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

168 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

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175 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

176 Copyright © 2004 by A. Ruprecht Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma Odontogenic Odontogenic The Radiology of Benign Neoplasms

177 Copyright © 2004 by A. Ruprecht Cementifying fibroma Ossifying fibroma Cemento-ossifying fibroma The Radiology of Benign Neoplasms

178 Copyright © 2004 by A. Ruprecht Cementifying fibroma all age groups, mainly around 40 radiolucent, mixed, radiopaque usually unilocular The Radiology of Benign Neoplasms

179 Copyright © 2004 by A. Ruprecht The Radiology of Benign Neoplasms

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