Treatment Treatment range from simple enucleation and curretage to block resection.

Calcifying epithelial odontogenic tumor Benign , locally aggressive tumor originated from the rest of dental lamina and/or REE . Rare tumor ( Less than 1%) ,could be mistaken with poorly differentiated squamous cell carcinoma

Calcifying epithelial odontogenic tumor Clinically : Affect adult ,40 years. More common in the mandible Molar and premolar region crown of the unerupted teeth. Either central or peripheral Intraosseous lesion mainly produce slowly growing painless mass at the mandible. Nasal obstruction is some time present in the maxillary lesion. Peripheral ( Extraosseous) is most commonly present in the anterior part of the mouth .

Calcifying epithelial odontogenic tumor Radiograph: The lesion appears as radiolucent area with poorly defined margin with fine flecks of radio-opacities (due to calcification). Impacted tooth and flicks of calcification

Histopathology the Pindborg tumor is quite unique. islands, strands, or sheets of epithelial cells in a fibrous stroma . Large areas of amorphous eosinophilic hyalinized (amyloid-like) material are also present. Calcifications, which are a distinctive feature of the tumor, develop within the amyloid-like material .

Treatment: Conservative local resection is the treatment of choice as these lesions are typically less aggressive than the ameloblastoma. With this treatment the recurrence rate is approximately 15 % and the overall prognosis is good

3-7% of all odontogenic tumors Adenomatoid tumor Uncommon benign tumor, originated from reduced enamel epithelium during enamel development 3-7% of all odontogenic tumors REE

Radiolucent area surrounding impacted tooth Adenomatoid tumor Clinical feature : Associated with an impacted. Asymptomatic Late adolescent or young adulthood . Female . 65% in the maxilla 75% associated with impacted teeth Small slow growing mass on the anterior maxilla, rarely premolar Cause an elevation of the upper lip. Pain and tooth placement. Rarely extra-osseous (Gingival) Radiolucent area surrounding impacted tooth

Adenomatoid tumor Radiography: AOTs typically appear as pericoronal radiolucencies, which may have radiopaque material (“snowflake” calcifications) within the lucency lesion appears as a well-circumscribed unilocular radiolucency that involves the crown of an erupted tooth, frequently a canine.radiolucency extend beyond the cemento-enamel junction

Adenomatoid tumor Histopathology: Sheets or islands of epithelial cells arrange around microcyst ( Ducts or ductules ) . Surrounded by thin vascularized stroma . The ductules bordered by ameloblast like cells . The lumen filled by homogenous eosinophilic material . Small foci of calcification .

Treatment Histologically, the adenomatoid odontogenic tumor is a well-defined lesion that is usually surrounded by a thick fibrous capsule Owing to this lesion being encapsulated, it separates easily from the surrounding bone.As such, an enucleation and curettage surgery is curative

Calcifying odontogenic cyst Uncommon . Developed from odontogenic epithelial remnants within gingiva, mandible, or maxilla. Affect young patients . More in females. Mostly seen in maxilla. The central (intraosseous ) lesions cause painless expansion of the buccal and lingual cortics. Rarely, peripheral (extraosseous ) mass presence

Unilocular or multilocular radiolucency with well demarcated margins. Radiographically Unilocular or multilocular radiolucency with well demarcated margins. May be associated with crown of unerupted tooth. Scattered irregular sized calcifications may be seen within the radiolucency. Calcifying odontogenic cyst. Maxillary radiolucent lesion containing calcifi ed structures. large radiolucency in the posterior maxilla.

A well-defined cystic lesion is found with a fibrous capsule and a lining of odontogenic epithelium. In some cases, the epithelial lining proliferates into the lumen so that the lumen is largely filled The epithelial lining similar to that of ameloplastoma composed of outer layer of palisaded columer basal cell and inner layer of stellate reticulum Presence of ghost cells (enlarged eosinophilic cells without visible nuclei) within the stellate reticulum –like area.

Calcifying odontogenic cyst. The cyst lining shows ameloblastoma-like epithelial cells, with a columnar basal layer. Large eosinophilic ghost cells are present within the epithelial lining.

Ameloblastic fibroma Benign mixed odontogenic tumors Rare biphasic tumor, because the epithelial and mesenchymal components are part of the neoplastic process. Resembles dental papillae

Clinical feature: Young adult and children. 70% in mandible frequently located at mandibular molar area, often over an unerupted tooth

Radiography: Generally, these lesions appear as either a unilocular or multilocular radiolucency. They tend to be well-defined and may have a sclerotic border. Approximately, 50 % are associated with an unerupted tooth.

Ameloplastic fibroma Histopathology : Microscopically characterize by thin strand and cords of odontogenic epithelium that resemble dental lamina at the cap and bell stages of early odontogenesis. The background compose of loose but cellular fibromyxoid connective tissue wildly separated by fibroblast, which resemble the immature dental papillae.

Odontomas Compound Complex Odontomas are developmental malformation ( hamartoma) of dental tissue, it is not neoplasim Compound Complex Compound: Composed of multiple small tooth-like structures. Complex: composed of a conglomerate mass of enamel and dentin, which bears no anatomic resemblance to a tooth

Odontomas Clinical feature : 70% of odontogenic tumor . More common in the maxilla. The compound type is more often in the anterior maxilla . complex type occurs more often in the posterior regions of either jaw. Most odontomas are small and do not exceed the size of a normal tooth in the region.

Compound odontoma many small teeth Most common sites are anterior maxilla

Complex odontoma disordered mass of dental hard tissue Most common site are posterior mandible or maxilla Treatment ; Odontomas are treated with simple enucleation and curettage . Not known to recur .

Odontomas Histopathology: Compound Complex The compound odontoma is composed of enamel, dentin and cementum arrange in recognizable tooth forms; some enamel matrix may be retained in immature and hypomineralized specimens. The complex odontoma is composed of enamel, dentin and cementum but these tissues are arranged in a random manner that bears no morphological resemblance to a tooth. Compound Complex

Odontogenic fibroma Benign mesenchymal odontogenic tumors Benign neoplasm derived from connective tissue of odontogenic origin containing widely scattered islands and strands of embryonic odontogenic epithelium and calcification. Two types: Central ( Intraosseous) type odontogenic fibroma . Peripheral odontogenic fibroma . Peripheral odontomas

Odontogenic fibroma Uncommon Patient age ranged from 9-80 years old with a mean of 40 years. More common in Female 60 % in the maxilla ,anterior to the first molar. In the mandible, 50 % occur in the posterior jaw. Small lesion usually asymptomatic. The larger associated with localized bony expansion or with the loosening of adjacent teeth

Odontogenic fibroma. Histopathology: The odontogenic fibroma appears as a fairly cellular fibrous connective tissue with collagen fibers arranged in interlacing bundles.