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

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

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

Well Defined Poorly Defined

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

Corticated

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

Space Occupying vs. Non-Space Occupying

Space Occupying

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

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

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

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

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

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

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

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

The Radiology of Benign Neoplasms Cyst or Benign Neoplasm Malignant Neoplasm

The Radiology of Benign Neoplasms I. Odontogenic

The Radiology of Benign Neoplasms Odontogenic Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal

The Radiology of Benign Neoplasms Odontogenic Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal

. Dental Lamina Ameloblastoma Enamel organ Adenomatoid Odontogenic Tumor Dental Lamina Odontoma Root sheath of Hertwig Ameloblastic fibroma

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

The Radiology of Benign Neoplasms Ameloblastoma Age: 20 - 50 years (predominantly 30s and 40s) Mandible:Maxilla = 85:15 60% mandibular molar-ramus area

Ameloblastoma 10% 3% 2% 60% 15% 10%

Unilocular Multilocular (coarse septa) Soap bubble Honeycomb The Radiology of Benign Neoplasms Ameloblastoma Unilocular Multilocular (coarse septa) Soap bubble Honeycomb

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Ameloblastoma Displacement or resorption of teeth Extends beyond radiographic limits Superior aspect often lost

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

Keratocyst -> Ameloblastoma The Radiology of Benign Neoplasms Keratocyst -> Ameloblastoma

The Radiology of Benign Neoplasms July 26, 1973

The Radiology of Benign Neoplasms March 8, 1974

The Radiology of Benign Neoplasms

Simple Bone Cyst -> Ameloblastoma The Radiology of Benign Neoplasms Simple Bone Cyst -> Ameloblastoma

The Radiology of Benign Neoplasms February 5, 1966

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms December 29, 1967

The Radiology of Benign Neoplasms July 19, 1968

The Radiology of Benign Neoplasms January 11, 1969

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms July 14, 1969

Recurrent Ameloblastoma The Radiology of Benign Neoplasms Recurrent Ameloblastoma

Recurrent Ameloblastoma The Radiology of Benign Neoplasms Recurrent Ameloblastoma radiolucent areas circular pattern

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

Squamous odontogenic tumor (SOT) The Radiology of Benign Neoplasms Squamous odontogenic tumor (SOT)

Squamous odontogenic tumor (SOT) The Radiology of Benign Neoplasms 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 Squamous odontogenic tumor (SOT) radiolucent well-circumscribed semilunar associated with roots of teeth

The Radiology of Benign Neoplasms Squamous odontogenic tumor (SOT) locally invasive recur with conservative treatment excision is treatment of choice

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

Adenomatoid odontogenic tumor (AOT) The Radiology of Benign Neoplasms Adenomatoid odontogenic tumor (AOT)

Adenomatoid odontogenic tumor (AOT) The Radiology of Benign Neoplasms Adenomatoid odontogenic tumor (AOT) 10-20 (18 years of age) anterior maxilla or mandible radiolucent or with radiopaque foci may mimic dentigerous cyst

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

Calcifying epithelial odontogenic tumor (CEOT) The Radiology of Benign Neoplasms Calcifying epithelial odontogenic tumor (CEOT)

Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) The Radiology of Benign Neoplasms Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) 10-90 (mean 40) maxilla:mandible = 1:2 ramus-molar region

Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) The Radiology of Benign Neoplasms 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

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

Clear cell odontogenic tumor The Radiology of Benign Neoplasms Clear cell odontogenic tumor

Clear cell odontogenic tumor The Radiology of Benign Neoplasms Clear cell odontogenic tumor rare 60 years of age females maxilla or mandible

Clear cell odontogenic tumor The Radiology of Benign Neoplasms Clear cell odontogenic tumor radiolucent poorly circumscribed locally aggressive

The Radiology of Benign Neoplasms Odontogenic Epithelial Ameloblastoma Squamous odontogenic tumor Adenomatoid odontogenic tumor Calcifying epithelial odontogenic tumor Clear cell odontogenic tumor [Melanotic neuroectodermal tumor of infancy]

Melanotic neuroectodermal tumor of infancy The Radiology of Benign Neoplasms Melanotic neuroectodermal tumor of infancy

Melanotic neuroectodermal tumor of infancy (MNTI) The Radiology of Benign Neoplasms 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

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal

The Radiology of Benign Neoplasms Odontogenic Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Compound odontoma Complex odontoma

The Radiology of Benign Neoplasms Ameloblastic fibroma Ameloblastic fibro-odontoma Compound odontoma Complex odontoma

The Radiology of Benign Neoplasms –>Compound Odontoma Ameloblastic Fibroma–>Ameloblastic Fibro-odontoma –>Complex Odontoma

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Ameloblastic Fibroma primitive myxoid connective tissue resemblance to dental pulp strands of odontogenic epithelium 2 cells wide Ameloblastic Fibro-odontoma primitive myxoid connective tissue resemblance to dental pulp strands of odontogenic epithelium 2 cells wide cells differentiate to produce enamel and dentin

The Radiology of Benign Neoplasms Compound Odontoma Complex odontoma prominent enamel matrix often seen before final maturation of hard tissue enamel and dentin in the form of compound or complex odontoma Ameloblastic Fibro-odontoma prominent enamel matrix often seen before final maturation of hard tissue enamel and dentin in the form of compound or complex odontoma

The Radiology of Benign Neoplasms Odontogenic Epithelial with induction Ameloblastic fibroma Ameloblastic fibro-odontoma Odonto-ameloblastoma

Odonto-ameloblastoma The Radiology of Benign Neoplasms Odonto-ameloblastoma

Odonto-ameloblastoma The Radiology of Benign Neoplasms Odonto-ameloblastoma rare young, first decade ameloblastoma component odontoma component

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Epithelial Epithelial with induction/Mixed (epithelial and mesenchymal) Mesenchymal

The Radiology of Benign Neoplasms Odontogenic Mesenchymal Odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma

The Radiology of Benign Neoplasms Odontogenic Mesenchymal Odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma

The Radiology of Benign Neoplasms Odontogenic fibroma Central odontogenic fibroma Peripheral odontogenic fibroma

Central odontogenic fibroma The Radiology of Benign Neoplasms Central odontogenic fibroma

Central odontogenic fibroma The Radiology of Benign Neoplasms Central odontogenic fibroma rare all age groups radiolucent usually unilocular

The Radiology of Benign Neoplasms

Peripheral odontogenic fibroma The Radiology of Benign Neoplasms Peripheral odontogenic fibroma

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma

The Radiology of Benign Neoplasms Odontogenic myxoma

The Radiology of Benign Neoplasms Odontogenic myxoma 10-50 years (15-35, mean 30) maxilla:mandible 1:1 may be infiltrative and aggressive

The Radiology of Benign Neoplasms Odontogenic myxoma “tennis racket” appearance (neither coarse nor fine septa) cortical expansion root displacement rather than resorption

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma

Benign cementoblastoma The Radiology of Benign Neoplasms Benign cementoblastoma

Benign cementoblastoma The Radiology of Benign Neoplasms Benign cementoblastoma second or third decade, usually before 25 continuous with root , which is resorbed pulp vitality unrelated

Benign cementoblastoma The Radiology of Benign Neoplasms Benign cementoblastoma radiopaque mass surrounded by radiolucent line surrounded by radiopaque line

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms Odontogenic Mesenchymal Central odontogenic fibroma Odontogenic myxoma Benign cementoblastoma Cementifying fibroma

Cementifying fibroma Ossifying fibroma Cemento-ossifying fibroma The Radiology of Benign Neoplasms Cementifying fibroma Ossifying fibroma Cemento-ossifying fibroma

The Radiology of Benign Neoplasms Cementifying fibroma all age groups, mainly around 40 radiolucent, mixed, radiopaque usually unilocular

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms

The Radiology of Benign Neoplasms