DrTorabi Kerman Dental School

MIXED ODONTOGENIC TUMORS Proliferating odontogenic epithelium in a cellular ectomesenchyme Varying degree of inductive effect enamel and dentin

Ameloblastic fibroma True mixed tumor May be early developing stage of odontoma

Clinical features Younger patients Slightly more common in males Asymptomatic Larger :swelling 70%posterior mandible

Radiographic features Radiolucent: multilocular or unilocular 75% with an unerupted tooth

Histopathologic features

Treatment and prognosis Conservative surgery Recurrence rate:0-18% in some series43.5% More aggressive surgery for recurrent lesions

Ameloblastic fibro-odontoma Ameloblastic fibroma +enamel and dentin Exhibiting progressive growth

Clinical features In children mean 10 years Posterior of jaws Male =females asymptomatic

Radiographic feature Well defined radiolucent, unilocular, Calcified material (radiodensity like tooth structure) Unerupted teeth

histopathology

Treatment and prognosis Conservative curretage Exellent

Ameloblatic fibrosarcoma Mean 27.5 years 80%in mandible male> female Pain and swelling rapid clinical growth

Ill-defined radiolucency

histopathology

Treatment and prognosis Radical surgical excision Locally aggressive 20%of these patients will succumb to their tumor

odontoma The most common odontogenic tumor Prevalence >other odontogenic is Hamartoma Compound>& complex Compound : multiple,small tooth-like Complex :no anatomic shape

Clinical features First 2 decade Mean age14 Asymptomatic Large odontoma up to6 cm Maxilla>mandible Compound more in anterior maxilla,compound in posterior early:Radiolucent with rim radioopaque Developed :radioopaue

histopathology Compound :multiple structures like tooth :Enamel matrix, pulp tissue, Complex :mature tubular dentin,odontogenic epithelium,cementum May be :odontogenic cyst

Tumors of odontogenic ectomesenchyme Odntogenic myxoma: Young adults Mean:25-30 No sex predilection Mandible> Small :no symptomatic Large :painless expansion Sometimes :rapid expansion accumulation myxoid ground substance

Radiographic features Unilocular or multilocular Displaced or resorption of teeth Irregular or scalloped margin Step ladder Soap bubble

histopathology Haphazardly arranged stellate, spindle shape, round Loose myxoid stroma Hyaluronic acid,chodroitin sulfate Cells:vimentin

Treatment and prognosis Small : curettage and periodic evaluation for at least5 years Large :extensive resection Recurrence :25% Myxosarcoma :no distant metastases

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