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

2. 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

3. 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 .

4. 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

5. 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 .

6. 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

7. 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

8. 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

10. 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

11. 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 .

12. 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

13. 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

15. 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.

16. 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.

17. 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.

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

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

20. 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.

21. 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.

22. 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

23. 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.

24. Compound odontoma many small teeth
Most common sites are anterior maxilla

25. 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 .

26. 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

27. 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

28. 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

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