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The Radiology of Benign Neoplasms

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

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

4 Well Defined Poorly Defined

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

6 Corticated

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

8 Space Occupying vs. Non-Space Occupying

9 Space Occupying

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

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

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

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

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

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

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

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

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

48 The Radiology of Benign Neoplasms
I. Odontogenic

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

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

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

52 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]

53 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]

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

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

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

57 The Radiology of Benign Neoplasms

58 The Radiology of Benign Neoplasms

59 The Radiology of Benign Neoplasms

60 The Radiology of Benign Neoplasms

61 The Radiology of Benign Neoplasms

62 The Radiology of Benign Neoplasms

63 The Radiology of Benign Neoplasms

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

65 The Radiology of Benign Neoplasms

66 The Radiology of Benign Neoplasms

67 The Radiology of Benign Neoplasms

68 The Radiology of Benign Neoplasms

69 The Radiology of Benign Neoplasms

70 The Radiology of Benign Neoplasms

71 The Radiology of Benign Neoplasms

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

73 The Radiology of Benign Neoplasms
July 26, 1973

74 The Radiology of Benign Neoplasms
March 8, 1974

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

77 The Radiology of Benign Neoplasms
February 5, 1966

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79 The Radiology of Benign Neoplasms
December 29, 1967

80 The Radiology of Benign Neoplasms
July 19, 1968

81 The Radiology of Benign Neoplasms
January 11, 1969

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83 The Radiology of Benign Neoplasms

84 The Radiology of Benign Neoplasms

85 The Radiology of Benign Neoplasms
July 14, 1969

86 Recurrent Ameloblastoma
The Radiology of Benign Neoplasms Recurrent Ameloblastoma

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

88 The Radiology of Benign Neoplasms

89 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]

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

91 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?

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

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

94 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]

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

96 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

97 The Radiology of Benign Neoplasms

98 The Radiology of Benign Neoplasms

99 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]

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

101 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

102 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

103 The Radiology of Benign Neoplasms

104 The Radiology of Benign Neoplasms

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106 The Radiology of Benign Neoplasms

107 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]

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

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

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

111 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]

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

113 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

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115 The Radiology of Benign Neoplasms

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

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

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

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

121 The Radiology of Benign Neoplasms

122 The Radiology of Benign Neoplasms

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

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

125 The Radiology of Benign Neoplasms

126 The Radiology of Benign Neoplasms

127 The Radiology of Benign Neoplasms

128 The Radiology of Benign Neoplasms

129 The Radiology of Benign Neoplasms

130 The Radiology of Benign Neoplasms

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132 The Radiology of Benign Neoplasms

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

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

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

136 The Radiology of Benign Neoplasms

137 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

138 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

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

140 Odonto-ameloblastoma
The Radiology of Benign Neoplasms Odonto-ameloblastoma

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

142 The Radiology of Benign Neoplasms

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

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

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

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

147 Central odontogenic fibroma
The Radiology of Benign Neoplasms Central odontogenic fibroma

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

149 The Radiology of Benign Neoplasms

150 Peripheral odontogenic fibroma
The Radiology of Benign Neoplasms Peripheral odontogenic fibroma

151 The Radiology of Benign Neoplasms

152 The Radiology of Benign Neoplasms

153 The Radiology of Benign Neoplasms

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

155 The Radiology of Benign Neoplasms
Odontogenic myxoma

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

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

158 The Radiology of Benign Neoplasms

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160 The Radiology of Benign Neoplasms

161 The Radiology of Benign Neoplasms

162 The Radiology of Benign Neoplasms

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

164 Benign cementoblastoma
The Radiology of Benign Neoplasms Benign cementoblastoma

165 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

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

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175 The Radiology of Benign Neoplasms

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

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

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

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