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BENIGN TUMORS OF JAW



ODONTOGENIC TUMOR

Ameloblastoma

Squamous odontogenic tumor

Calcifying epithelial odontogenic tumor Adenomatiod odontogenic tumor

Odontogenic myxoma

Odontogenic fibroma

Benign cementoblastoma Odontoma

Ameloblastic fibroma

Ameloblastic fibro-odontoma



AMELOBLASTOMA

It is the most common odontogenic tumor.

It is a benign but locally invasive neoplasm

derived from odontogenic epithelium.

It has three different clinicopathologic subtypes : Multicystic ( 86 % )

Unicystic ( 13 % )

Peripheral ( extraosseus 1 % )



CLINICAL FEATURES

y Early symptoms are often absent, but late symptoms may

include a painless swelling, lose teeth. Malocclusion or

nasal obstruction.

y Maxillary tumors frequently perforate into the antrum and

may grow freely with extension into the nasal cavity,

ethmoid sinuses, and skull base.



RADIOGRAPHIC FEATURES It show a well circumscribed expansile soap bubble

radioluceny with clearly demarcated borders.



TREATMENT Treatment varies according to type and the growth

characteritics of each neoplatic entity.

The peripheral subype occurs as a soft tissue mass, which

can be treated successfully with complete excision.



SQUAMOUS ODONTOGENIC TUMOR

This is a hamartomatous proliferation of

odontogenic epithelium, probably arising from

the rests of Malassez.

CLINICAL FEATURES The maxillary central incisor-canine area and mandibular

molar area are most commonly involved.

Most cases are unifocal and tooth mobiliby is the usual chief

complaint.



CALCIFYING EPITHELIAL

ODONTOGENIC TUMOR

Also known as the Pindorg tumor, this is an

aggressive odontogenic neoplasm of epithelial

derivation.

CLINICAL FEATURES Most of the cases are associated with an impacted tooth and

the mandibular body or ramus is by far the most common

site.

The sign is cortical expansion. Pain is usually not a complaint.



RADIOGRAPHIC FEATURES. The tumor is well defined, expansile with root divergence,

and radiolucent with clacified flecks ( target appearance ).



TREATMENT It is done with simple surgical enucleation and recurrence

Is extremely rare.



ODONTOGENIC MYXOMA

This tumor is believed to originate from the

dental papilla or follicular mesnechyme.

CLINICAL FEATURES.

It is usually multilocular and expansile, sometimesassociatd with impacted teeth.

These are slow growing tumors but are aggressively

invasive and may become quite large.



RADIOGRAPHIC FEATURES. the radiolucency has coursing septae which look like a

finely reticulated spider web.



TREATMENT Treatment should be with en bloc resection to prevent

recurrence, although curettage may be attempted for more

fibrotic lesions.



ODONTOGENIC FIBROMA

This tumor shows more collagen and less ground

substance than the myxoma.

CLINICAL FEATURES.

When present, include swelling or depression of the palatemucosa with tooth mobility.



TREATMENT Complete removal of the tumor.

Recurrence is unlikely following



BENIGN CEMENTOBLASTOMA

This is a true neoplasm of cementoblasts.

CLINICAL FEATURES It occures most often on the first mandibular molars.

The cortex is slightly expanded both buccally and lingually

without pain.

The involved tooth is ankylosed to the tumor mass and

vital.

Percussion reveals an audible difference between affected

and unaffected teeth.



RADIOGRAPHIC FEATURES The apical mass may be lucent with either central opacities

or a solid opacity.

A thin radiolucent halo can be seen around densely calcified

lesoins.



CLINICAL FEATURES It doesn·t show any gender predelication.

Mostly it occurs in 2nd decade of life

Many times are found during investigation of delay

eruption of adjacent teeth or retained primary teeth.



RADIOGRAPHIC FEATURES

y PERIPHERY

The border of odontoma are well defined may be smooth or

irregular.

y LOCATION

Compound types of odontomas occur in anterior maxilla in

association with the crown of an unerupted canine.

Complex odontoma are found in the mandible first and

second molar area



TREATMENT Complex and compound types are removed by simple

excision.

They don·t recurre and are not locally invasive.



AMELOBLASTIC FIBROMA

They are benign, mixed odontogenic tumor.

They are characterized by neoplastic proliferation

of maturing and early functional ameloblast, as

well as the primitive mesenchymal component of the dental papilla.

Enamel, dentin and cementum are not formed in

this tumor.



CLINICAL FEATURES Most of this tumor occurs between 5 and 20 years of age

during the period of tooth formation.

They usually produce painless, slow growing expansion, and

displacement of the involved teeth.



RADIOGRAPHIC FEATURES. PERIPHERY

The borders of it are well defined and often corticated in

a manner similar to that of a cyst.

LOCATION They usually develop in the premolar-molar area of the

mandible.

In some cases tumor may involve the ramus.



TREATMENT

y A conservative surgical approach, including

enucleation and mechanical curretage of the

surrounding bone.



AMELOBLASTIC FIBRO-ODONTOMA

Ameloblastic fibro-odontoma is a mixed tumor

with all the elements of an ameloblastic fibroma

but with scatered collection of enamel and dentin

CLINICAL FEATURESy Features are similar to odontoma, often associated

with a missing tooth or tooth that has failed to erupt.

y No sex predilecation.



RADIOGRAPHIC FEATURES PERIPHERY

The tumor is mostly well defined and sometimes

corticated.

LOCATION Occur in the posterior aspect of the mandible.



TREATMENT Usually conservative ennucleation is used, although

recurrence has been reported

benign tumor of jaw...1

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