oral pathology – pathology of salivary glandsustavpatologie.upol.cz/_data/section-1/498.pdf ·...
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ORAL PATHOLOGY – PATHOLOGY OF JAWS
VII. practical training
3rd year Dentistry
Odontogenic cyst 1. Radicular Inflammatory Around apex of non-vital tooth frequent adults (20-60 years), 3× more common in the maxila than in the mandibula Clin: slow progression, may be asymptomatic, when infammed – pain+ edema RTG: bone resorption, size cca 1 cm Histology: cavity with squamous cell epithelium (Malassez rest), dense
chronic or mixed inflammatory infiltrace, cholesterol crystals
Radicular cyst
Odontogenic cyst
2. Follicular (dentigerous)
Associated with the crown of an unerupted (or partially erupted) tooth. The cyst
cavity is lined by epithelial cells derived from the reduced enamel epithelium of
the tooth forming organ.
The most common location of dentigerous cysts are the mandibular 3rd molars
and the maxillary canines
M:F=2:1
more common in childhood
RTG: well demarcated, size up to 10 cm
Histology: multilayered epithelium , fibrous wall, nerly no inflammation
Odontogenic cyst
3. Eruption cyst
Eruption cyst is a benign cyst associated with a primary or permanent tooth in its
soft tissue phase after erupting through the bone.
Derived from epithelium of enamel organ
Superficially in the gingiva
Odontogenic cyst
4. Keratocyst
a rare and benign but locally aggressive developmental cystic neoplasm. It most
often affects the posterior mandible.
Multiple reccurences
Malignant transformation to squamous cell carcinoma may occur
Males 20- 30 years
Mandibula
RTG: multilocular cyst
Histology: squamous cell epithelium, keratinization,
Keratocyst
Keratocyst
Odontogenic cyst
5. Gingival
newborns, small nodule in gingiva – proliferation of epithelial remnants of
dental crest
Histology: thin squamous epithelium with keratinization,
6. Periodontal (paradental)
inflammatory odontogenic cyst typically related to crown or root of partially
erupted molar tooth.
Odontogenic tumor
Rare, from remnants od dental crest,
Classification:
• Epithelial
• Mesenchymal
• Mixed
Epithelial odontogenic tumors
Ameloblastoma (Adamantinoma)
• The most common
• Manifestation 20-40 yars
• Mandibula
• Cystic, ill.defined borders – destructive growts
• Histology: Histopathology will show cells that have the tendency to move the nucleus away from the basement membrane. This process is referred to as "Reverse Polarization". The follicular type will have outer arrangement of columnar or palisaded ameloblast like cells and inner zone of triangular shaped cells resembling stellate reticulum
• Commom reccurences
• May be malignant transformation
Ameloblastoma (adamantinoma)
Ameloblastoma (adamantinoma)
Ameloblastoma (adamantinoma)
Mesenchymal odontogenic tumors
Cementoblastoma
• Childhood
• Both jaws
• Cementoblastic proliferation around molars
Cementoblastoma
Mesenchymal odontogenic tumors
Odontogenic myxoma
• arising from embryonic connective tissue associated with tooth formation.
• consists mainly of spindle shaped cells and scattered collagen fibers distributed through a loose, mucoid material.
• young people
• Ill - defined borders
• bone resorption
• often reccurences
Mesenchymal odontogenic tumors Odontogenic myxoma
Mezenchymal odontogenic tumors
Odontogenic myxoma
Mesenchymal odontogenic tumors
Odontogenic fibroma 55% in mandible
45% in maxilla
• 2/3 of maxillary tumors found in the anterior segment
• 4-80 years
• Females 69%
• Recurrence rate is low
• Cellular tumor with minimal ground substance and droplets of calcified matrix representing bone or atubular dentin
• Small round nests and irregular clusters of epithelial cells
Mesenchymal odontogenic tumors
Odontogenic fibroma
Mixed odontogenic tumors
Ameloblastic fibroma
• Childhood, adolescence
• Ameloblastic fibromas are neoplasms of odontogenic epithelium and mesenchymal tissues
• 2% of odontogenic tumors
• Uni or multilocular cysts
Mixed odontogenic tumors Ameloblastic fibroma
Mixed odontogenic tumors
Odontoma • 66% of odontogenic tumors are odontomas • hamartoma • Between 10 and 20 years • More often in maxila • compound odontoma – three separate dental tissues (enamel, dentin and
cementum) no definitive demarcation of separate tissues between the individual "toothlets
• Complex odontoma – type is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities.
Mixed odontogenic tumors Odontoma
Mixed odontogenic tumors Odontoma
Ameloblastic fibrosarcoma
• Rare malignant variant of ameloblastic fibroma
• Invazive and destructive growth, minimal metastases
Ameloblastic fibrosarcoma
Ameloblastic fibrosarcoma