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Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
Odontogenic tumours part 4
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Odontogenic tumours part 4

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Mixed Odontogenic tumours followed by malignant odontogenic tumours

Mixed Odontogenic tumours followed by malignant odontogenic tumours

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  • 1. Derived from Ectomesenchyme Dr. Ali Tahir. M.Phil Oral Pathology
  • 2. Ameloblastic Fibroma A circumscribed lesion located over un-erupted molars in young patients consisting of odontogenic epithelium & connective tissue Dr. Ali Tahir. M.Phil Oral Pathology
  • 3. Clinical & radiographical features Younger patients, average age of 14 yrs Slow growing Common in mandible, molar areas, 75% associated with un-erupted tooth Small are asymptomatic, larger ones cause swelling Well defined Unilocular/Multilocular radiolucency Dr. Ali Tahir. M.Phil Oral Pathology
  • 4. Histopathology Thin stands & cords of odontogenic epithelium Background of embryonic connective tissue Zones of hyalinization Focal areas of calcification Dr. Ali Tahir. M.Phil Oral Pathology
  • 5. Odontoma Most common odontogenic tumour in west Hamartomatous (not true neoplasm) lesion commonly associated with unerupted teeth & composed of enamel, dentin, pulp & cementum in either recognizable tooth shapes (compound) or a solid, gnarled mass (complex) Dr. Ali Tahir. M.Phil Oral Pathology
  • 6. Odontoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 7. Clinical Features First & second decade, mean age 14 yrs Majority asymptomatic More common in maxilla Compound are common in anterior jaws Complex is common in post jaws Dr. Ali Tahir. M.Phil Oral Pathology
  • 8. Radiographic Compound  Unilocular, containing multiple radiopaque structures resembling miniature teeth  May contain 2-3 or upto 20-30 tooth like structures Complex:  Unilocular,usually small but may grow upto 10cm  Solid radiopaque mass  Surrounded by thin zone of radiolucency  Cortication Dr. Ali Tahir. M.Phil Oral Pathology
  • 9. Radiographic Usually associated with an unerupted tooth A developing odontoma may be radiolucent Radiographic findings are usually diagnostic Dr. Ali Tahir. M.Phil Oral Pathology
  • 10. HistopathologyComplex odontoma, A singled gnarled mass of enamel, dentine, pulp May also contain reduced enamel epith, secretory ameloblasts & odontoblasts Spherical calcifications Dr. Ali Tahir. M.Phil Oral Pathology
  • 11. HistopathologyCompound Enamel, dentin, pulp arranged in orderly fashion Surrounded by follicular connective tissue Dr. Ali Tahir. M.Phil Oral Pathology
  • 12. Ameloblastic Fibro-odontoma Expansile growth in young patients containing soft tissue components of ameloblastic fibroma & hard tissue components of complex odontoma Greater potential for growth & destruction Differs from odonto-ameloblastoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 13. Clinical Features First & second decade Common in post mandible Presents as slow growing swelling Usually in area of un-erupted tooth Pain is rare Dr. Ali Tahir. M.Phil Oral Pathology
  • 14. Radiographic Unilocular, well circumscribed, mixed radiopaque & radiolucent lesion Opacities are usually diffuse & nodular May contain an impacted tooth Variable amount of calcifications with radio-density of a tooth structure Dr. Ali Tahir. M.Phil Oral Pathology
  • 15. Dr. Ali Tahir. M.Phil Oral Pathology
  • 16. Histopathology Soft tissue component resembles ameloblastic fibroma  Strands & cords of epithelium resembling dental lamina  Background of embryonic CT containing fibroblasts Hard tissue component is mature or immature form of complex odontoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 17. Histopathology Dr. Ali Tahir. M.Phil Oral Pathology
  • 18. Odontogenic Malignancies Dr. Ali Tahir. M.Phil Oral Pathology
  • 19. Malignant Ameloblastoma andAmeloblastic Carcinoma Less than 1 % of the ameloblastomas show malignant behavior with the development of metastases. Malignant ameloblastoma is a tumor that shows histologic features of the typical (benign) ameloblastoma in both the primary and secondary deposits. Ameloblastic carcinoma is a tumor that shows cytologic features of malignancy in the primary tumor, in recurrence and any metastases. Dr. Ali Tahir. M.Phil Oral Pathology
  • 20. Radiographic With the malignant ameloblastoma, the appearance is similar to the typical solid/multicystic ameloblastoma. The ameloblastic carcinoma is often more aggressive with the lesion appearing as an ill-defined radiolucency with cortical destruction Dr. Ali Tahir. M.Phil Oral Pathology
  • 21. Dr. Ali Tahir. M.Phil Oral Pathology
  • 22. Ameloblastic Carcinoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 23. Clear Cell Odontogenic Carcinoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 24. Clear Cell Odontogenic Carcinoma An aggressive & destructive intra-osseous lesion consisting of poorly differentiated epithelial cells and clear cells Dr. Ali Tahir. M.Phil Oral Pathology
  • 25. CCOCClinical Features Uncommon Painful swelling of anterior mandible 5th-7th decade, mean age 58 years Female predilection Loosening of teeth Potentially aggressive, capable of frequent recurrences & metastasis Features indicative of odontogenic origin Dr. Ali Tahir. M.Phil Oral Pathology
  • 26. CCOC Radiographically shows honeycomb poorly defined radiolucency Dr. Ali Tahir. M.Phil Oral Pathology
  • 27. Histopathology Biphasic Mono-phasic Ameloblastomatous Dr. Ali Tahir. M.Phil Oral Pathology
  • 28. HistopathologyBiphasic Nests of cells with clear cytoplasm mixed with cells containing eosinophilic cytoplasmMonophasic Only clear cellsAmeloblastomatous Nests of cells showing central cystic change & squamous differentiation Peripheral nuclear palisading with reverse polarity Dr. Ali Tahir. M.Phil Oral Pathology
  • 29. Histopathology Dr. Ali Tahir. M.Phil Oral Pathology
  • 30. Primary Intra-osseous Carcinoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 31. Primary Intra-osseous CarcinomaWHO DefinitionA squamous cell carcinoma arising within the jaw, having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium Two possible origins  Lining of odontogenic cysts  From remnants of odontogenic epithelium (arising de novo) 2/3rd cases arise from odontogenic cysts PIOC occurs only in the jaw bones Dr. Ali Tahir. M.Phil Oral Pathology
  • 32. Primary Intra-osseous CarcinomaClinical & Radiographic features Male to female ration is 2.2:1 Mostly in elderly patients above 60 yrs Painful swelling Bony expansion may be present Destroys large areas of bone Root resorption Sensory disturbances/Neural involvement Local/regional metastasizes Dr. Ali Tahir. M.Phil Oral Pathology
  • 33. Primary Intra-osseous Carcinoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 34. D.D (histological) Acanthomatous ameloblastoma Ameloblastic carcinoma Squamous odontogenic tumour Mucoepidermoid carcinoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 35. Diagnosis Clinical findings Ruling out the extension from oral, gingival or sinus epithelium Radiograph/CT Histopathology Dr. Ali Tahir. M.Phil Oral Pathology
  • 36. Forgive your enemy... ...but remember the bastard’s name Dr. Ali Tahir. M.Phil Oral Pathology

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