Odontogenic tumors are growths that develop in the jawbones or soft tissues of the mouth, arising from the tissues that form teeth. These tumors can be benign or malignant and vary widely in their presentation and behavior. Benign tumors include ameloblastoma, odontoma, and cementoblastoma, while malignant tumors include ameloblastic carcinoma and odontogenic sarcoma. Treatment typically involves surgical removal, and prognosis depends on the type and stage of the tumor.

1. Odontogenic tumors
Benign Malignant
Sclerosing odontogenic
carcinoma
Ameloblastic carcinoma
Clear cell odontogenic carcinoma
Ghost cell odontogenic carcinoma
Primary intraosseous carcinoma
NOS
Odontogenic carcinosarcoma
Odontogenic sarcomas
Epithelial Adenomatoid odontogenic tumour
Squamous odontogenic tumour
Calcifying epithelial odontogenic
tumour
Ameloblastoma, unicystic
Ameloblastoma,
extraosseous/peripheral
Ameloblastoma, conventional
Adenoid ameloblastoma
Metastasizing ameloblastoma
Mesenchymal Odontogenic fibroma
Cementoblastoma
Cemento-ossifying fibroma
Odontogenic myxoma
Mixed Odontoma
Primordial odontogenic tumour
Ameloblastic fibroma
Dentinogenic ghost cell tumour

2. Ameloblastoma :
 is a benign odontogenic tumor generally present in the jaw bone. The tumor originates from the
residual epithelium of the tooth germ.
Essential features:
 Slow growing, locally aggressive odontogenic epithelial neoplasm.
 Most commonly occurs in mandible.
 Multiple microscopic variants.
 bout 80% of ameloblastomas occur in the mandible mainly the third molar region ( ramus region)
and the remaining 20% in the upper jaw.
Biological subtypes :
Conventional ameloblastoma :
 Palisading of columnar cells around epithelial nests in apattern similar to that of ameloblasts of
the enamel organ.
 Central to these cells are loosely arranged cells that mimic the stellate reticulum of the enamel
organ.
 Most commonly grossly solid / multicystic, expansile, locally aggressive, requiring resection with
uninvolved margins.
 Slow growing, painless expansion of the involved jaw.
Increased size often related to more clinically significant symptoms :
 Malocclusion.
 Loose teeth.
 Pain possible if infected or hemorrhaging into tissues.
 Very large tumors may cause facial deformity, restrict mouth opening and eventually lead to
airway obstruction.

3.  Microscopic variants include follicular, plexiform, basal, acanthomatous, granular and
desmoplastic.
Ameloblastoma, unicystic type:
 Occurs as single cystic cavity with or without intramural growth.
 Usually asymptomatic; may be found incidentally on radiographic exam.
 Microscopic variants include luminal, intraluminal and mural.
Extraosseous / peripheral type:
 Most commonly occurs within gingiva.
 Peripheral ameloblastoma accounts for 1% of ameloblastoma cases.
 Usually asymptomatic.
 Found in soft tissue of posterior gingiva and retromolar area.
 Predilection for lingual side of mandible.
Metastasizing ameloblastoma ( malignant ) : (Rare)
 Usually metastasizes to lymph nodes or lung, other sites possible with organ associated
symptoms.
Calcifying epithelial odontogenic tumor (CEOT) : also known as Pindborg tumor.
 is a rare benign but locally aggressive odontogenic neoplasm, accounts for <1% of all
odontogenic tumors. CEOT is usually seen in the posterior area of the mandible in-between 30
and 50 years of age without definite sex predilection.
 The origin of CEOT is controversial, although it is believed to be derived from the oral epithelium,
reduced enamel epithelium, stratum intermedium or remnants of dental lamina.
 Radiologically, CEOT is characterized by unilocular or multilocular radiolucency that often
exhibits mixed radiographic feature (65%) due to the presence of scattered flecks of
calcifications, often produce a typical “snow driven’’ appearance.

4.  histopathological features : presence of eosinophilic amyloid-like substances and concentric
calcified areas as “Liesegang” ring-like pattern.
Adenomatoid odontogenic tumor :
 are most common in the anterior region of the jaws in young female patients associated with
impacted teeth.
 it is Epithelial odontogenic hamartom containing pesudoducts and enameloid.
 Also called the tumor of two - thirds as two - thirds of cases occur in female patients in the
maxilla, surrounding an impacted tooth.
 Radiologically : Most commonly appear as well defined, unilocular radiolucencies. May also
appear as mixed density or opaque lesions.
Squamous Odontogenic Tumor : ( rare )
 benign, locally infiltrative neoplasm of the jaws that appears to originate from the rests of
Malassez, gingival surface epithelium or from remnants of the dental lamina.
 Lesions always occur within the alveolar bone.
 It is a triangular, unilocular radiolucent lesion located between the roots.
 In histology, islands of mature squamous epithelium are observed.

5. Odontogenic fibroma :
 Rare, benign mesenchymal odontogenic tumor composed of mature fibrous tissue with variable
amounts of inactive appearing odontogenic epithelium.
Two common variants:
 Intraosseous or central odontogenic fibroma.
 Extraosseous or peripheral odontogenic fibroma, centered in gingival tissues associated with
tooth bearing regions of jaws.
Sites :
 Mandible and maxilla affected equally.
Peripheral odontogenic fibroma :
 More common along anterior gingival region.
Central odontogenic fibroma :
 Most involving mandible are posterior to first molar.
 Most involving maxilla are anterior to first molar.
Odontogenic myxoma : also known as fibromyxoma.
 a rare benign tumour of the jaw and characteristically presents as a slow, painless, bony
expansion It is most commonly associated with an unerupted tooth and probably arises from the
mesenchymal portion of the tooth germ.

6.  Essential features : Stellate, spindle shaped, round cells arranged haphazardly in abundant,
fibrillary myxoid / mucoid stroma with infiltration into surrounding bone.
 More common in mandible (67%) than maxilla (33%) In both the mandible and maxilla, more
common posteriorly.
 Radiographic features : Most lesions are separated by straight septa forming square,
rectangular or triangular spaces and show a “honeycomb”, “soap bubble” or “tennis racquet”
appearance.
Cementoblastoma :
 is a rare odontogenic tumor characterized by the formation of a mass of cementum or
cementum-like tissue attached to and replace the roots of a tooth.
 The most common site for occurrence of cementoblastoma is mandibular molar area.
 Histologically, cementoblastoma is characterized by masses of hypocellular cementum
embedded in a fibrovascular stroma.
Cemento-ossifying fibroma :
 Benign fibro-osseous neoplasm Characterized by production of bone and cementum-like
calcifications in a fibrous stroma.

7.  It develops from undifferentiated mesenchymal cells originating from the periodontal ligament.
 It is observed a little more frequently in 20-40 years old and women.
 It presents as a slowly growing, expansive swelling in the premolar-molar region of the mandible.
 Histopathology : Spindle or oval-shaped fibroblasts producing collagen and mineralized bone
trabeculae Oval-round shaped cementum like material.
Odontoma : (common on children)
 Mixed epithelial and mesenchymal tumor-like malformation (hamartoma) composed of dental
hard and soft tissues.
Subdivided into :
 compound odontoma : composed of multiple miniature teeth usually occurs in anterior maxilla.
 complex odontoma : a conglomerate mass of enamel and dentin usually occurs in posterior
mandible.
Multiple odontomas may occur as a component of:
 Gardner syndrome (familial colorectal polyposis).
Ameloblastic fibroma : ( common in childeren and teenagers)
 is an extremely rare true mixed benign tumor that can occur either in the mandible or maxilla.
 presenting as a slow, painless jaw expansion and appears as a unilocular radiolucency.

8.  associated with an unerupted tooth, usually in the mandible.
 Radiographically, ameloblastic fibromas are unilocular lesions, occasionally multilocular when
larger, with smooth well-demarcated borders.
 in histology: Small islands and cords of markedly attenuated ameloblastic epithelium two cells
thick within dense collagenous stroma that is often immature.
Dentinogenic Ghost Cell Tumor :
 is a rare tumorous form of calcifying odontogenic cyst . More solid neoplastic variant of
Calcified Odontogenic Cyst.
 It occurs at a later age than Calcified Odontogenic Cyst.
 It can be seen in benign or malignant (dentinogenic ghost cell odontogenic carcinoma) form.
 Benign ones may show malignant transformation by time.
Primordial odontogenic tumour :
 Most of these reported cases were observed as well-defined unilocular or multilocular
radiolucent lesions close to the crown of an unerupted tooth. Patients were mostly in the first
two decades of life (3-19 years old), manifesting with bone swelling, root resorption of the
involved teeth and buccal or lingual cortical expansion.