1. The document discusses and compares different types of odontogenic tumors including ameloblastoma, odontogenic fibroma, odontogenic myxoma, benign cementoblastoma, adenomatoid odontogenic tumor, ameloblastic fibroma, compound odontome, and complex odontome. 2. It provides information on histology, age, sex, location, symptoms, radiographic features, histopathology, and treatment for each tumor type. 3. The goal is to help test and differentiate between these odontogenic tumors based on important diagnostic criteria.

1. 1
SIMPLIFIED DENTISTRY
Test yourself and answer these very important questions :
1. Discuss Histological pattern of unicystic ameloblastoma (histological types) .
2. Compare between benign ameloblastoma , malignant ameloblastoma , ameloblastic carcinoma .
Odo Epith Solid or Multisyctic 86% Unicystic 13% Peripheral 1% CEOT (pindporg)
origin Enamel organ (developing – cell rest) – basal layer of oral mucosa – epith of dentigerous cyst Stratum intermedium of enamel organ
Age 3-7 d (av 33 ) 2 d (av 23) Middle age (av 33) Middle age (40)
Sex Equal Equal Equal Equal
Site 85% post.mandible
15% post.maxilla
90% post.mandible Gingiva or alveolar mucosa in
post area
Central intraosseous (post.mandible )
Peripheralextraosseous (ingingiva)
symptoms Painless
Slowly growing
Bone expansion
with invasion
Egg shell crackling
Painless
Slowly growing
Bone expansion
with invasion
Egg shell crackling
Painless
Slowly growing
Sessile or pedunculated
not ulcerated mass
Painless
Slowly growing
Bone expansion
with invasion
Egg shell crackling
R/F Multilocular radiolucent area
Small loculi honey combed
Large loculi soap bubble
Unilocular radiolucent area Slight erosion on bone surface
(Cup shape )
Unilocular radiolucent area contain
radiopaque areas
(driven snow or snowflakes)
Histopath Follicular  epith arrange in
discrete island or follicles
Abundant C.T (high collagens)
Plexiform  epith arrange in
interconnected strands
forming network
Scanty C.T (cellular)
Outar layercolumnar cells
with reversed polarity , basilar
cytoplasmic vacuolization
(ameloblast like cells)
Central massstellate
reticulum like cells
Luminal tumor is confined
to luminal surface of cyst by
fibrous C.T
Intraluminal tumor
nodules project from the
cystic lining
Mural tumor infiltrate the
cystic fibrous wall
(more aggressive – high
recurrence rate )
Islands of ameloblastic epith
found in lamina propria C.T
beneath surface epith of gingiva
The same varients
Sheets of polyhedral epith cells showing
pleomorphism ,multinucleated,
hyperchromatic .
Fibrous c.T stroma
Amyloid like subs (homogenous eosinophilic
by congo red , thioflavin T stains ) 
calcification  liesegang rings(rounded
calcified masses arrange in concentric mannar)
Treatment Enucleation with curettage
Recurrence  55:90%
Segmental resection
Marginal resection(most used)
Enucleation with curettage
Recurrence  10:20%
Surgical excision
Recurrence  25%
Enucleation or Resection
ODONTOGENIC TUMORS

2. 2
SIMPLIFIED DENTISTRY
Odonto
ectomesen
Odontogenic fibroma Odontogenic myxoma Benign cementoblastoma
True cementoma
Periapical cemental dysplasia
Periapical cementoma
Age 9-80 (av 40) Wide range (young age) 2d -3d (10-30) Middle age (30-50)
Sex Females > males (7:1) Equal Equal Black female > males (14:1)
Site Post.mandible – ant.maxilla Post.mandible Around roots of mandibular
premolars amd molars
Mand.incisor area
Symptoms Painless
slowly growing
Bone expansion
without invasion
Divvergance of root or
resorption  teeth looseness)
Painless
Rapidly growing
Bone expansion
with invasion
Painless
slowly growing
Bone expansion
without invasion
Painless
slowly growing
without Bone expansion
without invasion
R/F Unilocular or multilocular
radiolucent area
Root resorption or divergence
multilocular radiolucent area 
soap bubbles
Radiopaque mases attach to roots
with radiolucent at periphery
Root outline is obscured
May root resorption
Early stage radiolucency at apex
Second stage radiolucency
contains radiopacities
Late stage  radiopaque mass
Histopath Fibroblasts arranged in whorled
pattern with fine collagen fibrils
May inactive odontogenic epith is
present
Islands of cementum like tissue
(cementifying fibroma)
Osteoid tissue (ossifying fibroma
Stellate or spindle shaped cells in
abundant mucoid stroma
Collagen fibers may be seen
(fibromyxoma)
May inactive odontogenic epith is
present
Myxosarcoma is very rare
Cementoblasts form cementum
like tissue with entrapped cells
(cementocytes) 
cellular cementum
Cementoclasts  MNGCs
Vascular C.T stroma
Replacement of bone by
fibroblastic tissue
Formation of islands of cementum
in the vascular C.T which develop
and fuse to form large irregular
mass of  Acellular cementum
Treatment Surgical removal
No recurrence
Simple enucleation followed by
25% recurrence
Surgical removal with safety
margin
Surgical removal with( the related
tooth or root amputation)
No recurrence
No TTT
Typical cases not require biopsy

3. 3
SIMPLIFIED DENTISTRY
Mixed Ameloblastic fibroma Adenomatoid odontogenic tumor Compound odontome Complex odontome
Age Young age <21 2d Children , young adults Children , young adults
Sex Males > Females Females > Males( 2:1)
Site Post.mandible Ant.maxilla Ant.maxilla Ant.maxilla + post.mandibl
Signs Painless
slowly growing
Bone expansion
without invasion
Painless
slowly growing
Bone expansion
without invasion
Painless
slowly growing
Bone expansion
without invasion
may associated with permenant
dentition
Painless
slowly growing
Bone expansion
without invasion
may develop in place of
missing tooth
R/F Unilocular or multilocular
radiolucent area
Unilocular radiolucent area may show
radiopaque spots (snowflakes)
Follicular type  75% associated with
unerupted tooth extend beyond CEJ on root
Extrafollicular type  25% between roots of
erupted teeth
Early stage radiolucency
Later  numerous tooth like
structure radiopaque
surrounded by radiolucent rim
Early stage radiolucency
Later  nodular radiopaque
areas surrounded by
radiolucent rim
Histopath Biphasic tumor  Epith
Follicular : smaller follicles than
Ameloblastoma (rosette like)
Plexiform : anastomosing long
thinner strands
C.T  more cellular than that of
Ameloblastoma
Fibroblasts are plump stellate or
angular with little collagen fibers
Narrow cell free zone around
epith
Juxta epith hyalinization around
epith follicles or strands
Sheets or strands of spindle shape epith
cells with oval basilar (away from lumen)
nuclei  arranged in double layered
tubular structure (convoluted bands) with
thin layer of eosinophilic homogenous
material  expand to include central space
 duct like structure
Scanty fibrous C.T
May foci of abnormal dentine or enamel
space
Treatment  Enucleation
with no recurrance
Early stage  as ameloblastic
fibroma
Later many teeth like
structures arranged in normal
pattern (central core of pulp
surrounded by dentine covered
by enamel space coronally and
cementum radiculary
Irregular arranged masses of
enamel space , dentine ,
cementum
Ghost cells 
20% of cases