The hadith advises against suspicion, spying, listening to gossip, and having enmity with others. It encourages people to be brothers and avoid these false and harmful behaviors.

2. Hazrat Abu Huraira narrated
The Prophet (PBUH) said,
“Beware of suspicion( about others)
as suspicision is the falsest talk,
and do not spy upon each other,
and do not listen to the evil talk of
people about other’s affairs
and do not have enemity with one
another but be brothers”
Bukhari Book#62 Hadith# 74

4. Outline
 What is an odontogenic tumor
 Odontogenic tissues giving rise to
tumors
 Classification
 Clinical, radiographic and
histopathological features
 Take home message

5. WHAT IS A TUMOR?
Abnormal growth of tissue resulting from
uncontrolled progressive multiplication
of cells, serving no physiologic function.
ODONTOGENIC TUMOR?
Tumor arising from odontogenic tissue.

6. The Origin Of Odontogenic
Tumors
Ectodermal
(epithelial)
Dental lamina /
Epithelial rests of serres
Enamel organ /
Reduced enamel epithelium
Epithelial root sheath of
Hertwig’s /
Epithelial rest of Malassez
Mesenchymal
(C.T)
Dental papilla
Dental sac

7. Classification
Odontogenic
epithelium
Ameloblastoma
CEOT
(Pindborg tumor)
AOT
SOT
Clear Cell odontogenic
Carcinoma
Mixed
Ameloblastic Fibroma
Ameloblastic fibro
Odontoma
Ameloblastic
fibrosarcoma
Odontoameloblastoma
Odontoma
Odontogenic
Mesenchyme
Odontogenic
fibroma
Odontogenic
myxoma
Cementoblastoma
Granular cell
odontogenic tumor

9. Locally aggressive neoplasm of odontogenic epithe-
-lium that has a wide spectrum of histologic
pattern resembling early odontogenesis.
1. Dental lamina/Rest of serres
2. Enamel organ/Reduced enamel epithelium
3. Basal layer of oral mucosa
4. Epithelial lining of dentigerous cyst

10. Clinico-radiographic
types
Multicystic
Unicystic
Peripheral
Histopathologic types
Plexiform
Follicular
Desmoplastic
Acanthomatous
Granular cell
Basal cell

12. Raiographic Features
Soap bubble
Destructive radiolucent
lesion and root resorption

13. Desmoplastic A
 More common in anterior regions esp maxilla.
 Radiographicaly margins are ill defined
 Mixed radiolucent and radio-opaque appearance

14. Follicular Pattern Plexiform pattern

15. Granular cell variant Acanthomatous

16. Desmoplastic variant Basal cell variant

17. Radiographic
features
•Well circumscribed
Unilocular radiolucency
Younger age group most
commonly affected

18. Luminal
MuralIntraluminal

19. Mural Variant Intraluminal variant

20. Mural variant

21.  Painless non ulcerated, sessile or
pedunculated masses in gingival or
alveolar mucosa.
 Some lesions may cause superficial
bone erosion.
 Histological features are same as
intraoseous Ameloblastoma.

23.  Solid Ameloblastoma are treated with block
excision or resection followed by
immediate reconstruction.
 Margin of resection 1-1.5 cm past
radiographic margins.
 Luminal and intraluminal Enucleation
 Intramural resection with peripheral
osteotomy
 Perioheral types conservative local
excision
 Ameloblastic CA and Malignant A treated
more aggressively but prognosis is v poor.
 Patients should be followed indefinitely.

24. Question
 Resection / en bloc resection ?
 Marginal / segmental resection ?
 Partial resection ?
 Total resection ?
 Composite resection ?

25. Resection
Removal of tumor by incising
through uninvolved tissue around the
tumor.
Marginal resection; bony continuity not
disrupted
Partial resection; portion of jaw is removed
creating a continuity defect
Total resection; Complete bone is removed
with tumor, e.g mandibulectomy
Composite resection; tumor resection with
bone, soft tissue and lymph channels.

26. CEOT ( PINDBORG
TUMOR)Cells of origin unknown, dental lamina remnants
and stratum intermedium suggested.
Clinical features
•Mean age 40 yrs
•Mandible> maxilla
•Molar-ramus area
Radiographic features
•Unilocular or multilocular giving
honeycomb appearance
•May be complete radiolucent or
may contain small opacities
•Well circumscribed but sclerotic
margins may not always be
seen.

27. HISTOPATHOLOGY
•Large polyhedral cells in a fibrous stroma
•Nucei show considerable variation in size and
shape
•Extracellular amyloid of epithelial origin typical
of these tumors.
Liesegang rings
•Concentric calcific
rings with annular
staining pattern
seen in amyloid
material.

28. TRAETMENT
 Conservative local resection with a
narrow rim of surrounding bone is
treatment of choice.
 Recurrence 15%
 Rare malignant transformation

29. Probably originates from
reduced enamel epithelium
Clinical features;
 Teenagers mostly
affected
 F>M
 Anterior portion of jaws
 Maxilla>mandible
 Associated with crown
of an impacted tooth

30. 9%
53%2%
2% 7%
27%
AOT

31. HISTOPATHOOGY
•Thick capsule
•Polyhedral and spindle cells
•Ductlike structures of
columnar epithelium
Adenomatoid appearance

32. Follicular
73%
Peripheral
3%
Extrafollicular
24%

33. Adenomatoid OT
Radiographic features;
Folliclar; Well circumscribed unilocular
lesion, around the crown of an impacted
tooth.
Extrafolicular; Same but appear above,
between or superimposed over roots of
an unerupted tooth.
Small opaque foci are distributed
throughout the lesion.

34. Conservatively treated, enucleation is all
that is required.

35. SQUAMOUS ODONTOGENIC
TUMOR
Rare tumor thought to arise from dental lamina
rests or rests of Malassez.
Occurs over a wide age range and are randomly
distributed through mandible and maxilla.
Radiographically well circumscribed lucency
associated with cervical region of roots of
teeth.
Microscopically has some similarity to
ameloblastoma, but lacks peripheral columnar
palisaded layer.

36. CLEAR CELL ODONTOGENIC
TUMOR (CARCINOMA)
 Rare neoplasm
 Origin is unknown but location and histology
suggests odontogenic origin
 Usually found in women older than 60 years
 Locally aggressive and poorly circumscribed
 Metastasis to lungs and lymph nodes
 Radical surgery is required and recurrence rates
upto 50% are reported.

37. MESENCHYMAL TUMORS
ODONTOGENIC MYXOMA
Resembles microscopically dental pulp or
follicular C.T.
Clinical features
 Smaller asymptomatic, may cause bony
expansion.
 More common in mandible
 Mean age 30 yrs

38. RADIOGRAPHIC
FEATURES
 Unilocular or
Multilocular lucency
“ Soap bubble appe-
arance “
 Margins are irregular
 Lucent defect may
contain thin whispy
trabeculi of bone arr-
anged at right angle
to each other
“Stepladder pattern”

39. HISTOPATHOLOGY
 Cells are haphazardly
distributed through
loose abundant
myxoid stroma
containing only few
collagen fibrils.
 Bony islands

40. TREATMENT
 Surgical excision is treatment of choice
 Due to lack of encapsulation recurrence
rates are high if treated conservatively.

41. CENTRAL ODONTOGENIC
FIBROMA
 Rare tumor, more common in females
 Aprox 45% occur anterior to 1st molar
region in maxilla.
 Usually appears as multilocular
radiolucency causing bony expansion.
 Surgical excision or enucleation is
traetment
 Recurrence is rare

42. CEMENTOBLASTO MA/ TRUE
CEMENTOMA
 Rare benign neoplasm of cementoblasts
 Microscopically resembles
osteoblastoma but is connected or fused
to the root of a tooth.
 More common in posterior mandible
 Radiographically it is an opaque tumor,
usually surrounded by thick, uniform
radiolucent ring, contiguous with PDL
space.

43. MIXED TUMORS
Ameloblastic Fibroma and Fibro-odontoma
Except for presence of odontoma both are same
and considered together…
Clinical Features;
 Younger age group mean 12yrs
 F=M
 Mandibular molar area is favoured location
 Commonly asymptomatic

44. Radiographic
features
 Well circumscribed with
sclerotic margins
 Unilocular/ multilocular
 AF complete radiolucent,
AFO opaque focus
appears
 May be associated with
crown of impacted tooth

45. HISTOPATHOLOGY
 Fibrous capsule
 Myxoid C.T
 Evenly distributed
strands of epithelium
 In fibro-odontoma
one or more foci
containing enamel,
dentine and
cementum are found

46. TREATMENT
Because of encapsulation and general
lack of invasive capacity treated through
conservative surgical approaches like
curettage or excision.
Rare malignant counterpart Mlignant
Ameloblastic Fibrosarcoma has been
reported

47. ODONTOMA
Most common odontogenic tumor
Biologicaly may be considered as
Hamartomas, composite of enamel and
dentine.
Compound Odontoma;
Miniature or rudimentary teeth.
Complex odontoma;
Amorphous conglomeration of hard
tissue.

48. Question ?
Hamartoma ?
Choristoma ?

49. Hamartoma;
Excess of normal tissue in normal
location, e.g odontomas
Choristoma;
Excess of normal tissue in abnormal
location e.g osseous choristomas in
tongue

50. Clinical Features
Histopathology
 Younger adults
 Maxilla > mandible
 Compound O more
common in anterior
 Complex O more
common in posterior
regions
 Mostly associated
with impacted or
retained tooth
 Normal appearing
enamel, dentine,
pulp or cementum
may be seen

51. Radiographic Features
Compound O;
Numerour tiny opaque masses in a
single focus
Typically in tooth bearing area.
Complex O;
Amorphous opaque masses

52. TREATMENT
Limited growth potential
Enucleation is curative

53. TAKE HOME MESSAGE
 Most of the bony tumors of mandible
and maxilla have odontogenic origin.
 Clinical, radiographic and histopathology
correlation is required for diagnosis.
 Excision is treatment of choice.

54. THANK YOU
