Odontogenic tumors / dental implant courses by Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.for more details please visit www.indiandentalacademy.com
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Odontogenic tumors / dental implant courses by Indian dental academy
- 1. Odontogenic Tumors INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.com
- 2. OBJECTIVES At the end of the lecture student should be able to – Describe WHO classification of odontogenic tumors – Describe epidemiology,& etiology of ameloblastoma www.indiandentalacademy.com
- 3. INTRODUCTION • Odontogenic tumors are lesions derived from epithelial, ectomesenchymal &/or mesenchymal elements that are or have been a part of tooth forming apparatus. • Exclusively found in jaw bones (Intrabony or centrally located) or in the soft tissues overlying the tooth bearing areas (Peripherally located) www.indiandentalacademy.com
- 4. • Can occur at any age • Earliest classification by Broca in 1867 • Classified by WHO in 1971 and 1992 • Recent classification proposed in 2005 www.indiandentalacademy.com
- 5. Broca 1867 • French physician and Prof Of Pathology • Introduced the term ODONTOME • Any tumor arising from dental formative tissues • Suggested to classify the lesion according to the stage of development Malassez 1885 • Frenchmen Louis Charles Malassez • Minor modifications to Broca’s classifcation www.indiandentalacademy.com
- 6. Bland-Sutton’s 1888 • Laid down foundation for OT taxonomy • Based the classification on the cells from which the tumor arose • Included the odontogenic cysts and fibrous osteogenic tumors www.indiandentalacademy.com
- 7. Gabell, James & Paine (1914) • Epithelial odontomes – Arising from dental epithelium • Composite odontomes – Arising from both dental epithelium and mesenchyme • Connective tissue odontomes – Arising from dental mesenchyme only www.indiandentalacademy.com
- 8. Thoma & Goldman 1946 • Excluded cysts • Included enamelomas • Widely accepted by American academy of Oral Pathology www.indiandentalacademy.com
- 9. Pindborg & Clausen 1958 • Divided the tumors into epithelial and mesodermal • Further division based on inductive influence on mesenchyme www.indiandentalacademy.com
- 10. WHO 1971 • Lesions consisting of odontogenic epithelium – Ameloblastoma – Adenomatoid odontogenic tumor – Calcifying epithelial odontogenic tumor – Calcifying odontogenic cyst • Lesions consisting of odontogenic epithelium & mesenchyme – Ameloblastic fibroma – Ameloblastic sarcoma • Lesions consisting of odontogenic epithelium and calcified dental tissues – Odontoameloblastoma www.indiandentalacademy.com
- 11. • Lesions consisting of calcified dental tissues but without odontogenic epithelium – Complex odontome – Compound odontome – Dens invaginatus – Enameloma – Dentinoma – Cementoma • Lesions consisting of odontogenic mesenchyme – Fibroma – Myxoma www.indiandentalacademy.com
- 12. WHO 1992 Benign odontogenic tumors I.Odontogenic epithelium without odontogenic ectomesenchyme • Ameloblastoma • Squamous odontogenic tumor • Calcifying epithelial odontogenic tumor (Pindborg tumor) • Clear cell odontogenic tumor II.Odontogenic epithelium with odontogenic ectomesenchyme, with or without dental hard tissue formation • Ameloblastic fibroma • Ameloblastic fibrodentinoma (dentinoma) and ameloblastic fibro- odontoma • Odontoameloblastoma • Adenomatoid odontogenic tumor • Calcifying odontogenic cyst • Complex odontoma • Compound odontoma www.indiandentalacademy.com
- 13. III.Odontogenic ectomesenchyme with or without included odontogenic epithelium • Odontogenic fibroma • Myxoma (odontogenic myxoma, myxofibroma) • Benign cementoblastoma (cementoblastoma, true cementoma) www.indiandentalacademy.com
- 14. Malignant Odontogenic tumors • Odontogenic carcinomas • Malignant ameloblastoma • Primary intraosseous carcinoma • Malignant variants of other odontogenic epithelial tumors • Malignant changes in odontogenic cysts • Odontogenic sarcomas • Ameloblastic fibrosarcoma (ameloblastic sarcoma) • Ameloblastic fibrodentinosarcoma & Ameloblastic fibroodontosarcoma • Odontogenic carcinosarcomawww.indiandentalacademy.com
- 15. WHO 2005 1.Benign odontogenic tumors I.Odontogenic epithelium with mature, fibrous stroma without odontogenic ectomesenchyme • Ameloblastoma, – Solid / multicystic type – Extraosseous / peripheral type – Desmoplastic type – Unicystic type • Squamous odontogenic tumour • Calcifying epithelial odontogenic tumour • Adenomatoid odontogenic tumour • Keratinizing cystic odontogenic tumourwww.indiandentalacademy.com
- 16. II.Odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation • Ameloblastic fibroma • Ameloblastic fibrodentinoma • Ameloblastic fibro-odontoma • Odontoma – Complex type – Compound type • Odontoameloblastoma • Calcifying cystic odontogenic tumor • Dentinogenic ghost cell tumor www.indiandentalacademy.com
- 17. III.Mesenchyme and/or odontogenic ectomesenchyme with or without odontogenic epithelium • Odontogenic fibroma • Odontogenic myxoma / myxofibroma • Cementoblastoma www.indiandentalacademy.com
- 18. 2.Malignant odontogenic Tumours Odontogenic carcinomas • Metastasizing (malignant) ameloblastoma • Ameloblastic carcinoma – Primary type – Secondary type (dedifferentiated), Intraosseous – Secondary type (dedifferentiated), peripheral • Primary intraosseous squamous cell carcinoma – Solid type – Derived from keratocystic odontogenic tumour – Derived from odontogenic cysts • Clear cell odontogenic carcinoma • Ghost cell odontogenic carcinoma Odontogenic sarcomas • Ameloblastic fibrosarcoma • Ameloblastic fibrodentinosarcoma & fibroodontosarcoma www.indiandentalacademy.com
- 20. History • 1827- Reported by Cusack • 1868- Broca described it in detail • 1879- Falkson description • 1885- Malassez named it as Epithelioma Adamantin (Could arise from Debris Epitheliaux) • 1930- Churchill and Churchil & Ivy named it as AMELOBLASTOMA www.indiandentalacademy.com
- 21. Definition • Robinson defined it as “ A tumor that is usually unicentric, intermittent in growth, anatomically benign and clinically persistent” www.indiandentalacademy.com
- 22. Introduction • The ameloblastoma is a true neoplasm of odontogenic epithelial origin. • Second most common odontogenic neoplasm. • The incidence of ameloblastoma is at least equal to the incidence of all the other odontogenic neoplasms combined • The ameloblastoma may occur centrally within bone or peripherally, without an intraosseous component, in the soft tissues overlying the alveolar ridge. • Intraosseous lesions outnumber peripheral lesions by at least a 9:1 margin. www.indiandentalacademy.com
- 23. Epidemiological data • 1% of all tumors of oral cavity • Ameloblastoma occurs over a broad age range. Average age at diagnosis in the age range of 33 to 39. • Only about 10% of cases are reported to arise in children, and less than one third of those occur in children younger than 10 years. • No significant sex predilection has been reported. • Increased incidence of ameloblastoma in black individuals • Asians as the population with the greatest number of affected patients. www.indiandentalacademy.com
- 24. Etiology • Previous oral infection • Extraction of teeth • Injury to teeth • Trauma/Inflammation • Dietary deficiencies • Polyoma virus • Paramyxovirus www.indiandentalacademy.com
- 25. Origin • The exact origin of ameloblastoma is not known – Enamel organ – Cell rests of Serres – Cell rests of Malassez – Oral mucosa – Epithelial lining of odontogenic cysts www.indiandentalacademy.com
- 26. Site of occurrence • Mandible is the most commonly affected area (more than 80% of all cases occurring there). • Molar-Angle-Ramus area is involved three times more commonly than are the premolar and anterior regions • Equivalent incidence in the maxillary anterior & posterior region. www.indiandentalacademy.com
- 27. • Maxillary tumors tend to occur in slightly older patients than do mandibular lesions • Asians seem to have fewer tumors involving the ramus than do whites or blacks, whereas blacks have an increased frequency of tumors in the anterior mandible compared with the other two groups. www.indiandentalacademy.com
- 28. SUMMARY • Various researchers have classified odontogenic tumors which were based on tissue of origin, whether epithelial, mesenchymal or both • WHO classification is the most widely accepted & used, which was first classified in 1971,further modified in 1992 & latest in 2005 • It is categorized into three, based on, whether the tumor originates from odontogenic epithelial tissue in odontogenic area, or ectomesenchyme, or both • Epidemiology,& Etiology of Ameloblastomawww.indiandentalacademy.com
- 29. BIBLIOGRAPHY • Text book of oral pathology Shafer's, 5 & 6th edition • Odontogenic Tumors & Allied Lesions Reichart/ Philipsen Ist edition • Color Atlas of Oral Diseases Cawson, R. 2nd edition • Oral and Maxillofacial Pathology Neville, Brad W. 2nd • Lucas’s Pathology Of Tumor’s of the Oral Tissues • Cawson, R. A., Bennie, W. H 5th edition www.indiandentalacademy.com