Odontogenic and non-odontogenic tumors

Odontogenic and non-odontogenic tumors

Introduction

Group of polymorphic lesions; of diverse origin and nature.
Odontogenic tumors: pre-forming tissues of the tooth.
Non-odontogenic tumors: bone, vascular, nervous structures, etc.
Benign tumors +++

Interest :

Positive diagnosis.
Etiological approach.
Assessment of loco-regional extension.
Evolutionary monitoring.

Circumstances of discovery

Swelling-Pain.
Bone deformation.
Complication: pathological fracture.
Fortuitous.

Means of exploration

Standard X-ray:

– Incidences studying the entire facial mass:

Headshot face + profile
Blondeau’s incidence

-Special effects on the mandible:

Maxillary parade
Dental panoramic
Intraoral incidences.
CT scan of the facial mass:

Choice exam
Millimeter cuts Multi-strip scanner
SPC / APC
Multiplanar reconstructions

Denta-Scan:

Software for two-dimensional reconstruction of dental arches from axial slices.

MRI:

– Limited indication

– Classic sequences: T1, T2, T1+ injection of contrast product.

– Additional sequences: fatsat, gradient echo, MRI angiography, dynamic sequences.

Others:
Cervical ultrasound: its place is limited in tumor pathology
External carotid arteriography:

Pre-operative mapping
Preoperative embolization
Bone scan with technitium 99 or gallium 67

Radiological semiology

General characteristics in favor of benignity:

– Well-defined image, regular contours, condensation border.

– Narrow transition zone with healthy bone.

– Tilting, telescoping of neighboring teeth.

– Swelling, thinning or even rupture of the cortex without invasion of the soft parts.

General characteristics in favor of aggression:

Irregularity of contours.
Imprecise limits.
Cortical rupture.
Persistent reaction.
Invasion of soft tissues.
Tumors of dental origin:

– Tooth tone opacity.

– Presence of an included tooth within the lesion.

Odontogenic and non-odontogenic tumors

Results .

cysts :

Intraosseous cavities; the wall of which is lined with epithelium; and containing a secretory product.
Origin: – Dental ++++

– Non-dental.

Cysts of dental origin
Inflammatory cysts: (radiculo-dental cyst).

– Frequent +++

-Secondary to dental infections (caries, pulpitis).

– Rx: lacunar image, well-limited, surrounded by a thin border of osteosclerosis.

– Seat :

Odontogenic and non-odontogenic tumors

Odontogenic and non-odontogenic tumors Odontogenic and non-odontogenic tumors

Dentigerous cysts (pericoronary cysts)

Odontogenic and non-odontogenic tumors

C:\Users\tar\Desktop\stomatology\IMG_1813.PNG

Epidermoid cysts (keratocysts):

– Homogeneous lacuna, of variable size, regular contours, clear limits; polycyclic, leading to root resorption of adjacent teeth.

C:\Users\tar\Desktop\stomatology\IMG_1809.PNG

C:\Users\tar\Desktop\stomatology\IMG_1807.PNG Odontogenic and non-odontogenic tumors

Cysts of non-dental origin
Fissure cysts:

Of embryonic origin.
The diagnosis is suspected on the topography:

– Between the lateral incisor and the upper canine.

– On the midline: maxilla, mandibular

Odontogenic and non-odontogenic tumors

Nasopalatine duct cysts (incisive duct cyst):

– Topography: upper inter-incisor, heart-shaped.

Odontogenic and non-odontogenic tumors

Benign tumors

Benign tumors of dental origin:
Ameloblastoma :

– Epithelial tumor that derives from

ameloblasts (enamel cells).

– Age of onset: 15 to 30 years.

– Mandibular predominance: angle+++

– Benign tumors with local malignancy

Radiologically:

Unilocular cystic image.
Multilocular, multigeodic images: soap bubble or honeycomb image.
Large, incomplete image with some partition walls.

Odontogenic and non-odontogenic tumors

Odontogenic and non-odontogenic tumors Odontogenic and non-odontogenic tumors

C:\Users\tar\Desktop\stomatology\IMG_1789.PNG

Odontomes :

Frequently occurring amartomas
Age: before 20 years old.
We distinguish: complex odontoma; compound odontoma
Radiologically:
– At the beginning: radiolucent image gradually replaced by a compact, very dense opacity surrounded by a peripheral clear halo attached to the tooth or welded to the adjacent bone; with coarse heterogeneous calcifications (complex) and miniature teeth (compound). $C:\Users\tar\Desktop\stomatology\IMG_1795.PNG$ $C:\Users\tar\Desktop\stomatology\IMG_1794 - Copy.PNG$
Mesodermal tumors :

Rare
Anatomopathological diagnosis.
We distinguish:

– myxomas

– fibroid.

– cementomas

– cementoblastomas

Myxomas :

– Well-limited osteolytic lesion with the presence of thin intra-lesional trabeculae.

Cementoblastoma :

– Multiple small rounded formations of dense tone; well defined, confluent with the dental root(s) to which they are attached.

Odontogenic and non-odontogenic tumors

Cementomas :

Arises from cementoblasts.
Young subject 20-30 years old.
Opacity or osteocondensation of intermediate density between bone and dental density; surrounded by a clear halo.
Others:

Adenomatoid odontogenic tumor.
Calcified odontogenic epithelial tumor (Pindborg tumor).
Clear cell odontogenic tumor.
Calcified odontogenic cyst……

Benign tumors of non-dental origin:

Bone tumors:

osteoid osteoma, osteoma +++

C:\Users\tar\Desktop\stomatology\IMG_1812.PNG Odontogenic and non-odontogenic tumors

Cartilaginous tumors:

Chondroma.

Osteochondroma $C:\Users\tar\Desktop\stomatology\IMG_1825.PNG$

Chondroblastoma.

Chondromyxoid fibroma.

Connective tissue tumors:
Giant cell tumors

Malignant tumors

Malignant tumors of dental origin:

Exceptional
Odontogenic carcinoma and sarcoma.

Malignant tumors of non-dental origin:
Osteosarcomas:

Develop immature osteoid bone tissue.
Age: 10 to 20 years old.
Radiologically:

Poorly defined mixed lytic and condensing images, with rupture of the cortex, periosteal reaction and invasion of the soft tissues

C:\Users\tar\Desktop\stomatology\IMG_1841.PNG Odontogenic and non-odontogenic tumors

Chondrosarcomas:

Primary malignant bone tumor of cartilaginous origin.
Very rare craniofacial localization.
Age ≥ 40 years
Rx: osteolytic image; matrix

cartilaginous (calcifications)

in popcorn).

Odontogenic and non-odontogenic tumors

Ewing’s tumors:

Rare
Of ectodermal origin
Child and adolescent+++
Radiologically: permeative or moth-eaten osteolysis, destruction of the cortex, and invasion of soft tissues; periosteal reaction in the form of a sunbeam
Malignant hematological diseases:

Lymphoma.
Multiple myeloma $C:\Users\tar\Desktop\stomatology\IMG_1842.PNG$
Others

Metastases
Fibrosarcoma
Liposarcoma
hemangiosarcoma….

Differential diagnosis:

Osteodystrophy of undetermined origin

-Fibrous dysplasia:

– Chronic osteopathy

– Thickening with homogeneous condensation (flaky or

in frosted glass).

-Unique or polystotic.

C:\Users\tar\Desktop\stomatology\IMG_1824.PNG Odontogenic and non-odontogenic tumors

Osteodystrophy of undetermined origin

-Paget’s disease: Chronic, deforming and hypertrophic osteopathy.

C:\Users\tar\Desktop\stomatology\IMG_1843.PNG

Osteitis

Conclusion

Odontogenic and non-odontogenic tumors are numerous and the diagnostic approach requires a good knowledge of the various radiological aspects of these tumors.
Imaging, particularly CT scans, is an essential examination in the positive diagnosis and assessment of the extent of these tumors.
The definitive diagnosis of these tumors remains anatomopathological.

Odontogenic and non-odontogenic tumors

Untreated cavities can reach the nerve of the tooth.
Porcelain veneers restore a bright smile.
Misaligned teeth can cause headaches.
Preventative dental care avoids costly treatments.
Baby teeth serve as a guide for permanent teeth.
Fluoride mouthwash strengthens tooth enamel.
An annual checkup helps monitor oral health.

Odontogenic and non-odontogenic tumors

Odontogenic and non-odontogenic tumors

Leave a Comment Cancel Reply

Join Our Community