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DISORDERS OF MAXILLA AND MANDIBLE(CYSTS AND TUMOURS)

DNT 243. DR.SHAHZADI TAYYABA HASHMI. DISORDERS OF MAXILLA AND MANDIBLE(CYSTS AND TUMOURS). DEVELOPMENTAL ODONTOGENIC CYSTS. GINGIVAL CYST OF ADULT: Usually form after the age 40 Clinically, they form dome-shaped swellings less than 1cm in diameter.

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DISORDERS OF MAXILLA AND MANDIBLE(CYSTS AND TUMOURS)

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  1. DNT 243 DR.SHAHZADI TAYYABA HASHMI DISORDERS OF MAXILLA AND MANDIBLE(CYSTS AND TUMOURS)

  2. DEVELOPMENTAL ODONTOGENIC CYSTS GINGIVAL CYST OF ADULT: • Usually form after the age 40 • Clinically, they form dome-shaped swellings less than 1cm in diameter. • They are lined by very thin, flat, stratified squamous epithelium. • Can be treated by Enucleation

  3. INFLAMMATORY ODONTOGENIC CYST PERIAPICAL CYST: An Odontogenic cyst derived from rests ofMALASSEZthat proliferate in response to inflammation Rests of MALASSEZ are the remnants of HERTWIG’S EPETHELIAL root sheath that persist in the periodontal ligament after root formation is complete

  4. PATHOLOGY

  5. CLINICAL FEATURES • Develops at the apex of root adjacent to pulp canal opening • Measures less than 1cm in diameter RADIOGRAPHIC FEATURES: Appears as \ rounded, well-circumscribed radiolucency at the apex of a non-vital tooth

  6. HISTOPATHOLOGY AND TREATMENT • Characterized by a cavity lined with a layer of non-keratinized Squamous epithelium • Cysts are usually inflamed and neutrophils are present within the epithelial lining TREATMENT: • Surgical enucleation after extraction • If Periapical cyst is not removed, residual cyst may develop • A cyst that remains at the site of previously extracted tooth Is termed as Residual cyst

  7. NON-ODONTOGENIC CYSTS

  8. NASOPALATINE DUCT CYST(INCISIVE CANAL CYST) CLINICAL FEATURES: • Slow growing cysts • Occasionally they cause intermittent discharge with a salty taste • May cause swelling in the midline of the anterior part of the palate near the incisive foramen RADIOGRAPHIC FEATURES: • Oval or heart shaped radiolucency located in the midline of anterior maxilla between the roots of central incisors TREATMENT: • Surgical enucleation using a palatal approach

  9. NASOLABIAL CYST • A developmental cyst of the soft tissues of the anterior mucobuccal fold beneath the ala of the nose • Also known as Nasoalveolar Cyst CLINICAL FEATURES: • Unilateral or bilateral painless soft tissue swelling • Common in females TREATMENT • Surgical ENUCLEATION

  10. ODONTOGENIC And NON-ODONTOGENIC TUMOURS of JAWS

  11. IMPORTANT TYPES OF ODONTOGENIC TUMOURS BENIGN EPITHELIAL NEOPLASMS: • AMELOBLASTOMA and its variants • SQUAMOUS ODONTOGENIC TUMOUR (SOT) • CALCIFYING ODONTOGENIC TUMOUR (COT) • ADENOMATOID ODONTOGENIC TUMOUR (AOT) • CALCIFYING ODONTOGENIC CYST BENIGN MIXED EPITHELIAL AND CONNECTIVE TISSUE NEOPLASMS: • AMELOBLASTIC FIBROMA

  12. IMPORTANT TYPES OF ODONTOGENIC TUMOURS BENIGN CONNECTIVE TISSUE NEOPLASMS • ODONTOGENIC FIBROMA • ODONTOGENIC MYXOMA • CEMENTOBLASTOMA MALIGNANT EPITHELIAL NEOPLASMS • ODONTOGENIC CARCINOMAS • CLEAR CELL ODONTOGENIC CARCINOMA MALIGNANT CONNECTIVE TISSUE NEOPLASMS • ODONTOGENIC SARCOMAS

  13. BENIGN EPITHELIAL NEOPLASMS

  14. 1) AMELOBLASTOMA KEY FEATURES: • Most common odontogenic neoplasm • Usually present between ages 30 and 50 • Locally invasive but does not METASTASISE • Appears as Multilocular cyst radiographicaly • Most commonly forms in posterior mandible • Treated by excision

  15. TYPES OF AMELOBLASTOMA • COMMON AMELOBLASTOMA (polycystic) • UNICYSTIC AMELOBLASTOMA • PERIPHERAL ( EXTRAOSSEOUS) AMELOBLASTOMA 1) COMMON AMELOBLASTOMA (POLYCYSTIC ) : • Also known as simple/follicularAMELOBLASTOMA • Commonly located in mandible (molar and ramus area) RADIOGRAPHIC FEATURES: Soup Bubble appearance TREATMENT: • Marginal resection • Hemimandibulectomy / hemimaxillectomy

  16. 2) UNICYSTIC AMELOBLASTOMA CLINICAL FEATURES: • Found in younger patients (16-20 yrs) • Most common in mandible RADIOGRAPHIC FEATURES: • Unilocular • Well demarcated from adjacent area TREATMENT: • Enucleation • marginal resection

  17. 3) PERIPHERAL AMELOBLASTOMA CLINICAL FEATURES: • Lesion appear as firm sessile nodules of Gingiva that range in size from 0.5-2.0 cm • Most common in mandible RADIOGRAPHIC FEATURES: • Cup shapedradiolucency TREATMENT: • Surgical enucleation

  18. 2) ADENOMATOID ODONTOGENIC TUMOR (AOT) ETIOLOGY • Derivation from epithelial component of the enamel organ CLINICAL PRESENTATION • Most cases noted during second decade • Femalesare more affected • Anterior jaw location common (anterior maxilla) • Associated with unerupted tooth

  19. RADIOGRAPHIC FINDINGS • Well defined, unilocular, often adjacent to crown of uneruptedtooth • May be noticed by chance on a radiograph TREATMENT: • Surgical Enucleation

  20. 3) CALCIFYING EPETHELIAL ODONTOGENIC TUMOUR (CEOT) • Also known as PINDBORGTUMOUR • Usually present between age 40 and 70 • Most commonly forms in posterior mandible • Locally invasive but does not metastasize • May be unilocular or multilocular TREATMENT: • Treated by excision with a small margin

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