UNDER GUIDANCE OF :- SUBMITTED BY :-

DR. NAVEEN CHHABRA ALKA RANGRAY

DR. SHRUTI CHHABRA B.D.S 3
RD

DR. SHIKHA MALIK 976
DR. NITIN SAINI
ODONTOM
A
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ODONTOGENIC TUMOURS:-
Odontoma is a mixed odontogenic tumour.
Mixed odontogenic tumours are composed of
odontogenic epithelium and
ectomesenchymal elements.
Dental hard tissue may or may not be formed
in these lesions.
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CLASSIFICATION OF ODONTOGENIC TUMOURS:-
Tumours of odontogenic epithelium
a. Ameloblastoma
b. Calcifying epithelial odontogenic
tumour
c. Adenomatoid odontogeic tumour
d. Squamous odontogenic tumour
Mixed odontogenic tumours
a. Ameloblastic fibroma
b. Ameloblstic fibro odontoma
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c. Odonto ameloblastoma
d. Complex odontoma
e. Compound odontoma
Tumours of odontogenic ectomesenchyme
a. Odontogenic fibroma
b. Odontogenic myxoma
c. Cementoblastoma

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ODONTOMA

. It means a growth in which both the epithelial and
mesenchymal cells exhibit complete differentiation,with the
result that the functional ameloblasts and odontoblasts form
enamel and dentin.This enamel and dentin are usually laid
down in an abnormal pattern because the organization if the
odontogenic cells fail to reach a normal state of
morphodifferentiation.
Some uthors believe that odontoma represnts a
hamartomatous malformation rather than neoplasm

It refers to any tumour of the odontogenic origin.
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ETIOLOGY :-

Unknown.
Local trauma or tumour may lead to production of such
a lesion.
No prediliction for occurrence of odontoma in particular
sites of oral cavity.
Occur with great frequency between central incisors or
distal to maxillary third molar.
Either inherited or due to a mutant gene.

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CLINICAL FEATURES OF ODONTOMA

Mainly detected during the first 2 decades of ife
Mean age at the time of diagnosis is 14 years
Majority of these lesions are completely asymptomatic
Discovered on routine radiographic examination
Typically relatively small
Rarely exceed the size of a tooth in the area where they
are located

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Large odontomas more than 6 cm in diameter are
also seen
These large odontomas can cause expansion of the
jaw
Odontoms are frequently seen in maxilla as
compared to mandible
Ocassionally it develop completely within the gingival
soft tissues
Males are more prone as compared to females
Ocassionally become large and produce expansion of
bone with consequent facial asymmetry
Generally consists of impacted or unerupted teeth

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TYPES
COMPOSITE ODONTOMA-Composed of more
than one type of tissue



COMPOUND COMPLEX
ODONTOMAS ODONTOMAS



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COMPOUND ODONTOMA :-


Composd of multiple
small tooth like structures
More frequently diagnosed than complex
odontomas
Occur more commonly in anterior maxilla
Regularly shaped,solitary or multiple small
denticles

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Appears as bizzare peg shaped teeth that
show anatomic resemblance to normal teeth
They are formed of enamel and dentin,also
have variable amounts of cementum and
pulpal tissue
Incidence is found in 9-37% of cases
More common in females
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RADIOGRAPHICALLY :-


It appears as tooth like collection of
varying size and shape surrounded by a
narrow radiolucent zone

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RADIOGRAPHICALLY
COMPOUND ODONTOMA
A small cluster of tooth like
Structure..
Multiple toothlets
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HISTOPATHOLOGIC FEATURES


Consists of multiple structures resembling
small, single rooted teeth contained in a loose
fibrous matrix

Varying amounts of enamel matrix are often seen

Pulp tissue may be seen in coronal and root
portions of tooth like structures




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HISTOPATHOLOGY OF COMPOUND ODONTOMA
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COMPLEX ODONTOMAS



Much less common than compound
odontomas

In this case, the calcified dental tissues are
simply an irregular mass bearing no
morphologic similarity even to rudimentary
teeth

Occur more common in molar region of
either jaw

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Amorphous conglomeration of dental tissues
Appears as an irregular mass
There is no morphological similarity
These tumours are formed of enamel and
dentin but they can also have variable
amount of cementum and pulpal tissue
Found in 5-30% of cases
More commom in females
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RADIOGRAPHICALLY


Appears as calcified mass with the
radiodensity of tooth structure, which is
also surrounded by a narrow radiolucent
rim



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HISTOPATHOLOGIC FEATURES

Consists largely of mature tubular dentin
This dentin encloses clefts or hollow
circular structures that contained the
mature enamel that was removed during
de-calcification
Spaces may contain small amounts of
enamel matrix or immature enamel
Small islands of eosinophilic staining
epithelial ghost cells are present

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Represents remnants of odontogenic
epithelium that have undergone keratinization
and cell death from local anoxia

Thin layer of cementum is often present about
the periphery of mass

Ocassionally a dentigerous cyst may arise from
the epithelial lining of the fibrous capsule of a
complex odontoma


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HISTOPATHOLOGICALLY COMPLEX ODONTOMA
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TREATMENT AND PROGNOSIS

Surgical removal is the treatment of
odontoma

Chances of recurrence are rare

Prognosis is excellent

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REFRENCE
Textbook of oral pathology-SHAFERS
Textbook of maxillofacial pathology-NEVILLE
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