Adenomatoid odontogenic tumor

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Adenomatoid odontogenic tumor
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Specialty Dentistry

The adenomatoid odontogenic tumor is an odontogenic tumor [1] arising from the enamel organ or dental lamina.

Contents

Signs and symptoms

Two thirds of cases are located in the anterior maxilla, and one third are present in the anterior mandible. [2]

Two thirds of the cases are associated with an impacted tooth (usually being the canine).

Diagnosis

On radiographs, the adenomatoid odontogenic tumor presents as a radiolucency (dark area) around an unerupted tooth extending past the cementoenamel junction.

It should be differentially diagnosed from a dentigerous cyst and the main difference is that the radiolucency in case of AOT extends apically beyond the cementoenamel junction.

Radiographs will exhibit faint flecks of radiopacities surrounded by a radiolucent zone.

It is sometimes misdiagnosed as a cyst. [3]

Treatment

Treatment can involve enucleation. [4]

Epidemiology

It is fairly uncommon, but it is seen more in young people. Two thirds of the cases are found in females. [5]

Related Research Articles

Cyst Closed sac growth on the body

A cyst is a closed sac, having a distinct membrane and division compared with the nearby tissue. Hence, it is a cluster of cells that has grouped together to form a sac ; however, the distinguishing aspect of a cyst is that the cells forming the "shell" of such a sac are distinctly abnormal when compared with all surrounding cells for that given location. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, sometimes a cyst may resolve on its own. When a cyst fails to resolve, it may need to be removed surgically, but that would depend upon its type and location.

Ameloblastoma cell type benign neoplasm that has material basis in odontogenic epithelium

Ameloblastoma is a rare, benign or cancerous tumor of odontogenic epithelium much more commonly appearing in the lower jaw than the upper jaw. It was recognized in 1827 by Cusack. This type of odontogenic neoplasm was designated as an adamantinoma in 1885 by the French physician Louis-Charles Malassez. It was finally renamed to the modern name ameloblastoma in 1930 by Ivey and Churchill.

Dental follicle

The dental follicle, also known as dental sac, is made up of mesenchymal cells and fibres surrounding the enamel organ and dental papilla of a developing tooth. It is a vascular fibrous sac containing the developing tooth and its odontogenic organ. The dental follicle (DF) differentiates into the periodontal ligament. In addition, it may be the precursor of other cells of the periodontium, including osteoblasts, cementoblasts and fibroblasts. They develop into the alveolar bone, the cementum with Sharpey's fibers and the periodontal ligament fibers respectively. Similar to dental papilla, the dental follicle provides nutrition to the enamel organ and dental papilla and also have an extremely rich blood supply.

Dentigerous cyst

Dentigerous cyst, also known as follicular cyst is an epithelial-lined developmental cyst formed by accumulation of fluid between the reduced enamel epithelium and crown of an unerupted tooth. It is formed when there is an alteration in the reduced enamel epithelium and encloses the crown of an unerupted tooth at the cemento-enamel junction. Fluid is accumulated between reduced enamel epithelium and the crown of an unerupted tooth. Dentigerous cyst is the second most common form of benign developmental odontogenic cysts.

Dens evaginatus is a rare odontogenic developmental anomaly that is found in teeth where the outer surface appears to form an extra bump or cusp.

Osteoporotic bone marrow defect is a condition which may be found in the body of the mandible. It is usually painless and found during routine radiographs. It appears as a poorly defined radiolucency where there was a previous history of an extraction of a tooth. It may resemble a metastatic disease.

Periapical cyst

Commonly known as a dental cyst, the periapical cyst is the most common odontogenic cyst. It may develop rapidly from a periapical granuloma, as a consequence of untreated chronic periapical periodontitis.

Odontogenic keratocyst

An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. It most often affects the posterior mandible and most commonly presents in the third decade of life. Odontogenic keratocysts make up around 19% of jaw cysts.

Lateral periodontal cysts (LPCs) are defined as non-keratinised and non-inflammatory developmental cysts located adjacent or lateral to the root of a vital tooth.” LPCs are a rare form of jaw cysts, with the same histopathological characteristics as gingival cysts of adults (GCA). Hence LPCs are regarded as the intraosseous form of the extraosseous GCA. They are commonly found along the lateral periodontium or within the bone between the roots of vital teeth, around mandibular canines and premolars. Standish and Shafer reported the first well-documented case of LPCs in 1958, followed by Holder and Kunkel in the same year although it was called a periodontal cyst. Since then, there has been more than 270 well-documented cases of LPCs in literature.

Calcifying odontogenic cyst lesion of the jaws with features of both a cyst and a solid neoplasm

Calcifying odotogenic cyst is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. It is most common in people in their second to third decades but can be seen at almost any age. On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency. In one-third of cases, an impacted tooth is involved. Microscopically, there are many cells that are described as "ghost cells", enlarged eosinophilic epithelial cells without nuclei.

Glandular odontogenic cyst

The glandular odontogenic cyst is a rare odontogenic cyst. In 85% of cases, it is found in the mandible, especially in anterior areas. It is more common in adults in their fifth and sixth decades. On radiographs, it can appear as a unilocular or multilocular radiolucency. Since the glandular odontogenic cyst can range in size, treatment can be as simple as enucleation and curettage to en bloc resection of the affected jaw.

Squamous odontogenic tumors (SOTs) are very rare benign locally infiltrative odontogenic neoplasms of epithelial origin. Only some 50 cases have been documented. They occur mostly from 20-40 and are more common in males. Treatment is by simple enucleation and local curettage, and recurrence is rare.

An ameloblastic fibroma is a fibroma of the ameloblastic tissue, that is, an odontogenic tumor arising from the enamel organ or dental lamina. It may be either truly neoplastic or merely hamartomatous. In neoplastic cases, it may be labeled an ameloblastic fibrosarcoma in accord with the terminological distinction that reserves the word fibroma for benign tumors and assigns the word fibrosarcoma to malignant ones. It is more common in the first and second decades of life, when odontogenesis is ongoing, than in later decades. In 50% of cases an unerupted tooth is involved.

Odontoma benign tumour of dental tissue

An odontoma, also known as an odontome, is a benign tumour linked to tooth development. Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way. It includes both odontogenic hard and soft tissues. As with normal tooth development, odontomas stop growing once mature which makes them benign.

The central odontogenic fibroma is a rare benign odontogenic tumor. It is more common in adults, with the average age being 40. It is twice as likely to affect women than men. It is usually found either in the anterior maxilla or the posterior mandible. Radiographically it presents with either radiolucency or mixed radiolucency/opaque. The simple type is characterized by delicate fibrillar stroma of collagen containing fibroblasts; the WHO type is characterized by more mature fibrillar stroma of collagen. Treatment is by surgical removal

The odontogenic myxoma is an uncommon benign odontogenic tumor arising from embryonic connective tissue associated with tooth formation. As a myxoma, this tumor consists mainly of spindle shaped cells and scattered collagen fibers distributed through a loose, mucoid material.

The calcifying epithelial odontogenic tumor (CEOT), also known as a Pindborg tumor, is an odontogenic tumor first recognized by the Danish pathologist Jens Jørgen Pindborg in 1955. It was previously described as an adenoid adamantoblastoma, unusual ameloblastoma and a cystic odontoma. Like other odontogenic neoplasms, it is thought to arise from the epithelial element of the enamel origin. It is a typically benign and slow growing, but invasive neoplasm.

Nasopalatine duct cyst

The nasopalatine duct cyst (NPDC) occurs in the median of the palate, usually anterior to first molars. It often appears between the roots of the maxillary central incisors. Radiographically, it may often appear as a heart-shaped radiolucency. It is usually asymptomatic, but may sometimes produce an elevation in the anterior portion of the palate. It was first described by Meyer in 1914.

Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. It may contain air, fluids, or semi-solid material. Intra-bony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. That odontogenic epithelium is critical in normal tooth development. However, epithelial rests may be the origin for the cyst lining later. Not all oral cysts are odontogenic cyst. For example, mucous cyst of the oral mucosa and nasolabial duct cyst are not of odontogenic origin.
In addition, there are several conditions with so-called (radiographic) 'pseudocystic appearance' in jaws; ranging from anatomic variants such as Stafne static bone cyst, to the aggressive aneurysmal bone cyst.

A cyst is a pathological epithelial lined cavity that fills with fluid or soft material and usually grows from internal pressure generated by fluid being drawn into the cavity from osmosis. The bones of the jaws, the mandible and maxilla, are the bones with the highest prevalence of cysts in the human body. This is due to the abundant amount of epithelial remnants that can be left in the bones of the jaws. The enamel of teeth is formed from ectoderm, and so remnants of epithelium can be left in the bone during odontogenesis. The bones of the jaws develop from embryologic processes which fuse together, and ectodermal tissue may be trapped along the lines of this fusion. This "resting" epithelium is usually dormant or undergoes atrophy, but, when stimulated, may form a cyst. The reasons why resting epithelium may proliferate and undergo cystic transformation are generally unknown, but inflammation is thought to be a major factor. The high prevalence of tooth impactions and dental infections that occur in the bones of the jaws is also significant to explain why cysts are more common at these sites.

References

  1. Nigam S, Gupta SK, Chaturvedi KU (2005). "Adenomatoid odontogenic tumor - a rare cause of jaw swelling". Braz Dent J. 16 (3): 251–3. doi:10.1590/S0103-64402005000300015. PMID   16429194.
  2. Nonaka CF, de Souza LB, Quinderé LB (2007). "Adenomatoid odontogenic tumour associated with dentigerous cyst--unusual case report". Rev Bras Otorrinolaringol (Engl Ed). 73 (1): 129–31. doi:10.1016/s1808-8694(15)31135-6. PMID   17505612.
  3. Handschel JG, Depprich RA, Zimmermann AC, Braunstein S, Kübler NR (August 2005). "Adenomatoid odontogenic tumor of the mandible: review of the literature and report of a rare case". Head Face Med. 1: 3. doi:10.1186/1746-160X-1-3. PMC   1266042 . PMID   16270916.
  4. Vasconcelos BC, Frota R, Cardoso AB, Porto GG, Carneiro SC (2008). "Adenomatoid odontogenic tumor". Braz J Otorhinolaryngol. 74 (2): 315. doi:10.1016/s1808-8694(15)31107-1. PMID   18568215.
  5. "Odontogenic tumors". Archived from the original on 2011-07-20. Retrieved 2009-01-04.
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