Tumors of jaw bones

TUMORS OF JAW BONESTUMORS OF JAW BONES

TUMOR / NEOPLASM – TUMOR / NEOPLASM –

Abnormal new growth which results from Abnormal new growth which results from

Excessive, Autonomous, Uncoordinated ,Purposeless Excessive, Autonomous, Uncoordinated ,Purposeless Proliferation of Cells which continues its growth even Proliferation of Cells which continues its growth even after cessation of stimuli. after cessation of stimuli.


BENIGN TUMOR MALIGNANT TUMORBENIGN TUMOR MALIGNANT TUMOR

Grows slowly Rapid growthGrows slowly Rapid growth

Encapsulated Poorly circumscribed, Encapsulated Poorly circumscribed, Irregular Irregular

Adjoining structures Compressed Invasion of adjoining Adjoining structures Compressed Invasion of adjoining structures structures

Not Fixed Fixed to sorrounding Not Fixed Fixed to sorrounding structuresstructures

No Tendency Tendency towards No Tendency Tendency towards Ulceration Ulceration

& Hemorrhage& Hemorrhage

Exhibits no Metastasis Metastasis presentExhibits no Metastasis Metastasis present


All Tumors - 2 componentsAll Tumors - 2 components

ParenchymaParenchyma - Proliferating Tumor Cells - Nature & - Proliferating Tumor Cells - Nature & EvolutionEvolution

Supportive Stroma Supportive Stroma – Fibrous Connective Tissue & Blood – Fibrous Connective Tissue & Blood Vessels –Vessels –

Provide Framework on which Provide Framework on which Parenchymal Parenchymal

Tumor Cells Grow Tumor Cells Grow Suffix ‘ oma’ - Suffix ‘ oma’ - Benign TumorBenign Tumor

Malignant tumors of Epithelial Origin - Malignant tumors of Epithelial Origin - CARCINOMASCARCINOMAS

Malignant tumors of Mesenchymal Origin - Malignant tumors of Mesenchymal Origin - SARCOMAS SARCOMAS

BENIGN JAW TUMORS – 2 TYPESBENIGN JAW TUMORS – 2 TYPES

ODONTOGENIC TUMORSODONTOGENIC TUMORS

NONODONTOGENIC TUMORSNONODONTOGENIC TUMORS

BENIGN JAW TUMORSBENIGN JAW TUMORS

CLASSIFICATION OF ODONTOGENIC TUMORS CLASSIFICATION OF ODONTOGENIC TUMORS

( KRAMER, PINDBORG , SHEAR – 1992)( KRAMER, PINDBORG , SHEAR – 1992)

A. ODONTOGENIC EPITHELIUMA. ODONTOGENIC EPITHELIUM

1. Ameloblastoma1. Ameloblastoma

2. CEOT / Pindborg’s Tumor2. CEOT / Pindborg’s Tumor

3. Clear Cell Odontogenic Tumor3. Clear Cell Odontogenic Tumor

4. Squamous Odontogenic Tumor4. Squamous Odontogenic Tumor

B. Odontogenic Epithelium with Odontogenic Ectomesenchyme B. Odontogenic Epithelium with Odontogenic Ectomesenchyme

With / Without Dental Hard Tissue FormationWith / Without Dental Hard Tissue Formation

1. Ameloblastic Fibroma 1. Ameloblastic Fibroma

2. Ameloblastic Fibrodentinoma 5. Compound 2. Ameloblastic Fibrodentinoma 5. Compound OdontomeOdontome

3. OdontoAmeloblastoma 6. Complex 3. OdontoAmeloblastoma 6. Complex Odontome Odontome

4. Adenomatoid Odontogenic Tumor ( AOT)4. Adenomatoid Odontogenic Tumor ( AOT)

CLASSIFICATION OF ODONTOGENIC TUMORSCLASSIFICATION OF ODONTOGENIC TUMORS

C. Odontogenic Ectomesenchyme with / without Odontogenic C. Odontogenic Ectomesenchyme with / without Odontogenic epitheliumepithelium

1. Odontogenic Fibroma1. Odontogenic Fibroma 2. Myxoma2. Myxoma 3. Benign Cementoblastoma 3. Benign Cementoblastoma

NON ODONTOGENIC TUMORS (NON ODONTOGENIC TUMORS (WHO Classification)WHO Classification) A . OSTEOGENIC NEOPLASMSA . OSTEOGENIC NEOPLASMS Cemento Ossifying FibromaCemento Ossifying Fibroma B. NON NEOPLASTIC BONE LESIONSB. NON NEOPLASTIC BONE LESIONS Fibrous DysplasiaFibrous Dysplasia Cemento Osseous DysplasiaCemento Osseous Dysplasia - Periapical Cemento Osseous Dysplasia- Periapical Cemento Osseous Dysplasia - Focal Cemento Osseous Dysplasia- Focal Cemento Osseous Dysplasia - Florid Cemento Osseous Dysplasia - Florid Cemento Osseous Dysplasia

Classification Of Non Odontogenic TumorsClassification Of Non Odontogenic Tumors

C. C. CEMENTO OSSEOUS DYSPLASIASCEMENTO OSSEOUS DYSPLASIAS

CherubismCherubism

Central Giant Cell GranulomaCentral Giant Cell Granuloma

General Principles in Management of Jaw General Principles in Management of Jaw LesionsLesions

HISTORY OF LESIONHISTORY OF LESION Duration – Duration – Long without Pain – Benign NeoplasmLong without Pain – Benign Neoplasm Short , Rapid Growth – Malignant LesionShort , Rapid Growth – Malignant Lesion Mode of Onset - Mode of Onset - H/o Trauma - Osteogenic Sarcomas H/o Trauma - Osteogenic Sarcomas Rapid growth – BenignRapid growth – Benign Slow growth - MalignantSlow growth - Malignant Site & Shape Site & Shape Progress of Lesion – Progress of Lesion – Stationary, Continous, IntermittentStationary, Continous, Intermittent Change in Character of Lesion – Change in Character of Lesion – Ulcerations, FluctuationUlcerations, Fluctuation Associated Symptoms – Associated Symptoms – Pain , Paresthetia, Tenderness, Pain , Paresthetia, Tenderness, Lymphadenopathy, Difficulty in Lymphadenopathy, Difficulty in

breathingbreathing TrismusTrismus Recurrence Loss of Body weight HabitsRecurrence Loss of Body weight Habits


INSPECTIONINSPECTION Number Size Shape Color Surface Number Size Shape Color Surface Skin Over Swelling Pedunculated / SessileSkin Over Swelling Pedunculated / Sessile PALPATIONPALPATION Consistency Pulsations Fixity Lymph Node Consistency Pulsations Fixity Lymph Node

ExaminationExamination

IMAGINGIMAGING Plain Radiographs Plain Radiographs CT ScansCT Scans MRIMRI Angiographic StudiesAngiographic Studies Bone Scans / ScintigraphyBone Scans / Scintigraphy

BIOPSYBIOPSY

EXFOLIATIVE CYTOLOGY ASPIRATION BIOPSYEXFOLIATIVE CYTOLOGY ASPIRATION BIOPSY

FNAC EXCISIONAL BIOPSYFNAC EXCISIONAL BIOPSY

INCISIONAL BIOPSYINCISIONAL BIOPSY

Exfoliative Cytology - Exfoliative Cytology - Malignancy ,Scrapings are transfered to Malignancy ,Scrapings are transfered to slide ,slide ,

stained & examined under microscopestained & examined under microscope

Aspiration BiopsyAspiration Biopsy – Nature of lesion – Nature of lesion

FNACFNAC - Deep seated lesions ( salivary glands, neck, ) - Deep seated lesions ( salivary glands, neck, )

Excisional BiopsyExcisional Biopsy

Incisional BiopsyIncisional Biopsy


Goal of Treatment Goal of Treatment

Complete Eradication of lesionComplete Eradication of lesion

Preservation of normal tissuePreservation of normal tissue

Excision with least morbidityExcision with least morbidity

Restoration of tissue loss, form , functionRestoration of tissue loss, form , function

Long term follow upLong term follow up Gold ,Upton, & Marx 1991 – Terminology for Surgical Gold ,Upton, & Marx 1991 – Terminology for Surgical

ExcisionsExcisions

Enucleation Enucleation

CurettageCurettage

Marsupialization Marsupialization

RecontouringRecontouring

Resection with Continuity DefectResection with Continuity Defect

Resection without Continuity DefectResection without Continuity Defect

DisarticulationDisarticulation

General Principles in Management of General Principles in Management of Jaw LesionsJaw Lesions

ENUCLEATION With / Without CURETTAGE - ENUCLEATION With / Without CURETTAGE -

INDICATIONSINDICATIONS

- Small Benign Tumors , Non Aggressive- Small Benign Tumors , Non Aggressive

- - Tumors which tend to grow by Expansion rather than InfiltrationTumors which tend to grow by Expansion rather than Infiltration

- Distinct seperation between sorrounding bone & Lesion- Distinct seperation between sorrounding bone & Lesion

- Cortical margin of bone that separates Tumor / Cyst from bone- Cortical margin of bone that separates Tumor / Cyst from bone

Indicated in Following TumorsIndicated in Following Tumors

a) a) Odontogenic TumorsOdontogenic Tumors

Odontoma Ameloblastic Fibroma Ameloblastic Odontoma Ameloblastic Fibroma Ameloblastic FibroodontomaFibroodontoma

AOT CementoblastomaAOT Cementoblastoma


B) B) Non Odontogenic TumorsNon Odontogenic Tumors

Ossifying Fibroma Cherubism OsteoblastomaOssifying Fibroma Cherubism Osteoblastoma

Central Giant Cell GranulomaCentral Giant Cell Granuloma

C) C) Other LesionsOther Lesions

Hemangioma Neurofibroma NeurilemmomaHemangioma Neurofibroma Neurilemmoma

Eosinophilic GranulomaEosinophilic Granuloma


MARGINAL RESECTION / PERIPHERAL OSTEOTOMYMARGINAL RESECTION / PERIPHERAL OSTEOTOMY

RESECTION WITHOUT CONTINUITY DEFECTRESECTION WITHOUT CONTINUITY DEFECT

EN – BLOC RESECTIONEN – BLOC RESECTION

INDICATIONSINDICATIONS

- Benign lesions with known H/O Recurrence- Benign lesions with known H/O Recurrence

- Lesions that are incompletely Encapsulated- Lesions that are incompletely Encapsulated

- Recurrent Lesions previously treated by Enucleation- Recurrent Lesions previously treated by Enucleation

- Ameloblastoma, CEOT, Myxoma, Ameloblastic Odontoma, - Ameloblastoma, CEOT, Myxoma, Ameloblastic Odontoma,

Squamous Odontogenic Tumor Squamous Odontogenic Tumor

Benign Chondroblastoma , HemangiomasBenign Chondroblastoma , Hemangiomas

Allows for complete Excision of Tumor ,Continuity of Jaw Bone Allows for complete Excision of Tumor ,Continuity of Jaw Bone isis

maintained – Need for Secondary Cosmetic Surgery not maintained – Need for Secondary Cosmetic Surgery not requiredrequired


SEGMENTAL RESECTION OF JAWSEGMENTAL RESECTION OF JAW

- Infiltrative Lesions that have tendency to recur- Infiltrative Lesions that have tendency to recur

- Lesions which are close to Lower border, Posterior border - Lesions which are close to Lower border, Posterior border of mandible, of mandible,

- Lesions that extend to Maxillary sinus / Nasal cavity- Lesions that extend to Maxillary sinus / Nasal cavity

- Malignant Lesions with high recurrence potential- Malignant Lesions with high recurrence potential

- Maxillary Ameloblastomas with high Recurrence rate- Maxillary Ameloblastomas with high Recurrence rate

MAXILLECTOMYMAXILLECTOMY

AMELOBLASTOMAAMELOBLASTOMA

HistoryHistory

- Cuzack – 1827- Cuzack – 1827

- - Robinson –Robinson – Unicentric , NonFunctional , Intermittent in Growth, Unicentric , NonFunctional , Intermittent in Growth,

Anatomically Benign , Clinically PersisitentAnatomically Benign , Clinically Persisitent

- - WHO WHO – True Neoplasm of Enamel Organ which does not undergo – True Neoplasm of Enamel Organ which does not undergo

differentiation to the point of Enamel Formationdifferentiation to the point of Enamel Formation

- Benign but locally invasive Epithelial Odontogenic Neoplasm with- Benign but locally invasive Epithelial Odontogenic Neoplasm with

strong tendency to recurstrong tendency to recur- OriginOrigin - - - Late Development Source Late Development Source Cell Rests of Enamel Cell Rests of Enamel

OrganOrgan

Remnants of Dental Remnants of Dental LaminaLamina

Cell Rests of Malassez Cell Rests of Malassez

Follicular SacsFollicular Sacs


- Early Embryonic Sources – Early Embryonic Sources – Disturbances of Developing Enamel organDisturbances of Developing Enamel organ Dental Lamina Dental Lamina Tooth Buds Tooth Buds - Basal Cells of Surface EpitheliumBasal Cells of Surface Epithelium- Epithelium of Primordial , Dentigerous , Lateral Periodontal Epithelium of Primordial , Dentigerous , Lateral Periodontal

CystCyst- Heterotropic Epithelium from Pituitary Gland Heterotropic Epithelium from Pituitary Gland - Incidence - Incidence - 18% of all Odontogenic Tumors18% of all Odontogenic Tumors 3 – 4 th decade of life3 – 4 th decade of life- Site Site Mandible : Maxilla - 5:1Mandible : Maxilla - 5:1 Mandible – Posterior molar - 60 % Blacks – Anterior Mandible – Posterior molar - 60 % Blacks – Anterior

MaxillaMaxilla


Clinical FeaturesClinical Features

Early Stages – AsymptomaticEarly Stages – Asymptomatic

Slow growing, Painless, Hard , NonTender, Ovoid SwellingSlow growing, Painless, Hard , NonTender, Ovoid Swelling

Mobile Teeth, Ill Fitting Denture, Malocclusion, ExfoliationMobile Teeth, Ill Fitting Denture, Malocclusion, Exfoliation

Nasal ObstructionNasal Obstruction

ParesthetiaParesthetia

Egg shell cracklingEgg shell crackling

Non Encapsulated – invades by destroying rather than Non Encapsulated – invades by destroying rather than pushing pushing

Transform in to Malignant form ( 2 – 4 %)Transform in to Malignant form ( 2 – 4 %)


Radiological FeaturesRadiological Features

Unilocular Radiolucency - 6% Unilocular Radiolucency - 6%

Multilocular Radiolucency - 15%Multilocular Radiolucency - 15%

Honeycomb Appereance – Multilocular radiolucency with Honeycomb Appereance – Multilocular radiolucency with compartmentalized appearance due to Bony Septa – Giant cell compartmentalized appearance due to Bony Septa – Giant cell lesionslesions

Fibro Fibro MyxomaMyxoma

Root Resorption ( 30%)Root Resorption ( 30%)

Tooth DisplacementTooth Displacement

Buccolingual cortical Expansion - 80%Buccolingual cortical Expansion - 80%

Neurovascular bundle – displacedNeurovascular bundle – displaced

Desmoplastic Ameloblastoma Desmoplastic Ameloblastoma – Radioopaque – Dense – Radioopaque – Dense ConnectivetissueConnectivetissue

Anterior Maxilla / MandibleAnterior Maxilla / Mandible


Differential DiagnosisDifferential Diagnosis

Multilocular lesions - Dentigerous Cyst OKCMultilocular lesions - Dentigerous Cyst OKC

Cherubism Odontogenic Cherubism Odontogenic Myxoma Myxoma

Giant cell granuloma ABCGiant cell granuloma ABC


TREATMENTTREATMENT

Curettage – Curettage – Should never be considered Should never be considered

Unicystic Lesions – Recurrence Rate (18% – 25%)Unicystic Lesions – Recurrence Rate (18% – 25%)

Multicystic Lesions - Recurrence Rate ( 55% - 100%)Multicystic Lesions - Recurrence Rate ( 55% - 100%)

Microscopically infiltrates Bone beyond Tumor InterfaceMicroscopically infiltrates Bone beyond Tumor Interface

Safe Margin of uninvolved bone of 2 cm should be removedSafe Margin of uninvolved bone of 2 cm should be removed

Multicystic Ameloblastoma – Multicystic Ameloblastoma –

En Bloc Resection without Continuity DefectEn Bloc Resection without Continuity Defect

Segmental Resection with Continuity Defect - Cortical Bone Segmental Resection with Continuity Defect - Cortical Bone perforatedperforated

AMELOBLASTOMAAMELOBLASTOMA RECONTRUCTIONRECONTRUCTION

Immediate Reconstruction – Immediate Reconstruction –

Autogenous Free Bone Graft - Iliac / Rib GraftAutogenous Free Bone Graft - Iliac / Rib Graft

Autogenous Bone Marrow + Reconstruction PlateAutogenous Bone Marrow + Reconstruction Plate

Bank Allogenic Bone CribBank Allogenic Bone Crib

Reconstruction Plate with / without condylar process Reconstruction Plate with / without condylar process

Vascularized Composite Pedicled Graft of Bone + Vascularized Composite Pedicled Graft of Bone + Myocutaneos tissueMyocutaneos tissue


Tumor confined to Maxilla without Orbital Floor involvementTumor confined to Maxilla without Orbital Floor involvement

Partial MaxillectomyPartial Maxillectomy Tumor involving Orbital Floor – Tumor involving Orbital Floor – Total MaxillectomyTotal Maxillectomy Tumor involving Orbital Contents – Tumor involving Orbital Contents – Total Maxillectomy + Total Maxillectomy +

Orbit ExonterationOrbit Exonteration Tumor involving Skull Base – Tumor involving Skull Base – Neurosurgical ProcedureNeurosurgical Procedure

PrognosisPrognosis

Multicystic AmeloblastomaMulticystic Ameloblastoma – 50% Recurrence rate – 5 yrs – 50% Recurrence rate – 5 yrs Post opPost op

Long Term Follow up MustLong Term Follow up Must

CALCIFYING EPITHELIAL ODONTOGENIC CALCIFYING EPITHELIAL ODONTOGENIC TUMORTUMOR

- CEOT / Pindborg’s TumorCEOT / Pindborg’s Tumor- Origin – Epithelial remnants of Enamel organOrigin – Epithelial remnants of Enamel organ- 1% of all Odontogenic Tumors1% of all Odontogenic Tumors- 30 – 50 yrs30 – 50 yrs- Mandible – molar Mandible – molar - 50% associated with unerupted / embedded tooth50% associated with unerupted / embedded tooth- Painless slow growing , Nasal obstruction, Epistaxis Painless slow growing , Nasal obstruction, Epistaxis - Uni / Multi locular radiolucency with circumscribed / diffuse Uni / Multi locular radiolucency with circumscribed / diffuse

borderborder- Honey comb appereanceHoney comb appereance- Driven Snow Appereance – scattered flakes of calcification Driven Snow Appereance – scattered flakes of calcification

seen around crown of embedded toothseen around crown of embedded tooth- Recurrence – 15%Recurrence – 15%

ADENOMATOID ODONTOGENIC TUMOR AOTADENOMATOID ODONTOGENIC TUMOR AOT

- 3 – 7% of all Odontogenic Tumors3 – 7% of all Odontogenic Tumors- 10 – 20 yrs Females Maxilla ( 65%) – Anterior region10 – 20 yrs Females Maxilla ( 65%) – Anterior region- Associated with Impacted Canine – 74%Associated with Impacted Canine – 74%- Painless swellingPainless swelling- Unilocular Radiolucency around crown of impacted tooth - well Unilocular Radiolucency around crown of impacted tooth - well

defined margins. Radiolucency shows Fine Calcifications – defined margins. Radiolucency shows Fine Calcifications – Snow FlakesSnow Flakes

- DD – Pindborg’s tumor , CEOC, AmelobastomaDD – Pindborg’s tumor , CEOC, Amelobastoma- Treatment Treatment

Enucleation – encapsulatedEnucleation – encapsulated

- Recurrence rare - Recurrence rare

ODONTOMAODONTOMA

- Growth in which both Epithelial & Ectomesenchymal cells exhibit- Growth in which both Epithelial & Ectomesenchymal cells exhibit

coplete / incomplete differentiation in to tooth formationcoplete / incomplete differentiation in to tooth formation- 1 – 2 decade1 – 2 decade- Complex - Mandible – 67% , Posterior JawComplex - Mandible – 67% , Posterior Jaw- Compound - Maxilla , Anterior JawCompound - Maxilla , Anterior Jaw- Hamartomatous malformationHamartomatous malformation- Composite lesionComposite lesion- COMPOUND COMPOUND – consist of calcified toothlike structures / miniatured – consist of calcified toothlike structures / miniatured

Dwarfed toothDwarfed tooth- COMPLEX COMPOSITE ODONTOMA COMPLEX COMPOSITE ODONTOMA

Disorderly & Haphazard arrangement of Calcified Dental Disorderly & Haphazard arrangement of Calcified Dental StructuresStructures

- R / F - R / F -

Compound – Radioopaque Mass with anatomic similarity to normal Compound – Radioopaque Mass with anatomic similarity to normal toothtooth

Complex – Radioopaqe not resembling toothComplex – Radioopaqe not resembling tooth

- - Treatment -Treatment - Enucleation Enucleation

CEMENTOBLASTOMA / TRUE CEMENTOMACEMENTOBLASTOMA / TRUE CEMENTOMA

- Tumor of connective tissue forming cementum like calcification Tumor of connective tissue forming cementum like calcification fused to tooth rootfused to tooth root

- 10 – 20 yrs Premolar – Molar region10 – 20 yrs Premolar – Molar region- Mandibular lesions – attached to single toothMandibular lesions – attached to single tooth- Maxillary lesions – fused to 2 / more teethMaxillary lesions – fused to 2 / more teeth- Slow growing lesion ,vital tooth , Resorption of cortical boneSlow growing lesion ,vital tooth , Resorption of cortical bone- R / F – Oval radioopaque mass with radiolucent periphery fused R / F – Oval radioopaque mass with radiolucent periphery fused

to single / multiple rootsto single / multiple roots- DD – Condensing Osteitis, Cementifying DD – Condensing Osteitis, Cementifying

Fibroma,OsteoblastomaFibroma,Osteoblastoma- Treatment – Enucleation, Large lesions can be cut in to smaller Treatment – Enucleation, Large lesions can be cut in to smaller

piecespieces

CEMENTO OSSIFYING FIBROMACEMENTO OSSIFYING FIBROMA

- Benign lesion arising from undifferentiated cells of Benign lesion arising from undifferentiated cells of Periodontal Ligament Periodontal Ligament

- 3 – 4 decade Females – 5:1 Mandible – Premolar molar3 – 4 decade Females – 5:1 Mandible – Premolar molar- Painless slow persistent growth – Facial asymmetryPainless slow persistent growth – Facial asymmetry- R/F – Early – Radiolucent Late – RadioopaqueR/F – Early – Radiolucent Late – Radioopaque- Tr - EnucleationTr - Enucleation

OSTEOMAOSTEOMA- Benign tumors consist if Mature compact / cancellous boneBenign tumors consist if Mature compact / cancellous bone- Peripheral – surface of jaw bone as Polypoid / sessile massPeripheral – surface of jaw bone as Polypoid / sessile mass

Endosteal – develop centrally within medullary boneEndosteal – develop centrally within medullary bone- Slow growing asymptomatic bony hard massesSlow growing asymptomatic bony hard masses- R / F – Radioopaque massR / F – Radioopaque mass- Tr – surgical excisionTr – surgical excision

BENIGN OSTEOBLASTOMABENIGN OSTEOBLASTOMA

- Central Bone tumor – actively proliferating Osteoblasts, Central Bone tumor – actively proliferating Osteoblasts, multinucleated Giant cells in Osteoid tissuemultinucleated Giant cells in Osteoid tissue

- Males , < 25yrs Post aspect of jawsMales , < 25yrs Post aspect of jaws- R / F – Sun ray appereance - Central opacity with thin rim R / F – Sun ray appereance - Central opacity with thin rim

of radiolucencyof radiolucency- Tr – surgical excision Tr – surgical excision

ODONTOGENIC FIBROMAODONTOGENIC FIBROMA

- Central Benign Odontogenic Tumor Central Benign Odontogenic Tumor - Contains Fibrous CT stroma & inactive Odontogenic Contains Fibrous CT stroma & inactive Odontogenic

EpitheliumEpithelium- Intraosseous – Central Gingiva – PeripheralIntraosseous – Central Gingiva – Peripheral- Slow persistent growth, asymptomatic cortical expansion, Slow persistent growth, asymptomatic cortical expansion,

MandibleMandible- Males, Mean age 37yrsMales, Mean age 37yrs- R / F – Multiloculated radiolucency,well / ill defined sclerotic R / F – Multiloculated radiolucency,well / ill defined sclerotic

marginmargin

Root divergence / resorptionRoot divergence / resorption

- Tr – Enucleation & Curettage- Tr – Enucleation & Curettage

ODONTOGENIC MYXOMAODONTOGENIC MYXOMA- Central benign slow growing , infiltrative tumor of jaws Central benign slow growing , infiltrative tumor of jaws

which cause destruction of cortexwhich cause destruction of cortex- Found in Tooth bearing areas of jaws Mandible Found in Tooth bearing areas of jaws Mandible

FemalesFemales- ChildrenChildren- R / F – Multilocular / soapbubble / honeycombR / F – Multilocular / soapbubble / honeycomb- Recurrence rate – 33%Recurrence rate – 33%- Tr – Resection with / wthout continuity defect Tr – Resection with / wthout continuity defect

Tumors of jaw bones

Health & Medicine

Transcript of Tumors of jaw bones