JAW TUMORS

Dr.Sudipta Bera
PDT 1st Year
Plastic and Reconstructive Surgery
SSKM & IPGMER
 Tumors include cystic,
inflammatory,developmental, and
posttraumatic masses.
Radiologic evaluation: radiopaque,
radiolucent or combinations of varying
densities.
The final diagnosis usually requires
histologic interpretation.
 Jaw masses
Cysts Tumors
A.TUMORS OF ODONTOGENIC
A.ODONTOGENIC CYSTS(ARISE FROM EPITHELIUM
AN ALTERATION OF THE ENAMEL 1. Ameloblastoma
ORGAN) B.TUMORS OF ODONTOGENIC
1. Periapical (radicular) cysts EPITHELIUM AND MESENCHYME
2. Dentigerous cysts 1. Complex, compound, and mix Odontomas
2. Cementoma
3. Primordial (follicular) cysts
C. TUMORS OF NONODONTOGENIC
B.NONODONTOGENIC ORIGIN
DEVELOPMENTAL CYSTS(DERIVED 1. Bony exostoses (TORI)
FROM EPITHELIUM ENTRAPPED IN THE
2. Osteomas
LINES OF FUSION OF THE BODY PROCESS)
3. Giant cell reparative granuloma
1. Nasopalatine (incisive canal) cysts
4. Hemangioma
2. Globulomaxillary cysts
5. Osteogenic sarcoma
C.NONODONTOGENIC AND 6. Multiple myeloma
NONDEVELOPMENTAL CYSTS 7. Metastatic tumors
1. Aneurysmal bone cysts 8. Fibrous dysplasia
2. Traumatic bone cysts 9. Paget disease (Osteitis deformans)
10. Familial fibrous dysplasia (Cherubism)
PERIAPICAL (RADICULAR) CYSTS

M/C cyst of jawbone

Occurs at the apex of non vital tooth as a result
of chronic inflammation, a/w degeneration of pulp
tissue
Well circumscribed peri apical radiolucency,
Cholesterol crystal
Rx: small cyst->conservative, non surgical RCT.
>2cm->apical curretage,extensive root resection.
If restoration of dentition not possible,tooth
extraction
DENTIGEROUS CYSTS

Arise as a result of reduction in enamel forming

epithelium after crown is formed
Seen surrounding crown of an unerupted tooth
Posterior mandible M/c site,3rd Molar most
friquent
Sign/Symptoms:delayederuption,swelling,asymmet
ry
Rx:smaller cyst->enucleation+primary closure,
Large cyst->decompression,mersupialisation
PRIMORDIAL (FOLLICULAR) CYSTS

Develops before calcified enamel or

dentition formed, d/t abnormal formation
of enamel organ
Found in place of a tooth, c/b absence of
dentition with in cyst, epithelial lining
Well circumscribed,
radiolucent,multiloculer
Rx: enucleation, curretage
High recurrence-post surgical X-Ray
follow up
NASOPALATINE (INCISIVE CANAL)
CYSTS
Trapping tissue during fusion of palatine
process with pre maxilla
Anterior:Sratified squmous epithelium,
Posterior:cuboidal
S/S:painless buldging in the roof of mouth
Rx:Surgical excision with mucoperiosteal
flap elevation
GLOBULOMAXILLARY CYSTS

Fissural cyst at junction of globular

portion of median nasal process and
maxillary process
Usually at between maxillary lateral
incisor and canine
Radiolucency between roots,inverted tear
appearance
Rx; Surgical excision
ANEURYSMAL BONE CYSTS

Numerous capillaries intermixed with

with prominent vasculer space
Multineucleated giant cell, no epithelial
lining
Irreguler destruction of cortical
plate,scalloping
Rx:Aspiration f/b surgical curratage
TRAUMATIC BONE CYST

Devoid of lining
Mandible seldom involved,uncommon
over 25yrs age
Rx: Surgical exploration, enucleation and
curratage
AMELOBLASTOMA

Ectodermal epithelium origin differentiation

into enamel forming cell
Closely resembles dentigerous cyst, or
multiloculer, Honey comb appearance
Onset 20-40 yrs, posterior mandible M/c site
Histological type:Acanthometous(aggressive,
metastatic), folliculer, flexiform
Destruction of cortex and tooth apex
usually, high recurrence
Rx: Radical approach (wide block resection
and bone grafting) most effective
ODONTOMAS

Composed of aberrant tissue of dental

element
Complex: aberrant all dental element,
Compound:normal composition of tooth
like element independent of tooth follicle,
mixed
Radio opeque
M/c in maxilla(incisor-canine region)
Cementoma
Originates from peri odontal ligament of
unerupted tooth
Benign fibrosseus lesion replacing the
bone
M/c mandibuler premolar and molar
Rx: excision curratage
BONY EXOSTOSES (TORI)

M/c benign bone tumor,slow growing

bony protrusion
Palate,mandible,buccal surface of
mandibular or maxillary dentition
Hereditary
Cause mechanical and oral problem
Rx:surgical removal
OSTEOMA

Derived from osteoblastic activity

Single or multiple(Gardner syndrome)
Very opaque ireguler masses
GIANT CELL REPARATIVE GRANULOMA

Slowly expanding mass usually anterior to

2nd mandibular molar
Irreguler osteolytic lesion with migration
of tooth
D/D obscured d/t similarity between
benign cyst and ameloblastoma
HEMANGIOMA

Congenital or traumatic
Thin wall vessel scattered with in bony
trabeculae
C/f:Firm painless mass increasing in size,
loosening of dentition,gingival bleeding
Dx.angiography,Rx:Sclerotherapy,Surgery
or both
OSTEOGENIC SARCOMA

Highly malignant mass of bone or osteoid

originating from connective tissue
Young age(10-40yrs)
Sunray appearance
Rx: Resection and Radiation
MULTIPLE MYELOMA

Often involve jaw with plasmalike cells in

the marrow
Multiple osteolytic lucent area
Hyperglobulinemia, Bence Jones protein
,altered A:G ratio
Rx: Alkylating agent, systemic steroid
METASTATIC TUMORS

M/c from Squmous cell Ca. from

surrounding oral tissue, Others: primary
tumor of breast, uterus, lung and thyroid
Mandible m/c site
FIBROUS DYSPLASIA

Membrenous facial bone of young

individual
Commonly single Fibroosseous mass, M/c
in maxilla
Surge of growth during hormonal changes
CT Scan evaluation necessary to r/o
orbital or base of skull involvement
Rx: conservative surgical curratage
through intra oral route
PAGET DISEASE (OSTEITIS
DEFORMANS)
Resembles ossifying fibroma
Older age group
Maxilla M/c site,commonly multiple
serum PO4
FAMILIAL FIBROUS DYSPLASIA
(CHERUBISM)
Multiple areas of fibrous dysplasia in
mandible and maxilla
Occurs as early as 1 year
Inherited genetic disorder
Rx:multiple curratage spaced over a
number of years
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