Tumors of jaw bones

1. 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 after Proliferation of Cells which continues its growth even after
cessation of stimuli. cessation of stimuli.

2. TUMORS OF JAW BONESTUMORS OF JAW BONES
BENIGN TUMOR MALIGNANT TUMORBENIGN TUMOR MALIGNANT TUMOR
Grows slowly Rapid growthGrows slowly Rapid growth
Encapsulated Poorly circumscribed, Irregular Encapsulated Poorly circumscribed, Irregular

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

Not Fixed Fixed to sorrounding structuresNot Fixed Fixed to sorrounding structures
No Tendency Tendency towards Ulceration No Tendency Tendency towards Ulceration
& Hemorrhage& Hemorrhage
Exhibits no Metastasis Metastasis presentExhibits no Metastasis Metastasis present

3. TUMORS OF JAW BONESTUMORS OF JAW BONES
All Tumors - 2 componentsAll Tumors - 2 components
ParenchymaParenchyma - Proliferating Tumor Cells - Nature & Evolution - Proliferating Tumor Cells - Nature & Evolution
Supportive Stroma Supportive Stroma – Fibrous Connective Tissue & Blood Vessels –– Fibrous Connective Tissue & Blood Vessels –
Provide Framework on which Parenchymal Provide Framework on which 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

4. 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 Odontome2. Ameloblastic Fibrodentinoma 5. Compound Odontome
3. OdontoAmeloblastoma 6. Complex Odontome 3. OdontoAmeloblastoma 6. Complex Odontome
4. Adenomatoid Odontogenic Tumor ( AOT)4. Adenomatoid Odontogenic Tumor ( AOT)

5. CLASSIFICATION OF ODONTOGENIC TUMORSCLASSIFICATION OF ODONTOGENIC TUMORS
C. Odontogenic Ectomesenchyme with / without Odontogenic epitheliumC. Odontogenic Ectomesenchyme with / without Odontogenic epithelium
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

6. Classification Of Non Odontogenic TumorsClassification Of Non Odontogenic Tumors
C. C. CEMENTO OSSEOUS DYSPLASIASCEMENTO OSSEOUS DYSPLASIAS
CherubismCherubism
Central Giant Cell GranulomaCentral Giant Cell Granuloma

7. General Principles in Management of Jaw LesionsGeneral Principles in Management of Jaw Lesions

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 breathingLymphadenopathy, Difficulty in breathing
TrismusTrismus
Recurrence Loss of Body weight HabitsRecurrence Loss of Body weight Habits

8. General Principles in Management of Jaw LesionsGeneral Principles in Management of Jaw Lesions
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 ExaminationConsistency Pulsations Fixity Lymph Node Examination
IMAGINGIMAGING
Plain Radiographs Plain Radiographs
CT ScansCT Scans
MRIMRI
Angiographic StudiesAngiographic Studies
Bone Scans / ScintigraphyBone Scans / Scintigraphy

9. 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 slide , Malignancy ,Scrapings are transfered to 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

10. General Principles in Management of Jaw LesionsGeneral Principles in Management of Jaw Lesions
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 ExcisionsGold ,Upton, & Marx 1991 – Terminology for Surgical Excisions
Enucleation Enucleation
CurettageCurettage
Marsupialization Marsupialization
RecontouringRecontouring
Resection with Continuity DefectResection with Continuity Defect
Resection without Continuity DefectResection without Continuity Defect
DisarticulationDisarticulation

11. General Principles in Management of Jaw General Principles in Management of Jaw
LesionsLesions
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

12. General Principles in Management of Jaw General Principles in Management of Jaw
LesionsLesions
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

13. General Principles in Management of Jaw General Principles in Management of Jaw
LesionsLesions
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 isAllows for complete Excision of Tumor ,Continuity of Jaw Bone is
maintained – Need for Secondary Cosmetic Surgery not requiredmaintained – Need for Secondary Cosmetic Surgery not required

14. General Principles in Management of Jaw General Principles in Management of Jaw
LesionsLesions

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 of - Lesions which are close to Lower border, Posterior border of
mandible, 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

15. MAXILLECTOMYMAXILLECTOMY

23. 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 Organ Cell Rests of Enamel Organ
Remnants of Dental LaminaRemnants of Dental Lamina
Cell Rests of Malassez Cell Rests of Malassez
Follicular SacsFollicular Sacs

24. AMELOBLASTOMAAMELOBLASTOMA
-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 CystEpithelium of Primordial , Dentigerous , Lateral Periodontal Cyst
-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 MaxillaMandible – Posterior molar - 60 % Blacks – Anterior Maxilla

25. AMELOBLASTOMAAMELOBLASTOMA
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 pushing Non Encapsulated – invades by destroying rather than pushing
Transform in to Malignant form ( 2 – 4 %)Transform in to Malignant form ( 2 – 4 %)

26. AMELOBLASTOMAAMELOBLASTOMA
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 lesionscompartmentalized appearance due to Bony Septa – Giant cell lesions
Fibro MyxomaFibro Myxoma
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 Connectivetissue– Radioopaque – Dense Connectivetissue
Anterior Maxilla / MandibleAnterior Maxilla / Mandible

27. AMELOBLASTOMAAMELOBLASTOMA
Differential DiagnosisDifferential Diagnosis
Multilocular lesions - Dentigerous Cyst OKCMultilocular lesions - Dentigerous Cyst OKC
Cherubism Odontogenic Myxoma Cherubism Odontogenic Myxoma

Giant cell granuloma ABCGiant cell granuloma ABC

28. AMELOBLASTOMAAMELOBLASTOMA
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 perforatedSegmental Resection with Continuity Defect - Cortical Bone perforated

29. 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 + Myocutaneos tissueVascularized Composite Pedicled Graft of Bone + Myocutaneos tissue

53. AMELOBLASTOMAAMELOBLASTOMA
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 + Orbit Total Maxillectomy + Orbit
ExonterationExonteration
Tumor involving Skull Base – Tumor involving Skull Base – Neurosurgical ProcedureNeurosurgical Procedure
PrognosisPrognosis
Multicystic AmeloblastomaMulticystic Ameloblastoma – 50% Recurrence rate – 5 yrs Post op – 50% Recurrence rate – 5 yrs Post op
Long Term Follow up MustLong Term Follow up Must

54. 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 borderUni / Multi locular radiolucency with circumscribed / diffuse border
-Honey comb appereanceHoney comb appereance
-Driven Snow Appereance – scattered flakes of calcification seen Driven Snow Appereance – scattered flakes of calcification seen
around crown of embedded tootharound crown of embedded tooth
-Recurrence – 15%Recurrence – 15%

55. 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 defined Unilocular Radiolucency around crown of impacted tooth - well defined
margins. Radiolucency shows Fine Calcifications – Snow Flakesmargins. Radiolucency shows Fine Calcifications – Snow Flakes
-DD – Pindborg’s tumor , CEOC, AmelobastomaDD – Pindborg’s tumor , CEOC, Amelobastoma
-Treatment Treatment
Enucleation – encapsulatedEnucleation – encapsulated
- Recurrence rare - Recurrence rare

65. 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 StructuresDisorderly & Haphazard arrangement of Calcified Dental Structures
-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

66. CEMENTOBLASTOMA / TRUE CEMENTOMACEMENTOBLASTOMA / TRUE CEMENTOMA
-Tumor of connective tissue forming cementum like calcification fused to Tumor of connective tissue forming cementum like calcification fused to
tooth roottooth 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 to R / F – Oval radioopaque mass with radiolucent periphery fused to
single / multiple rootssingle / multiple roots
-DD – Condensing Osteitis, Cementifying Fibroma,OsteoblastomaDD – Condensing Osteitis, Cementifying Fibroma,Osteoblastoma
-Treatment – Enucleation, Large lesions can be cut in to smaller piecesTreatment – Enucleation, Large lesions can be cut in to smaller pieces

67. CEMENTO OSSIFYING FIBROMACEMENTO OSSIFYING FIBROMA
-Benign lesion arising from undifferentiated cells of Periodontal Benign lesion arising from undifferentiated cells of Periodontal
Ligament 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

68. 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

69. 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 of R / F – Sun ray appereance - Central opacity with thin rim of
radiolucencyradiolucency
-Tr – surgical excision Tr – surgical excision

70. ODONTOGENIC FIBROMAODONTOGENIC FIBROMA
-Central Benign Odontogenic Tumor Central Benign Odontogenic Tumor
-Contains Fibrous CT stroma & inactive Odontogenic EpitheliumContains Fibrous CT stroma & inactive Odontogenic Epithelium
-Intraosseous – Central Gingiva – PeripheralIntraosseous – Central Gingiva – Peripheral
-Slow persistent growth, asymptomatic cortical expansion, MandibleSlow persistent growth, asymptomatic cortical expansion, Mandible
-Males, Mean age 37yrsMales, Mean age 37yrs
-R / F – Multiloculated radiolucency,well / ill defined sclerotic marginR / F – Multiloculated radiolucency,well / ill defined sclerotic margin
Root divergence / resorptionRoot divergence / resorption
- Tr – Enucleation & Curettage- Tr – Enucleation & Curettage

71. ODONTOGENIC MYXOMAODONTOGENIC MYXOMA
-Central benign slow growing , infiltrative tumor of jaws which cause Central benign slow growing , infiltrative tumor of jaws which cause
destruction of cortexdestruction of cortex
-Found in Tooth bearing areas of jaws Mandible FemalesFound in Tooth bearing areas of jaws Mandible Females
-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