Calcifying cystic odontogenic tumor ccot is an uncommon odontogenic tumor. Gorlin nevoid basal cell carcinoma syndrome basal cell carcinomas in nonsun exposed areas. The history of cystic conditions of the jawbones and decompression also known as marsupialization or exteriorization 1 as a treatment modality is intimately related to the birth of oral and maxillofacial pathology. A dentigerous cyst, the most common odontogenic cyst, lacks the basal palisading and corrugated parakeratinized surface. The most significant change affecting odontogenic cysts was the reincorporation of odontogenic keratocyst and calcifying odontogenic cyst in the cyst classification when they had been classified in 2005 as neoplasms. They are characterised by an aggressive behaviour with a relatively high recurrence rate. The pathogenesis of the three common forms of odontogenic cyst is discussed. Kramer 1974 has defined a cyst as a pathological cavity having fluid, semifluid or gaseous contents and which is not created by the accumulation of pus. An odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues. Mar 28, 2015 odontogenic tumors ots are lesions derived from epithelial, ectomesenchymal or both the elements that have been part of the toothforming apparatus. Chapter 21 odontogenic and nonodontogenic tumors of the jaws introduction. Common benign cystic lesions include periapical radicular cysts, follicular dentigerous cysts, and odontogenic keratocysts. Although rare, because of its variable presentation calcifying cystic odontogenic tumor should be included in the differential diagnosis of jaw lesions.
Multiple jaw cysts odontogenic keratocysts numerous bone abnormalities including bi. The relationship of the cyst to adjacent structures. Furthermore, about 70% of odontogenic infections occur as periapical inflammation, i. These cystic lesions of the jaws, along with odontogenic tumors such as ameloblastomas abs, have the potential to grow and significantly expand the jaws through the process of bone resorp. It arises from odontogenic epithelial rests present. Boc is considered to be a variant of a lateral periodontal cyst. The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal. It was first reported as a separate pathologic entity by gorlinet al in 1962 as a likely analog of the cutaneous calcifyingepithelioma of malherbe or pilomatricoma. Diagnosing the most common odontogenic cystic and osseous. Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis.
Odontogenic cyst definition of odontogenic cyst by. Because of thediverse clinicohistologic features and the various neoplasticpotential, there have. A cyst is a closed sac, having a distinct membrane and division compared with the nearby tissue. Methods a total of 22 young and healthy patients 15 males, 7 females with a large odontogenic cystic lesion treated by decompression between the year 2002 and 2011 were included in this research. There were additional significant changes since other cysts had not appeared in the who classification since 1992. Different manifestations of calcifying cystic 367 einstein. Radiographs showed a welldemarcated, unilocular mixed.
Odontogenic lesions may be grouped into lesions without mineralization and lesions with mineralization. Odontogenic cysts, odontogenic tumors, fibroosseous, and. This obviously requires a compliant and dextrous patient who would be able to maintain hygiene. Pdf calcifying cystic odontogenic tumor with compound. To compare two methods of creating threedimensional representations of mandibular cysts and tumors on the basis of computed tomography ct and cone beam computed tomography cbct data. The remaining 40% arise from the reduced enamel epithelium of the dental follicle and are thus dentigerousorigin odontogenic keratocysts figure 7 b as we. The following is a report of a 16yearold boy with history of pain in the maxillary left central incisor and in the maxillary sinus area. The keratocystic odontogenic tumor kcot is a benign intraosseous neoplasm, usually found between the second and fourth decades of life, and with a large predilection for the mandible, especially. The next most common form of odontogenic infection is the periodontal abscess. The keratocystic odontogenic tumor kcot is a benign intraosseous neoplasm, usually found between the second and fourth decades of life, and with a. Odontogenic cysts and tumors were noted long before oral pathology was recognized as a specialty of dentistry by the american. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. Classification of odontogenic cysts and tumors antecedents. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis.
Ccot calcifying cystic odontogenic tumor derived from odontogenic epithelial cell rest. Calcifying cystic odontogenic tumor ccot is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. The calcifying cystic odontogenic tumor ccot, which is also known as a calcifying odontogenic cyst coc or gorlin cyst, is a rare developmental lesion that arises from the odontogenic epithelium 1. Proliferation or cystic degeneration of this epitheli. Developmental primordial and follicular primordial cyst odontogenic keratocyst cystic ameloblastoma radicular cyst hyperplastic follicle 14. Other odontogenic cysts must be considered in the differential diagnosis. Ct and cbct scans were obtained from all patients and saved in the digital imaging and communications in medicine. It is important that dental practitioners are aware of these lesions, thus allowing inclusion as a differential diagnosis and construction of an appropriate management plan. Odontogenic cysts and tumors ppt linkedin slideshare. The odontogenic cysts are a diverse groups of odontogenic lesions of the jaws the radicular cyst is an inflammatory lesion, and although by far the most common, it is clinically easy to diagnose and manage other cysts are less frequently encountered and some e. This article outlines the diagnostic features required for. Clinical and histologic features of botryoid odontogenic.
It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Most odontogenic keratocyst 60% arise from dental lamina rests or from the basal cells of oral epithelium and are thus primordialorigin odontogenic keratocysts figure 7a 10. Odontogenesis, odontogenic cysts, and odontogenic tumors. Cysts commonly occur in the mandible and appear as unilocular or multilocular radiolucencies on dental radiographs. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. Most common type of cysts in the jaws radicular cyts radicular cyts odontogenic.
Of note, a dentigerous cyst is, by definition, always associated with an unerupted tooth. Although it has commonly been recognized as a benign odontogenic cyst since its original description by gorlin. Radicular cyst radicular cysts are inflammatory in nature and the most common. The 2005 who histological classification of odontogenic tumors lays out a classification system for neoplasms and other tumors related to the odontogenic apparatus. At the time of writing 2016, it is still the most widely used classification system although a new revision is due to come up in 2017. Calcifying cystic odontogenic tumor, calcifying odontogenic cyst, dentinogenic ghost cell tumor, early history, odontogenic ghost cell lesions background most oral pathologists acknowledge that the first detailed account of calcifying odontogenic cyst coc was published in 1962 by gorlin et al. Calcifying cystic odontogenic tumor ccot previously knownas calcifying odontogenic cyst coc is a relatively rare lesion. Calcifying cystic odontogenic tumour ccot is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. Calcifying odontogenic cyst calcifying cystic odontogenic tumor calcifying odontogenic cyst was initially described by gorlin and colleagues 283 in 1962 as a possible oral analogue to malherbes calcifying epithelioma pilomatricoma of the skin, owing to the presence of ghost cell keratinization in both lesions. They arise as a result of proliferation and cystic degeneration of odontogenic epithelial rests. Odontogenic cysts, odontogenic tumors, fibroosseous, and giant cell lesions of the jaws joseph a regezi d.
The term calcifying odontogenic cyst was first introduced by gorlin in 1962 eshghyar et al. Botryoid odontogenic cyst boc was originally described in 1973 by weathers and waldron as an intraosseous lesion characterized by a macroscopic and microscopic multilocular growth pattern, resembling a bunch of grapes from the greek word botrios. Intrabony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. Eruption cyst is defined as an odontogenic cyst that surrounds a tooth crown that has erupted through bone but not soft tissue and is clinically visible as a soft fluctuant mass on the alveolar ridges. Odontogenic calcificant cystic tumor occt is an infrequent injury.
Radiologic and pathologic characteristics of benign and. Advances in assessing the volume of odontogenic cysts and. A unique case of a calcifying cystic odontogenic tumor. Clear cell odontogenic carcinoma mimicking a cystic lesion. Odontogenic cysts, tumors, and related jaw lesions preceptor. The following classification system is a modification of the world health organization. Past, present, and future jaime castronunez, dmd tumors and cystic lesions of the jawbones have been described since the late 1600s and it took another 200 years for classi. Odontogenic cysts and tumors were noted long before oral pathology was recognized as a specialty of dentistry by the american dental association in. Comparison of components of odontogenic cyst fluids. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development.
Different manifestations of calcifying cystic odontogenic. Odontogenic cyst definition of odontogenic cyst by medical. Cystic lesions within the mandible can cause bony remodeling that can weaken the bone, leading to functional changes and predisposing the patient to infection and pathologic fracture. Most are harmless, but they should be removed when possible because they occasionally may change into malignant growths, become infected, or obstruct a gland. Odontogenic cysts and osseous lesions are often seen as challenging diagnostic lesions but the majority of them are easily classified. Decompression as a treatment for odontogenic cystic lesions. Rightfully called the master of disguise, this lesion has been known for its varied clinical and histoarchitectural patterns. Retrospective study of spontaneous bone regeneration after. A total of 71 patients with acquired jaw cysts took part in this retrospective clinical study. Although cysts are common in the jaws, most are radicular cysts of in.
Nelson, in head and neck pathology third edition, 2019. Comparison of components of cystic fluid in odontogenic keratocyst, dentigerous cyst, and radicular cyst type of cystsalbumin globulin total protein odontogenic keratocyst between 2 and 4 gdl between 0. Introduction a cyst is an epithelium lined sac containing fluid or semifluid material the epithelial cells first proliferate and later undergo degeneration and liquefaction grow by expansion, causing displacement of adjacent teeth 3. The opening can also be maintained with packing material or a prosthetic bung. Cystic and cysticappearing lesions of the mandible. It enlarges by unicentric expansion from the hydrostatic pressure of its contents. Calcifying cystic odontogenic tumor a case report and. Case report cystic adenomatoid odontogenic tumor sonalgrover, 1 ahmedmujibbangalorerahim, 2 nithinkavasseryparakkat, 3 shekharkapoor, 4 kumudmittal, 5 bhushansharma, 1 andanilbangaloreshivappa 6 department of oral pathology and microbiology, christian dental college, cmc, ludhiana, punjab, india. Cury s e, cury s n, cury m, calderoni a, fajardo v d, carvalho m r, luderer l a. More aggressive odontogenic lesions such as odontogenic keratocyst, ameloblastoma, and other odontogenic tumors can have identical radiographic features bilateral dentigerous cysts are uncommon radiographic differential diagnosis for bilateral or multifocal cystic lesions around impacted partially impacted posterior teeth in a young person. Because the lesion sometimes appears as a solid noncystic lesion, referred to as odontogenic ghost cell tumor, it is no longer classified as one of the odontogenic cysts. Because cystic sp aces within the jaws have special characteristics, they require a more precise definition. It is clinically characterized as a painlessslowgrowing tumor that affects the maxilla as well as the mandible, and generally occurs in young adults in the third or fourth decade of life. Intrabony cysts are most common in the jaws, because the mandible and maxilla are the only bones with.
A 5yearold female without relevant medical history presented an asymptomatic swelling on the left cheek of two. Odontogenic keratocysts okcs, first described by philipsen in 1956, are benign intraosseous lesions of odontogenic origin that account for about 10% of jaw cysts. In addition to its purely cystic and solid forms, coc may be associated with an odontoma. Odontogenic cysts and tumors develop during or after the formation of teeth, 1. It is concluded that the dental cyst arises from proliferation of the epithelial rests of malassez in a focus of inflammation stimulated by pulpal necrosis of the associated tooth.
Results from the stimulation of the epithelial cell rests in the pdl by the inflammatory products from the nonvital tooth. Hence, it is a cluster of cells that has grouped together to form a sac like the manner in which water molecules group together, forming a bubble. Different manifestations of calcifying cystic odontogenic tumor. Cysts and odontogenic neoplasms 160 jaw cysts general features of jaw cysts to physicians, the term cyst means, simply, a space. The calcifying odontogenic cyst coc is an uncommon odontogenic lesion with a somewhat wide spectrum of histologic features.
Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. The lesion is unusual in that it has some features of a cyst but. In light of the long history of ogcl, the term calcifying epithelioma of malherbe first appeared in a 1931 french report, and the term ghost cells had its origin in two american seminal articles by thoma and goldman in 1946. Mandibular lesions develop from both odontogenic and nonodontogenic origins and have varying degrees of destructive potential. Adenomatoid odontogenic tumor aot is a wellestablished be nign epithelial lesion of odontogenic origin.
This article aims to give a brief overview of a variety of odontogenic cysts. The early history of odontogenic ghost cell lesions. This decompression facilitates a reduction in the size of the cyst and so, at a later an odontogenic cyst is a pathological. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. Cystic and cystlike lesions of the mandible are primarily ellipsoid, radiolucent, and clearly demarcated and may be odontogenic or nonodontogenic.
Because of thediverse clinicohistologic features and the various neoplasticpotential, there have been. Odontogenic and nonodontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. Odontogenic tumors questions and study guide quizlet. Histologically, ccot is usually composed of a cystic cavity with fibrotic capsule lined by an odontogenic epithelium. Odontogenic tumors ots are lesions derived from epithelial, ectomesenchymal or both the elements that have been part of the toothforming apparatus. Odontogenic infections can be severe if not treated and are associated with mortality rate of 10 to 40%. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Clinically, the kot is manifested by an asymptomatic growth. If this mitotic activity is the major component of the cyst expansion, it may be better to consider the lesion a cystic neoplasm rather than a simple cyst. Pdf calcifying epithelial odontogenic cyst of the mandible.
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