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42 Cards in this Set
- Front
- Back
In the United States, the most common location for the ameloblastoma is?
a) Anterior Maxilla b) Posterior Maxilla c) Anterior Mandible d) Posterior Mandible |
Posterior Mandible
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What is the most common clinically significant (not the most common) odontogenic tumor?
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Ameloblastoma
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What tissues may Ameloblastomas originate from?
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Cell rests of enamel organ
Developing enamel organ Lining of odontogenic cysts Basal cells of oral mucosa |
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T/F
Ameloblastomas are Slow-growing, locally invasive and runs a benign course |
True
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What are the 3 different clinico-radiographic situations requiring different therapeutic considerations and having different prognoses?
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Conventional Solid/Multicystic 86%
Unicystic 13% Peripheral or Extraosseous 1% |
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Where are Solid or Multicystic Ameloblastomas typically located?
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80% Mandible
70% in posterior region |
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How does a Solid or Multicystic Ameloblastoma appear radiographically?
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Radiolucent lesion which is usually well-circumscribed; it may be unilocular or multilocular (soap-bubble, honeycomb); occasionally an ameloblastoma will be ill defined with a ragged border
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What are the two most common subtypes of Solid or Multicystic Ameloblastomas?
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Follicular type - composed of islands of epithelium, which resemble the enamel organ in a mature fibrous connective tissue stroma
Plexiform - composed of long, anastomosing cords or larger sheets of odontogenic epithelium. Its stroma tends to be loose and vascular. |
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T/F
The granular cell type of solid or multicystic ameloblastoma is more Aggressive |
True
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Where does the desmoplastic form of Solid or Multicystic ameloblastoma occur most frequently?
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Anterior Maxilla
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What race is more frequently affected by solid/multicystic ameloblastomas?
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Blacks
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What is the treatment of solid or multicystic ameloblastomas?
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Enucleation and curettage with a margin of at least 1 cm beyond radiographic limits of the tumor (marginal resection)
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Who is most commonly affected by Unicystic Ameloblastomas?
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20s
90% occur in the Mandible usually in the Posterior region |
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How do Unicystic Ameloblastomas appear radiographically?
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Typically appears as a radiolucency around the crown of an unerupted tooth (most commonly a Mandibular 3rd molar)
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What are the 3 Unicystic Ameloblastoma histopathologic varients?
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Luminal: the tumor is confined to the luminal surface of the cyst
Intraluminal/plexiform: the tumor projects from the cystic lining; sometimes resembles the plexiform type of solid/multicystic ameloblastoma Mural: the tumor infiltrates the fibrous cystic wall |
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What are Peripheral (Extraosseous) Ameloblastomas?
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Peripheral (Extraosseous) Ameloblastomas occupy the lamina propria underneath the surface epithelium but outside of the bone.
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Where are Peripheral Ameloblastomas found clinically?
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Posterior gingival/alveolar mucosa is involved most frequently. There is a slight predilection for the mandible. The buccal mucosa has been reported rarely.
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What is the treatment and prognosis for Peripheral Ameloblastomas?
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Patients respond well to local surgical excision
Malignancy is very rare |
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What is the key feature that indicates malignancy in Malignant ameloblastoma and Ameloblastic carcinoma?
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Metasteses
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T/F
Malignant Ameloblastoma and Ameloblastic Carcinoma are the same thing. |
False
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What is a tumor that shows histologic features of the typical (benign) ameloblastoma in both the primary and secondary deposits?
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Malignant Ameloblastoma
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What is a tumor that shows cytologic features of malignancy in the primary tumor, in recurrence and any metastases?
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Ameloblastic carcinoma
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After metasteses what is the next most indicative feature of malignancy?
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Invasiveness
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Which of the following is the Most likely diagnosis of this radiopaque lesion shown blocking the eruption of an anterior permanent tooth?
a) Mandibular torus b) Osteoma c) Compound odontoma d) Complex odontoma e) Sialolith |
Compound odontoma
Compound type is more often in the anterior maxilla, while the complex type occurs more often in the posterior regions of either jaw. The compound type shows apparent tooth shapes while the complex type appears as a uniform opaque mass with no apparent tooth shapes present. Odontomas may Block the eruption of a permanent tooth and in these cases are often discovered when searching for the missing tooth radiographically |
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Which of the following is the Most likely diagnosis of the peripheral radiopacity observed at the apex of this non-vital tooth?
a) idiopathic osteosclerosis b) Focal sclerosing osteomyelitis c) Cementoblastoma d) Focal cemento-osseous dysplasia e) Hypercementosis |
Cementoblastoma
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Which of the following should head the list of a differential diagnoses for this mixed radiolucent/radiopaque lesion observed in an 18 yr girl?
a) Complex odontoma b) Ameloblastoma c) Adenomatoid odontogenic tumor d) Dentigerous cyst e) Ameloblastic fibroma |
Adenomatoid odontogenic tumor
17 yr Female (2:1), Maxillary Canine, Associated with the crown of an unerupted tooth |
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Which of the following should be considered among the differential diagnoses of this multilocular radiolucency?
a) Ameloblastoma b) Odontogenic Myxoma c) Ameloblastic Fibroma d) All of the above e) A & C only |
All of the above
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All of the following statements concerning adenomatoid odontogenic tumors are correct except
a) Are more common in males b) Usually occur in the second decade of life c) Are best treated by enucleation d) Are frequently associated with unerupted teeth e) Are more common in the anterior maxilla |
AOTs are Not more common in males
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Adenomatoid odontogenic tumors are more common in?
a) Maxilla b) Mandible |
Anterior portion of Maxilla
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Which of the following may appear as a mixed radiolucent/radiopaque lesion associated with teeth?
a) Peripheral cementoosseous dysplasia b) Adenomatoid odontogenic tumor c) Cementoossifying fibroma d) A & B e) All of the above |
All of the above
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Adenomatoid odontogenic tumors are
a) rare in females b) Most common in the mandible of patients over 50 years c) May appear as mixed radiolucent/radiopaque lesions d) A & B e) All of the above |
May appear as mixed radiolucent/radiopaque lesions
(common in females) |
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Which of the following is the most likely diagnosis for this mixed radiolucent/radiopaque lesion in a 45 yr Man?
a) Adenomatoid odontogenic tumor b) Ameloblastoma c) Ameloblastic fibroma d) Dentigerous cyst e) Calcifying epithelial odontogenic tumor |
Calcifying epithelial odontogenic tumor
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An odontoma is best classified as which of the following?
a) Neoplasm b) Choristoma c) Developmental (hamartoma) lesion d) Inflammatory lesion e) Immunological lesion |
A Developmental (hamartoma) Lesion
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Which of the following is the most common odontogenic tumor?
a) Ameloblastoma b) Ameloblastic fibroma c) Odontogenic myxoma d) Cementifying fibroma e) Odontoma |
Odontoma
(ameloblastoma is the most clinically significant) |
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In which of the following does the conventional solid/multicystic ameloblastoma vary from the ameloblastic fibroma?
a) Common radiographic appearance b) Site of predilection c) Average age of patient at diagnosis d) All of the above e) A & C |
Average age at diagnosis
Ameloblastoma = 3rd-7th decade Ameloblastic fibroma = 14 yrs Both posterior mandible Both unilocular or multilocular radiolucencies |
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Which of the following statements is true of the adenomatoid odontogenic tumor?
a) They have a female gender predilection b) They occur most commonly in the posterior mandible c) They are often encapsulated d) All of the above e) A & C only |
A & C only
They occur 65% maxillary canine region They have a thick fibrous capsule |
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Which of the following usually presents as a pericoronal radiolucency?
a) Unicystic ameloblastoma b) Aneurysmal bone cyst c) Dentigerous cyst d) All of the above e) A & C |
A & C
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Which of the following lesions may present with more than one radiographic appearance, i.e. radiolucent, mixed and/or radiopaque?
a) Periapical cemento-osseous dysplasia b) Adenomatoid odontogenic tumor c) Calcifying odontogenic cyst d) All of the above e) A & C only |
All of the above
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Peripheral odontogenic fibromas are located on which of the following?
a) Tongue b) Gingiva c) Lower lip d) Hard palate e) Buccal mucosa |
Facial gingiva of the mandible
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Which histological variant of the solid/multicystic ameloblastoma has a predilection for the anterior maxilla and may appear as a mixed (radiolucent/radiopaque) lesion?
a) Acanthomatous b) Basal cell c) Follicular d) Desmoplastic e) Granular cell |
Desmoplastic
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Which of the following is an example of a true mixed tumor in which the epithelial and mesenchymal tissues are both neoplastic?
a) Ameloblastoma b) Ameloblastic fibroma c) Odontoma d) Adenomatoid odontogenic tumor e) Squamous odontogenic tumor |
Ameloblastic Fibroma
The tumor is composed of a cell-rich mesenchymal tissue resembling the primitive dental papilla admixed with proliferating odontogenic epithelium |
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Which of the following is seen most commonly in the anterior part of the maxilla?
a) Ameloblastoma, desmoplastic type b) Ameloblastoma, solid or multicystic type c) Adenomatoid odontogenic tumor d) All of the above e) A & C |
A & C
(ameloblastoma, solid or multicystic type is found in the posterior mandible) |