Case 2Osteolysis regio 4815 year old male

Diagnosis Case 2Keratocystic odontogenic tumor withinflammatory changes

most common odontogenic tumor

behind 3-12% of all odont. cysts

3. decade, 3rd mandibular molar

asymptomatic, pot. superinfection

Gorlin-Goltz-Syndrom

circumscribed osteolysis

(40%?) with impacted tooth

Histology5-8 cell layers, parakeratosis

basal palisadingabsence of rete ridges

frequent mitoses, check for dysplasia

Differential DiagnosesRadicular cystDentigerous cystOOCUnicystic AB

Radicular cystmost common odontogenic cyst

apical osteolysis, devitalized tooth

inflammation of the dental pulp

periapical granuloma

radicular cyst

Dentigerous cyst2nd most common odontogic cyst

osteolysis surrounding an impacted toothliquid collection between crown and reduced

enamel epithelium (2-3 flat cell layers)always in contact with crown

enamel

dentin

pulp

outer enamel epitheliumstr. reticularestr. intermediumameloblastes

reduced enamel epithelium

Orthokeratinizing odontogenic cystno parakeratosis, no basal palisading

5-15 cell layers, flat interface posterior mandible, ¼ with impacted tooth

infrequent recurrences

intraluminal / luminal mural

Unicystic ameloblastomaunilocular osteolysis

2nd decade with, 4th decade without impacted toothluminal vs mural variant

> 90% mandible

Inflammatory changescan mask everything!!!

Keratocystic odontogenic tumorRadicular cyst

Dentigerous cyst

MALT lymphomaChronic rhinitis

Chronic inflammationMyeloma

Other

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