Difference between revisions of "Ameloblastoma, Central"

Latest revision as of 22:00, 31 October 2014

Also known as: Adamantinoma

Introduction

Amelobalstoma

The central or intraosseous ameloblastoma is one of the most common odontogenic tumours, originating from the dental lamina.

Different schools of thought exist on the differentiation between central ameloblastomas originating in bone, and peripheral ameloblastomas (also known as acanthomatous epulis).

This tumour is poorly differentiated and can arise from any part of the gingiva with no specific site predilection.

Central ameloblastomas are locally invasive and destructive to bone, but they are slow growing and do not metastasise.

The tumours have been reported to occur in dogs and cattle and occasionally in cats and horses.

Clinical Signs

Clinical signs of any oral tumours include: halitosis, oral bleeding, dental disruption or loss, facial deformity, salivation and an obvious mass.

Diagnosis

Grossly, the tumour may appear soft and fleshy on its gingival surface, but it may extend much deeper into the bone. It may be solid but often shows a multiple cystic structure.

Teeth at the site may be mobile, moved or absent.

Radiography of the affected area may reveal: loose or absent teeth, decreased radio-opacity of the mandible or maxilla due to local destruction, cystic opacities within the mass.

CT may enable a more detailed examination of the area.

Biopsy of the mass and histopathology will enable a definitive diagnosis: histological appearance of an ameloblastoma is a follicular arrangement of ameloblasts and stellate reticulum cells. There may be occasional keratinisation.

Treatment

As metastasis does not occur, complete resection is indicated, and is usually curative.

Depending on the location of the mass, this may involve various forms of mandibulectomies or maxillectomies to allow wide excision of the tumour and the underlying bone.

If complete resection is not feasible, surgical debulking followed by radiotherapy is also possible.

The prognosis is usually good if complete resection is possible, and animals usually make a good functional recovery with an acceptable cosmetic appearance for the owners.

Ameloblastoma, Central Learning Resources
Flashcards Test your knowledge using flashcard type questions	Veterinary Dentistry Q&A 02

References

Wiggs, R. (1997) Veterinary dentistry: principles and practice Wiley-Blackwell

Slatter, D. (2002) Textbook of small animal surgery Elsevier Health Sciences

Endorsed by WALTHAM®, a leading authority in companion animal nutrition and wellbeing for over 50 years and the science institute for Mars Petcare.

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-*Different from peripheral ameloblastoma - cystic changes and follicular arrangement of ameloblasts and stellate reticulum cells, resembling the basic structure of the [[Tooth Anatomy - Anatomy & Physiology|enamel organ]].
+{{OpenPagesTop}}
-<small>
+Also known as: '''''Adamantinoma'''''
-With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
-</small>[[Category:Teeth_-_Proliferative_Pathology]]
+==Introduction==
+[[File:Ameloblastoma dog.jpg|250px|right|thumb|Amelobalstoma]]
+The central or intraosseous ameloblastoma is one of the most common '''odontogenic tumours''', originating from the dental lamina.
+Different schools of thought exist on the differentiation between central ameloblastomas originating in bone, and [[Ameloblastoma, Peripheral|peripheral ameloblastomas]] (also known as acanthomatous epulis).
+This tumour is '''poorly differentiated''' and can arise from '''any part of the gingiva''' with no specific site predilection.
+Central ameloblastomas are '''locally invasive and destructive to bone''', but they are '''slow growing''' and do not metastasise.
+The tumours have been reported to occur in dogs and cattle and occasionally in cats and horses.
+==Clinical Signs==
+Clinical signs of any oral tumours include: '''halitosis''', oral bleeding, '''dental disruption or loss''', facial deformity, salivation and an '''obvious mass'''.
+==Diagnosis==
+'''Grossly''', the tumour may appear soft and fleshy on its gingival surface, but it may extend much deeper into the bone. It may be solid but often shows a multiple cystic structure.
+Teeth at the site may be mobile, moved or absent.
+'''Radiography''' of the affected area may reveal: loose or absent teeth, decreased radio-opacity of the mandible or maxilla due to local destruction, cystic opacities within the mass.
+'''CT''' may enable a more detailed examination of the area.
+'''Biopsy of the mass and histopathology''' will enable a definitive diagnosis: histological appearance of an ameloblastoma is a follicular arrangement of ameloblasts and stellate reticulum cells. There may be occasional keratinisation.
+==Treatment==
+As metastasis does not occur, '''complete resection''' is indicated, and is usually curative.
+Depending on the location of the mass, this may involve various forms of mandibulectomies or maxillectomies to allow '''wide excision''' of the tumour and the underlying bone.
+If complete resection is not feasible, '''surgical debulking followed by radiotherapy''' is also possible.
+The '''prognosis is usually good''' if complete resection is possible, and animals usually make a good functional recovery with an acceptable cosmetic appearance for the owners.
+{{Learning
+|flashcards = [[Veterinary Dentistry Q&A 02]]
+}}
+==References==
+Wiggs, R. (1997) '''Veterinary dentistry: principles and practice''' ''Wiley-Blackwell''
+Slatter, D. (2002) '''Textbook of small animal surgery''' ''Elsevier Health Sciences''
+{{Lisa Milella reviewed
+|date = 13 August 2014}}
+{{Waltham}}
+{{OpenPages}}
+[[Category:Teeth_-_Proliferative_Pathology]]
+[[Category:Neoplasia]][[Category:Dental Diseases - Dog]][[Category:Dental Diseases - Cat]][[Category:Dental Diseases - Cattle]][[Category:Dental Diseases - Horse]]
+[[Category:Oral Proliferations]]
+[[Category:Lisa Milella reviewed]]
+[[Category:Waltham reviewed]]