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1. Enamel organ
2. Remnants of dental lamina
3. Epithelial rest of malassez
4. Linning of odontogenic cyst
5. Basal layer of oral epithelium
AMELOBLASTOMA: BIOLOGICAL
SUBTYPES
Solid ameloblastoma
Cystic (unicystic) ameloblastoma
Peripheral ameloblastoma
Malignant ameloblastoma
Ameloblastic carcinoma
Clinical features
1. Age: 20-50 years
2. Sex: no significant sex predilection
3. Site: mandible > maxilla(more than 80%
mandible)
4. With in mandible molar-ramus area is
affected three times more commonly than
premolars & anteriors
5. It starts as a slow growing , painless,
hard, non tender, ovoid swelling
which often enlarges in size as it
causes little discomfort in early stage.
6. Facial assymetry
7. Mobilty of teeth and exfoliation
8. Expansion of jaw.
9. Pain or paresthesia if impinges on
nerve
In the absence of treatment,
It may be extremely
disfiguring fungating and
ulcerative like carcinoma
Keeps on enlarging and
cause “egg shell crackling’’&
fluctuation
Invades surrounding tissues
A. Odontogenic tumors-
Calcifying epithelial odontogenic tumor
Odontogenic myxoma
B. Cystic lesions-
Dentigerous cyst
Odontogenic keratocyst
C. Non-odontogenic lesions-
Central giant cell granuloma
Central hemangioma
Histological Feature:
Microscopically 5 types
1. Follicular
2. Plexiform
3. Granular cell
4. Basaloid
5. Desmoplastic
Follicular ameloblastoma-
The most common and most readily recognisable
type. There are islands with an outer layer of tall,
columnar, ameloblast-like cells with reversed
polarity surrounding a core of loosely arranged
polyhedral or angular cells, resembling stellate
reticulum
Ameloblastoma. Islands of follicular ameloblastoma
comprising ‘stellate reticulum’ and a peripheral layer of
elongate ameloblast-like cells
Plexiform ameloblastoma-
The epithelium forms strands and
interconnected sheets and the ameloblast
cells are often less prominent
.
Ameloblastoma, plexiform type. There are thin,
interlacing strands of epithelium, but typical
ameloblasts are often not seen in this pattern
Acanhomatous ameloblastoma-
This usually occurs in the follicular type of
ameloblastoma in which prickle cells replace
the stellate reticulum and sometimes form
keratin
Acanthomatous change in an ameloblastoma.
Stellate reticulum-like cells have undergone
squamous metaplasia to form keratin. This is called
acanthomatous because it looks like prickle cells in
keratinising epithelium
Granular cell ameloblastoma-
The epithelium in the central areas of the tumour
islands degenerates into sheets of large
eosinophilic granular cells.
Ameloblastoma. Granular cell change in an ameloblastoma.
Ameloblastoma and stellate reticulum-like cells have undergone
degenerative change to form large pink granular cells. In some
tumours this change is extensive, and the term granular cell
ameloblastoma’ is applied
Basal cell ameloblastoma-
Rare variety and consists of more darkly stainning
Basal cells with little evidence of ameloblasts
Investigations
• Radiograph
• Biopsy
• CT scan
• MRI
Treatment