Head & Neck Cancer
Odontogenic Tumours
What are odontogenic tumours
Odontogenic tumours are a group of tumours that occur in and around the jaws and the teeth and originate from cells and tissues that are involved in normal tooth development.
They are relatively rare and range from very benign and slow growing to more aggressive tumours that are capable of destroying bone, soft tissues and teeth. Very rarely they can be truly malignant and metastasize (spread ) to lymph nodes or to the lungs.
The cause of odontogenic tumours is unknown.
What types of odontogenic tumours are there?
There are a huge number of different types of odontogenic tumours. Some of the more common ones are:
- Odontomas - These are the most common type of odontogenic tumour and typically occur in children and younger people before the age of 20 years. They are very benign growths often containing lots of tiny tooth like structures. They are often found on X-rays investigating the cause of a tooth not erupting in a child. They are generally easily removed with simple surgery.
- Ameloblastomas - These are aggressive tumours that arise in the bones of the jaw. They can grow quite big and cause a visible swelling. They also can destroy the roots of the teeth causing them to become loose or even fall out. They can invade the nerves of the jaws leading to numbness of the facial skin. They are best treated with surgery to remove part or the whole of the affected jawbone. Generally, this missing bone will need to be replaced using bone from the leg, a fibular free flap. Occasionally radiotherapy will be used if all the tumour cannot be removed. Only rarely do ameloblastomas metastasize.
- Odontogenic Keratocystic Tumours - These are benign, slow growing nad locally invasive tumours but they never metastasize. They are generally not as aggressive as ameloblastomas and tend to thin the bone of the mandible and push on the teeth rather than destroy them. Surgery tends to be less aggressive than that used for ameloblastomas and often we will try to reduce the size of the OKT by small operation called marsupialisation in an attempt to conserve as many teeth as possible.
What are the symptoms of odontogenic tumours?
The symptoms for odontogenic tumours vary widely and can be difficult to diagnose. Some common symptoms include:
- A tooth that does not erupt
- Swelling or pain in the jaw or around the teeth
- Loosening of adult teeth
- Numbness in the upper or lower lips
How are odontogenic tumours diagnosed?
Most often these tumours are diagnosed on a CT scan or on Dental X-rays. A/Prof McGuinness will take a complete medical history as well as conduct a physical examination of the mouth, jaw, teeth and nose. He may take a biopsy during this examination and may also request further specialist imaging investigations including:
- CT Scan
- MRI
How are odontogenic tumours treated?
The treatment options vary and are dependent upon the type of tumour, whether it is benign or malignant, the stage of growth, and the symptoms. A/Prof McGuinness will determine the most suitable treatment which may include:
- Surgery. This is the most common treatment for odontogenic tumours and can vary from simple “shelling out” or enucleation to more radical excision of a portion of jawbone and microvascular free flap reconstruction.
- Radiation therapy. This uses high energy rays (radiation) to damage or kill abnormal cells to help stop their growth in specific areas of the body.
When should I see a specialist?
If your family doctor or dentist suspects you have an odontogenic tumour that requires treatment, they will refer you to an ENT surgeon who specialises in conditions of the head and neck. When you have your referral, please call our rooms to arrange for a consultation with A/Prof McGuinness.