Jaw neoplasms: Types of odontogenic cysts and tumors

A patient’s jaw may contain a tumor (abnormal growth or tissue mass) or cyst (contains liquid or semi-solid material). This rare lesion develops in the jawbone or soft tissues in the mouth and face. These jaw growths (odontogenic tumors and cysts) vary greatly in size and severity. In most cases the growths are benign, but sometimes they are aggressive and invade the surrounding bone and tissue, causing teeth to move and a patient to suffer from pain, swelling and difficulty eating, for example. The size, location and behavior of the tumor determine the type of treatment. The dental surgeon usually performs a surgical procedure to remove the tumor and/or uses other supportive treatment. Finally, the prognosis is variable.

  • Causes of odontogenic cysts and tumors
  • Types and symptoms of jaw tumors
  • Ameloblastoma
  • Central giant cell granuloma
  • Dentigerous cyst
  • Odontogenic myxoma
  • Odontogenic keratocyst (keratocystic odontogenic tumor)
  • Odontoma
  • Other types of cysts and tumors
  • Diagnosis and examinations
  • Treatment of jaw tumors and jaw cysts
  • Surgery
  • Supportive treatments
  • Check-up visits with doctor
  • Prognosis

 

Causes of odontogenic cysts and tumors

Odontogenic tumors and cysts originate from cells and tissues necessary for normal tooth development. Some growths also affect the jaw, but they originate in jaw tissues unrelated to the teeth. Usually the exact cause of jaw tumors and jaw cysts is not known. Occasionally, genetic disorders are the cause of a jaw tumor. Patients with Gorlin-Goltz syndrome sometimes experience multiple jaw tumors, such as odontogenic keratocysts, basal cell carcinomas, and jaw growths with other features. Patients with this hereditary condition lack a gene responsible for suppressing tumor formation.

Types and symptoms of jaw tumors

Ameloblastoma

An ameloblastoma is a relatively common, slow-growing, usually benign tumor in the jaw. The jaw growth most often develops near the molars and sometimes invades local structures such as bone and soft tissue. After treatment, the tumor may return, so aggressive surgical treatment is often necessary to reduce the chance of recurrence.

Central giant cell granuloma

Central giant cell granulomas are benign growths that usually appear in the anterior part of the lower jaw. Some tumors grow quickly, cause pain and destroy bone. They sometimes return after treatment. Other types are less aggressive and do not always lead to symptoms. Occasionally, a tumor shrinks or disappears spontaneously, but surgical treatment is usually required.

Dentigerous cyst

A dentigerous cyst comes from tissue that is around a tooth just before it erupts. Most commonly, these cysts occur around wisdom teeth that have not fully erupted, but they also occur around other teeth.

Odontogenic myxoma

An odontogenic myxoma is a rare, slow-growing, benign tumor most often found in the lower jaw. This jaw tumor is sometimes large and aggressive , affecting the surrounding tissue and causing teeth to be displaced. Aggressive surgical treatment is necessary because otherwise odontogenic myxomas will return.

Odontogenic keratocyst (keratocystic odontogenic tumor)

This slow-growing, benign cyst sometimes affects local structures. Most often, the cyst develops in the lower jaw near the third molars. Patients with basal cell nevus syndrome may be suffering from these types of cysts. The tumor also returns quickly after surgery.

Odontoma

Odontomes are benign tumors. These common tumors usually cause no symptoms, but occasionally they disrupt tooth development. The odontogenic tumors consist of dental tissue that grows around a tooth in the jaw. They sometimes resemble an oddly shaped tooth or resemble a small or large calcified tumor. These tumors sometimes occur in patients with a genetic condition.

Other types of cysts and tumors

Some other jaw cysts and jaw tumors include:

  • adenomatoid odontogenic tumors
  • ameloblastic fibroids
  • bone-forming fibroids
  • cementoblastomas, aneurysmal bone cysts
  • central odontogenic fibroids
  • glandular odontogenic cysts
  • osteoblastomas
  • squamous odontogenic tumors
  • calcifying epithelial odontogenic tumors
  • calcifying odontogenic cysts

 

Diagnosis and examinations

Importance of diagnosis
Tumors or cysts of the jaw are sometimes only discovered by the doctor during a standard dental X-ray or a standard examination of the oral cavity and teeth. Other times, the doctor diagnoses the odontogenic growths by the presenting symptoms of swelling (swollen jaw), severe pain (jaw pain), and tender bones. Most jaw tumors and jaw cysts originate from cells that form teeth. Even benign tumors and cysts are potentially destructive or malignant (cancer). Therefore, the doctor must examine and monitor them carefully.
Diagnostic examination
Imaging tests, such as an X-ray, CT scan or MRI scan, are necessary to obtain an image of the jaw and surrounding structures. Furthermore, the doctor sometimes performs a biopsy. He removes a sample of tumor or cyst cells, which he then has further analyzed in a laboratory. The doctor draws up a treatment plan based on all the research results.

Treatment of jaw tumors and jaw cysts

Surgery

The treatment for jaw tumors and jaw cysts depends on the location, tumor type, growth stage and presenting symptoms. Surgery is usually required in which the doctor removes the cyst or tumor and has it further examined in a laboratory. During the operation, the dental surgeon already receives information from the pathologist about the tissue removed, because he sometimes has to remove additional tissue. Furthermore, the doctor occasionally needs to reconstruct the jawbone or other structures.

Supportive treatments

The vast majority of jaw growths are completely benign. But even a benign tumor may hinder eating, swallowing, breathing and caring for the teeth (benign oral and dental hygiene). Therefore, supportive care is sometimes necessary to maintain quality of life, such as assistance with feeding, speech and swallowing, and replacement of missing teeth. It is also important not to underestimate the psychosocial consequences of treatment, whether surgical or medical, and that is why patients are also offered psychosocial help.

Check-up visits with doctor

Finally, the patient often has to visit the doctor for follow-up visits throughout the life of the patient in order to tackle any recurrence of odontogenic growths at an early stage.

Prognosis

The outlook for patients with one or more growths in the jaw is variable. Sometimes the tumor disappears after surgery and does not return, making the prognosis good. In other cases, the tumor is so aggressive that only supportive treatments are possible.

read more

  • Ameloblastoma: Benign, painless tumor in the jaw
  • Jaw pain: Causes and symptoms of painful jaw or jaws
  • Odontoma: Benign dental growth in jaw bone without symptoms
  • Swollen jaw/cheek: Causes of swelling jaws or cheeks
  • Stiff jaw: Causes of jaw stiffness (tight jaws)
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