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CALCIFYING EPITHELIALODONTOGENIC TUMOR
PINDBORG TUMOR)
UNDER THE GUIDENCE OF: SUBMITTED BY
DR NAVEEN CHABRA ASIMA JAAN
DR SHRUTI CHABRA ROLL NO:960
DR SHIKHA BDS 3rdYR
DR NITIN 1
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CLASSIFICATION:(BY WHO)
BENIGN ODONTOGENC EPITHELIUM WITHOUT ODONTOGENIC
ECTOMESENCHYME:
Ameloblastoma
Squamous odontogenic tumor
calcifying epithilal odontogenic tumor (Pindborgs tumor)Adenomatoid odontogenic tumor
ODONTOGENIC EPITHELIUM WITH ODONTOGENICECTOMESENCHYME WITH OR WITHOUT DENTAL HARDTISSUE:
Ameloblastic fibroma
Ameloblastic fibrodentinomaAmeloblastic fibro-odontoma
Odontoameloblastoma
Adenomatoid odontgenic tumor
Compound and complex odontoma
Calcifying odontogenic cyst2
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CALCIFYING EPITHELIAL
ODONTOGENIC TUMOR
INTRODUCTION:
It is a rare type of slow growing, usually
benign, odontogenic tumor.
first described in 1956 by the late DR JENSJORGEN PINDBORG. So also known aspindborgstumor.
Alternative abbreviation commonly used is
CEOT(calcifying epithelial odontogenic tumor). It accounts less than 1% of all odontogenic
tumors.
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DEFINITION:
It is an uncommon , benign ,
odon togenic neop lasm that is
exclusively epithel ial in o rigin .
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ETIOLOGY
Definite etiology of this neoplasm isenigmatic..Two theories have beensuggested
Some say that the epithelial cells ofthis tumor are reminiscent of the cellsin the stratum intermedium layer of theenamel organ in the tooth
development. some say that this tumor arises from
the remnants of the primitive dental
lamina found in the initial stage ofodonto enesis. 6
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CLINICAL FEATURES:
Clinically it is of two types
INTRAOSSEOUS EXTRAOSSEOUSINTRAOSSEOUS LESIONS: Mostly this type of lesions are seen.(113
reported cases)
Occurs mostly in middle age(40 yr) No significant diff. in male female ratio.
Slightly more in females. More commonly seen in mandible over
maxilla by ratio 2:1 Mostly seen in molar region than bicuspids.And even distribution in other regions ofjaw
asymptomatic lesion, only painless 7
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Extraosseous lesionS: This type of lesions are quite rare.(8
reported cases)
Occur at the age of 35 yr
Equal sex distribution
Mostly lesions occur on gingiva.. Mostlymandibular. And may be seen in anterior
segment, and rarely on the upper lip.
These lesions are histologically similar to
intraosseous lesions.
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HISTOLOGICAL FEATURES: It is composed of polyhedral epithelial cells
seen in large sheets closely packedtogether or scattered small islands of cell
in fibrous connective tissue stroma.
Tumor cells are arranged in rows or cordswith well outlined cell border and granular
eosinophilic cytoplasm.
intercellular bridges are often prominent. Nuclei are pleomorphic, with giant cell
nuclei and multinucleation.
Mitotic figures are rare. 12
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Clear cell varian tis a well recognizedform of this neoplasm. The tumor cells
exhibit a clear vacuolated cytoplasm ,nucleus may be round or oval in thecenter of the cell or flattened againstthe cell membrane.
There is presence of homogenous ,eosinophilic substance interpreted asamyloid. Which may be present inlarge or limited quantities.
Large amount of calcifications arepresent in form of LiesegangRings.
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Differential diagnosis:Dentigerous cyst
Ameloblastoma
Mucoepidermoid carcinoma
Adenomatoid odontogenic tumorCalcifying epithelial odontogenic cyst
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Treatment: Small intrabony lesions with well
defined borders can be treated withEnucleation or Curettage. Judicial
removal of a thin layer of bone
adjacent to the tumor. Recurrent or persistent tumors which
have become large and more
extensive (>4cm) require segmentalresections such as partial or hemi
mandibulectomy or hemi
maxillectomy. 16
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References:Text book of oral pathology:
SHAFERS
Text book of oral $maxillofacial pathology:
NEVILLE
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