Odontogenic lesions are cysts or tumors that develop in your jawbone or the soft tissues in your mouth. Odontogenic lesions can vary greatly in size and severity. These lesions are usually noncancerous (benign), but they may behave aggressively at times. Treatment generally involves surgical care but may include medical therapy for certain types of lesions.

  • Teamwork. Because the causes and circumstances of odontogenic lesions can be complex, mouth, jaw and face (oral and maxillofacial) surgeons work together with ear, nose and throat (ENT) specialists and experts in laboratory medicine, radiology and plastic surgery to solve your problem.
  • Experience and expertise. Mayo Clinic treats people who have odontogenic lesions with the help of sophisticated imaging and advanced surgical techniques such as computer-assisted surgery.
  • Efficient care. Your care team can schedule all the necessary tests and gather results quickly. Mayo Clinic pathologists analyze tissue samples rapidly, guiding the surgeon during your surgery and reducing the need for multiple surgeries.

Odontogenic lesions are often first noticed by your dentist. An oral and maxillofacial surgeon will usually oversee your care at Mayo. He or she will ask about past symptoms and examine the lesion and your entire head and neck region.

To determine the type of lesion, your doctor may remove a small piece of the lesion (biopsy) to view under a microscope. You'll be under local anesthesia for this procedure. Your doctor will also likely order one or more imaging tests, such as:

  • X-ray
  • Computerized tomography (CT) scan
  • Dental cone beam CT scan, a special type of CT scan that provides 3-D images of the bones, teeth, soft tissues and nerves in your mouth
  • Magnetic resonance imaging (MRI)

Read more about X-ray, CT scan and MRI.

Treatment options for odontogenic lesions vary, depending on the type of lesion and stage of growth. In some cases, medications may help, but odontogenic lesions usually require surgical removal. At Mayo, a pathologist examines the removed tissue during surgery and reports a diagnosis within a few minutes, so that the surgeon can act on this information immediately.

Keratocystic odontogenic tumors

Keratocystic odontogenic tumors are slow-growing cysts often associated with impacted teeth, such as third molars, and can occur in anyone. Usually, if you have a keratocystic odontogenic tumor, you may be symptom-free and have the lesion discovered only after routine dental X-rays. Keratocystic odontogenic tumors may also be found in people with an inherited condition called nevoid basal cell carcinoma syndrome.

Depending on a number of factors, you may have one of these types of treatment:

  • Removal of the cyst while under general anesthesia
  • Bone grafting of the cystic defect
  • Long-term drainage to shrink or eliminate the cyst, also called marsupialization (mahr-soo-pee-ul-ih-ZAY-shun)
  • Removal of the part of your jaw affected by the cyst, with immediate or delayed bone reconstruction, depending on the type of defect

Keratocystic odontogenic tumors have a potentially high recurrence rate after treatment.

Nevoid basal cell carcinoma syndrome

If your doctor suspects that nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) is the cause of your cyst, your doctor may recommend screening for you and your family. People with nevoid basal cell carcinoma syndrome lack a gene that suppresses tumors and may also have other subtle developmental conditions such as extra ribs, facial bone abnormalities, multiple basal cell skin cancers and, less commonly, brain tumors. Screening for nevoid basal cell carcinoma syndrome may help in early detection and treatment of these conditions.

Other tumors

Other types of odontogenic tumors include:

  • Ameloblastoma. This slow-growing tumor is the most common type of odontogenic tumor found. If not treated, ameloblastoma may cause significant disfigurement. Standard treatment involves surgical removal.
  • Myxoma. Myxoma, a slow-growing tumor, occurs most often in the lower jaw. It can become aggressive and should be removed. You may need reconstructive jaw surgery, depending on how invasive the tumor is.
  • Central giant cell lesions. Sometimes called central giant cell granulomas or central giant cell tumors, these slow-growing lesions most often occur in the front portion of the lower jaw in people age 30 or younger. Successful treatment usually requires a technique called curettage. During curettage, a surgeon opens the lesion, removes tissue and then gently scrapes the bony cavity. For a very large lesion, treatment might include removal of the tumor and reconstruction of the jawbone. Other treatments that may decrease tumor size include steroid injections or taking a drug called calcitonin.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Arizona, ear, nose and throat (ENT) specialists care for people who have odontogenic lesions, with other experts involved if needed.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, mouth, jaw and face (oral and maxillofacial) surgeons care for people who have odontogenic lesions. For cases that require reconstruction, specialists in ENT or plastic surgery may be part of the treatment team.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

See a list of publications by Mayo doctors on odontogenic lesions on PubMed, a service of the National Library of Medicine.

Nov. 19, 2012