Odontogenic Lesions

Treatment

Treatment options for odontogenic lesions vary depending on the type of lesion and its stage of growth. In some cases, lesions can be treated with medications, but they often require surgical removal. The removed tissue will be examined by a pathologist. At Mayo, the pathologist will report a diagnosis within a few minutes, so that the surgeon can act on this information immediately.

Cysts

Odontogenic cysts are much more common than odontogenic tumors. Cysts can be caused either by inflammation (as when tissue surrounding an impacted tooth is irritated) or by the malformation of teeth during development.

Odontogenic keratocysts
Odontogenic keratocysts are fast-growing cysts that have a higher rate of recurrence than other cysts. Keratocysts can occur in anyone, but they are often found in people with an inherited condition called nevoid basal cell carcinoma syndrome. Depending on a number of factors, you may have one of three types of treatment:

• Removal of the cyst while under general anesthesia
• Long-term drainage to shrink or eliminate the cyst (also known as marsupialization)
• Removal of the part of your jaw affected by the cyst, with immediate or delayed bone reconstruction (depending on the type of defect)

Nevoid basal cell carcinoma syndrome
If your doctor suspects that nevoid basal cell carcinoma syndrome is the cause of your cyst, you and your family will be recommended for screening. 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, skin cancer and tumors of the cerebellum. Screening for nevoid basal cell carcinoma syndrome may help in early detection and treatment of these conditions.

Tumors

Odontogenic tumors are rare lesions of the jaws and surrounding soft tissues in your mouth.

An ameloblastoma

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CT scan of a central giant cell tumor.

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• Ameloblastoma. This slow-growing tumor is the most common type found. If not treated, it can be significantly disfiguring. The standard treatment is surgical removal.
• Myxoma. This slow-growing tumor is most often found 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 referred to as central giant cell granulomas or central giant cell tumors, these very slow-growing lesions most often occur in the front portion of the lower jaw in people in their 20s and 30s. These lesions are most successfully treated using a technique called curettage. The lesion is opened, the tissue is removed, and then the bony cavity is gently scraped. If the lesion is very large, treatment might include removal of the tumor and reconstruction of the jawbone. These tumors may also be reduced in size by steroid injections or by taking a drug called calcitonin.