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The following odontogenic lesions are the ones most commonly treated at the Mayo Clinic.
Odontogenic tumors are rare lesions of the jaws and surrounding soft tissues of the mouth.
Ameloblastoma is the most common odontogenic tumor. It is typically a slow-growing tumor, which can be significantly disfiguring if left untreated. Mayo Clinic surgeons and pathologists rely on a rigorous analysis of the tissues and cells to identify the exact type of ameloblastoma, which determines the treatment options. Treatment of ameloblastoma is aimed at removing the tumor to prevent recurrence.
Myxoma is a slow-growing but sometimes aggressive tumor found almost exclusively in the jaws. This tumor is more common in the lower jaws, and affects patients from very young to very old. These lesions can aggressively spread throughout the jaw, and need to be removed and the jaw reconstructed, if necessary.
Odontogenic cysts are much more common than odontogenic tumors. Some of these cysts arise in the process of tooth development; others are caused by inflammation. Inflammatory cysts often surround the crown of an impacted tooth or they may extend around and beyond the tooth roots. These cysts are lined with epithelium (a layer of cellular tissue much like skin or the tissue inside the mouth).
Odontogenic keratocysts can be a very fast-growing form of odontogenic cyst and have a higher rate of recurrence than other odontogenic cysts. Keratocysts can occur in patients with nevoid basal cell carcinoma syndrome, or sporadically in any patient. Most odontogenic keratocysts occur in people between the ages of 10 and 60. Treatment for odontogenic keratocysts is individualized to each patient's needs, and depends on the location, specific type of epithelial lining, patient's age, and other factors. Treatments can include removal of the cyst under anesthesia, marsupialization (long-term drainage in order to shrink or eliminate the cyst), or removing part of the jaw.
Nevoid basal cell carcinoma syndrome (NBCCS) is an inherited condition caused by the absence of a gene that suppresses tumors. The syndrome is sometimes referred to as Gorlin's syndrome, after a renowned pathologist who traced the syndrome to PTCH, a tumor-suppressing gene. Because the condition carries a risk of developing basal cell carcinomas (skin cancer), Mayo specialists routinely assess people with odontogenic keratocysts, as well as their family members, for the presence of NBCCS.
People with this syndrome often have other subtle developmental conditions, such as extra ribs, facial bone abnormalities, tumors of the cerebellum, and skin abnormalities of the palms of the hands or soles of the feet.
CT scan of a central giant cell tumor.
Central giant cell lesions (sometimes referred to as central giant cell granuloma or central giant cell tumor) most often occur in the front portion of the lower jaw. Teeth can be displaced by the lesion or even resorbed. While they can occur at any age, central giant cell lesions are found most often among people in their 20s and 30s. Most central giant cell lesions develop very slowly. Central giant cell lesions are generally successfully treated through curettage, in which the lesion is opened and the tissue removed, followed by gentle scraping of the inside of the bony cavity. In the case of a very large lesion, surgery may include removal and reconstruction of the jaw. Other options for treatment include injections of steroids into the lesion, or the use of the drug calcitonin to decrease the size of the lesion.
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