Odontogenic lesions

Treatment

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.