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Squamous cell carcinomas arising from keratocystic odontogentic tumors are a rare phenomenon in head and neck cancer, accounting for only 1.45% of oral squamous cell carcinomas, and are classified as primary intraosseous carninomas. This cancer is locally aggressive, has a high potential for recurrence, and requires radical resection and subsequent rehabilitation. This case report describes a patient diagnosed with this uncommon tumor who was treated by dental specialists at Mayo Clinic. During convalescence, orthodontic changes to the maxillary dental archform were observed secondary to alterations in the soft tissue equilibrium following mandibulectomy and reconstruction with a microvascular fibula free flap. This highlights the need for treatment plan adaptability, the role of orthodontists in maintenance or treatment of pre-resection archforms, and the interdisciplinary nature necessary in managing the complex oncologic, functional, and esthetic needs in patients undergoing treatment for head and neck cancer. [ABSTRACT FROM AUTHOR]

Squamous Odontogenic Tumor is a rare, benign lesion of jaws affecting all age groups. This article highlights a case of Squamous Odontogenic Tumor of a 35yr old Male patient who has been clinically and radiographically diagnosed to be Pyogenic granuloma.

Background: Squamous odontogenic tumor-like proliferation (SOT-LP) is a rare benign lesion in the jaws with the same histological pattern to SOT but with different clinical and radiographic features. It originates from the epithelial cell rests of Malassez. The histological findings could be seen in the wall of some odontogenic cysts. Knowledge about the features of this lesion can help us in the diagnosis, treatment, and follow-up. Case Presentation: Here, we present two cases of SOT-LP in the wall of a radicular cyst and a residual cyst. Conclusion: SOT-LP shares several histologic characteristics with benign and malignant central jaw tumors. Making a definitive diagnosis is crucial to avoid incorrect treatment.

Tooth enamel is manufactured by the inner enamel epithelium of the multilayered enamel organ. Msx2 loss-of-function mutation in a mouse model causes an abnormal accumulation of epithelial cells in the enamel organ, but the underlying mechanism by which Msx2 regulates amelogenesis is poorly understood. We therefore performed detailed histological and molecular analyses of Msx2 null mice. Msx2 null ameloblasts and stratum intermedium (SI) cells differentiated normally in the early stages of amelogenesis. However, during subsequent developmental stages, the outer enamel epithelium (OEE) became highly proliferative and transformed into a keratinized stratified squamous epithelium that ectopically expressed stratified squamous epithelium markers, including Heat shock protein 25, Loricrin, and Keratin 10. Moreover, expression of hair follicle-specific keratin genes such as Keratin 26 and Keratin 73 was upregulated in the enamel organ of Msx2 mutants. With the accumulation of keratin in the stellate reticulum (SR) region and subsequent odontogenic cyst formation, SI cells gradually lost the ability to differentiate, and the expression of Sox2 and Notch1 was downregulated, leading to ameloblast depolarization. As a consequence, the organization of the Msx2 mutant enamel organ became disturbed and enamel failed to form in the normal location. Instead, there was ectopic mineralization that likely occurred within the SR. In summary, we show that during amelogenesis, Msx2 executes a bipartite function, repressing the transformation of OEE into a keratinized stratified squamous epithelium while simultaneously promoting the development of a properly differentiated enamel organ competent for enamel formation. [ABSTRACT FROM AUTHOR]

Purpose To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features. Materials and methods An electronic search was undertaken in January 2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm a definite diagnosis. Results A total of 74 publications reporting 110 SOTs (102 central, 8 peripheral) and 60 SOT-LPOC were included. Compared to SOT-LPOC, SOT showed lower mean age, no preference regarding maxilla or mandible localization, significant association with cortical bone perforation, multilocular radiographic appearance, and mobility of the tooth/teeth associated with the lesion. While 5 recurrent SOT were reported after enucleation, no recurrent SOT-LPOC was found. Conclusions SOT shows a more aggressive biologic behavior than SOT-LPOC, which supports the hypothesis that the two lesions are distinct clinicopathological conditions. [ABSTRACT FROM AUTHOR]

Objective: Oral lichen planus (OLP) and lichenoid lesions (OLL) are regarded as precursor lesions of oral squamous cell carcinoma (OSCC) with potential for malignant transformation. This potential is not clear due to difficulties in diagnosis of OLP and OLL. Our aim was therefore to evaluate previously identified OLP and OLL as precursor lesions in OSCC and to identify cancer related etiological factors such as smoking and alcohol consumption.Material and Methods: We retrospectively reviewed all cases (total 323, comprising 164 females and 159 males) with OSCC treated at the Department of Oral and Maxillofacial Diseases and Surgery, Helsinki University Hospital during 2015. Confirmed by histopathological biopsy, 58 (17.9%) had OLP and 13 had OLL (4.0%) as precursor lesion.Results: Patients with OLP were slightly older than those without it. OLP was more common in females than in males (p < .0001). TN class 1 tumors were more prevalent among patients with OLP or OLL (p = .006) and cancer relapses less common (p = .005). Smoking was less frequent in patients with OLP and OLL (p < .0001). Also alcohol abuse was less frequent among these patients (p < .001).Conclusion: Our findings confirm the importance of active follow-up of all patients with OLP and OLL even in patients who do not fit a traditional high-risk category for OSCC. [ABSTRACT FROM AUTHOR]

Odontogenic myxomas are a rare benign odontogenic mesenchymal tumor found exclusively in the tooth-bearing area of the jaw and are usually located centrally in the mandible. Soft tissue localization is rarely seen and is classified as peripheral odontogenic myxoma (POM). POM is slow growing and less aggressive as compared to central myxoma. It has a low recurrence rate, comprises 3-6% of all odontogenic tumors. Only a few cases of POM on maxillary gingiva are reported in the literature. Here, we present an unusual case of primary POM occurring in the gingiva of anterior maxilla in a 14-year-old female patient. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to identify changes in referral patterns and delays in diagnosis and treatment of oral squamous cell carcinoma (OSCC), managed at a tertiary institution in Victoria, Australia.Methods: The hospital records of all patients with newly diagnosed OSCC, managed by The Royal Melbourne Hospital (RMH) Head and Neck Tumour Stream between January 2008 and December 2010, were retrospectively reviewed.Results: Of the 101 patients, 52% first sought help from general medical practitioners (GMP) while 43% initially attended a general dental practitioner (GDP). The most common site of OSCC was oral tongue (42%). The most common presentation was ulceration (31%). Seventy per cent of patients presented with T1 (39%) or T2 (31%) tumours. The diagnostic delay ranged from 0 to 8 years with an average of 4.5 months. Patient delay ranged from 0 to 1.4 years with an average of 1.8 months. Professional delay ranged from 0 to 8 years with an average of 2 months.Conclusions: Delays in patients seeking advice have decreased compared to previous studies, while delays in professionals making a diagnosis have not improved considerably. There has been a significant shift towards initial presentation to GMP rather than GDP. Further decrease in delays is possible by improving both population awareness and clinician education. [ABSTRACT FROM AUTHOR]

We reported a very rare case of squamous odontogenic tumor(SOT) in a 23-year-old female. The tumor arose after an implanting operation of an orthodontic micro-screw, and was definitely diagnosed by the histopathological examination. Based on the case report and a review of the literature, we discussed about the general features, differential diagnosis and pathogenesis of SOT. [ABSTRACT FROM AUTHOR]

Squamous odontogenic tumors (SOTs) are benign, locally infiltrative neoplasms that localize to the periodontium. In total, <50 cases have been reported since the first description of SOTs in 1975. Although the exact etiology of SOTs is unknown, the tumors are considered to derive from the epithelial cell rests of Malassez. SOTs are characterized by radiological and clinical signs and symptoms, including pain with increased sensitivity in the affected area, bone expansion and increased tooth mobility. The present study describes the case of a patient that experienced numerous SOT recurrences and also discusses recommendations for treatment. A locally invasive mandibular SOT was identified in a Caucasian 41-year-old female patient. The treatment involved recommended conservative surgery, including local curettage. In addition, 49 cases published in the literature were reviewed to assess the treatment strategies. The present patient experienced two recurrences of the tumor during the 6-year follow-up period. Ultimately, the vitality of the adjacent teeth was compromised. An apicoectomy with a small amount of resection of the marginal bone was necessary. In >50% of the reported cases of SOT in the literature the adjacent teeth were extracted. The present case of SOT and the associated literature were also discussed. It was concluded that the treatment of choice appears to be a conservative surgical removal, but the successful management of SOTs often requires the removal of the adjacent teeth. [ABSTRACT FROM AUTHOR]

Aim To describe the clinicopathological and immuno-histochemical features of six tumours that do not fulfil the criteria of any of the currently classified odontogenic tumours. Methods and results The patients were three males and three females, whose ages ranged from 3 years to 18 years (mean, 11.05 years). In all cases there were well-defined radiolucencies associated with unerupted teeth apparently showing a pericoronal relationship. Microscopically, all tumours were composed of variably cellular loose fibrous tissue with areas similar to dental papilla, entirely surrounded by cuboidal to columnar epithelium resembling the internal epithelium of the enamel organ. Mesenchymal tissue was positive only for vimentin, and Ki67 expression was very low (<2%). The epithelium was positive for CK AE1/ AE3, CK5, CK14, and CK19, but negative for CK18 and CK20. All cases showed clear demarcation from the surrounding bone, and were surgically removed, with no recurrences after follow-up ranging from 6 months to 20 years. Conclusions These findings differ from those observed in other odontogenic lesions, such as ameloblastic fibroma, odontogenic myxoma, odontogenic fibroma, and hyperplastic dental follicles. The term primordial odontogenic tumour is proposed to describe this novel lesion. [ABSTRACT FROM AUTHOR]

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