Surgical Mini-Lectures and Clinics
Friday, October 16, 2009
3:30PM - 5:30PM
S334
Surgical Management of Odontogenic Tumors
Eric R. Carlson, DMD, MD
Professor and Chairman, Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center
Knoxville, TN
J. Michael McCoy, DDS
Professor, Departments of Pathology, Radiology, and Oral and Maxillofacial Surgery, University of Tennessee Medical Center
Knoxville, TN
Synopsis
Odontogenic tumors exhibit a spectrum of biologic behavior from slow-growing benign neoplasms that are capable of significant deformation of patients to rapidly growing malignancies capable of death of patients. While the international literature might suggest that these tumors as a whole are rare, the oral and maxillofacial surgeon is likely to encounter them with enough frequency to warrant a thorough understanding of their treatment. It is the intention of this presentation to review the clinical and radiographic presentations and surgical management of odontogenic tumors with objective information supporting curative treatment of these tumors.
Learning Objectives
At the conclusion of this presentation, participants should be able to:
- Recognize the aggressive behavior of the ameloblastoma, Pindborg tumor, and odontogenic myxoma, with the resultant need to manage these tumors with aggressive surgery. Recognize the relatively indolent behavior of the ameloblastic fibroma, ameloblastic fibro-odontoma, and adenomatoid odontogenic tumor where conservative enucleation and curettage is curative therapy.
- Discuss that while the ameloblastoma is radiosensitive, an appropriate protocol involving radiation therapy dictates that it be administered in the adjuvant setting, rather than the neoadjuvant setting.
- Describe how the use of intraoperative specimen radiographs and accurate processing of the tumor specimen indicates that a 1 cm bony linear margin represents curative therapy for this neoplasm, provided that all soft and hard tissue margins are negative in the final pathologic evaluation.