Removal of an odontoma:
An odontome is a growth of haphazardly arranged tooth tissue.
It can cause swelling, delayed eruption of nearby teeth, displacement of permanent teeth and an abnormal occlusion (bite). Depending on the age of the patient, once diagnosed we usually remove an odontome as soon as possible.
Cysts of the upper or lower jaw:
Cysts are fluid filled sacks within the jaw bone. They grow by expansion and can gradually increase in size to the extent that the adversely affect the support of the adjacent teeth and strength of the jaw. It is essential to treat cysts before they become too large.
We remove cysts in order that bone can grow into the empty space. There are two surgical treatments performed for this purpose:
- Enucleation – the cyst is opened and the lining of the cyst is removed.
- Marsupialisation – the cyst is opened, part of the lining is removed and a pouch is made so the remainder of the lining is continuous with the tissue inside the mouth. Marsupialisation is sometimes carried out in an effort to reduce the size of the cyst prior to definitive removal.
We always try to save teeth involved with the cyst, but one or more teeth may need to be extracted depending on the size and location of the cyst.
Tumor of Jaw:
Numerous tumor types, both benign and malignant, originate in the jaw. Symptoms are swelling, pain, tenderness, and unexplained tooth mobility; some tumors are discovered on routine dental x-rays, whereas others are found on routine examinations of the oral cavity and teeth. Treatment depends on location and tumor type. Benign tumors may be observed and may not need surgical excision, although most tumors require resection with possible reconstruction.
If not initially detected on x-ray, jaw tumors are diagnosed clinically because their growth causes swelling of the face, palate, or alveolar ridge (the part of the jaw supporting the teeth). They can also cause bone tenderness and severe pain.
Bony outgrowths (torus palatinus, torus mandibularis) may develop on the palate or mandible. These are common growths and may prompt concerns about cancer, although they are benign and of concern only if they interfere with dental care or function of the submandibular gland. When on the palate, they are in the midline and have intact, smooth mucosa.
The most common tumor of the mandible and maxilla is squamous cell carcinoma invading the bone through dental sockets. These can involve any portion of the intraoral mandible or maxilla.
Ameloblastoma, the most common epithelial odontogenictumor, usually arises in the posterior mandible. It is slowly invasive and rarely metastatic. On x-ray, it typically appears as multiloculated or soap-bubble radiolucency. Treatment is wide surgical excision and reconstruction if appropriate.
Odontoma, the most common odontogenictumor, affects the dental follicle or the dental tissues and usually appears in the mandibles of young people. Odontomas include fibrous odontomas and cementomas. A clinically absent molar tooth suggests a composite odontoma. Typically, these tumors are excised, particularly when the diagnosis is in doubt.
Osteosarcoma, giant cell tumor, Ewing tumor, multiple myeloma, and metastatic tumors may affect the jaw. Treatment is the same as for those tumors in other bony sites.
Biopsy:
If abnormal tissue occurs in the mouth, we may need to remove a small piece for analysis. We use a variety of cutting instruments in order to complete biopsies. We then send the tissue to a pathologist who can confirm the diagnosis. Once we receive the pathologist’s report, we’ll discuss treatment options with you.