Controversies in Odontogenic Tumours: Review

Abstract

Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.

Clinical and histomorphometric evaluation of decompression followed by enucleation in the treatment of odontogenic keratocyst

“…The WHO recognized that keratocystic odontogenic tumors (KCOTs) have the potential to be aggressive and that careful follow up is essential after treatment 1 . KCOT was reclassified as OKC in the classification of developmental odontogenic cysts and relocated from the neoplastic category back into the cyst category until there is more definite evidence for classifying as KCOT by WHO in 2017 with calcifying cystic odonogenic tumours 2 , 3 . Because patched homolog (PTCH) gene mutations are only found in 30% of sporadic OKCs, such genetic alterations have been even reported among several non-neoplastic lesions, including dentigerous and orthokeratinised odontogenic cysts 3 , 4 .…”

“…KCOT was reclassified as OKC in the classification of developmental odontogenic cysts and relocated from the neoplastic category back into the cyst category until there is more definite evidence for classifying as KCOT by WHO in 2017 with calcifying cystic odonogenic tumours 2 , 3 . Because patched homolog (PTCH) gene mutations are only found in 30% of sporadic OKCs, such genetic alterations have been even reported among several non-neoplastic lesions, including dentigerous and orthokeratinised odontogenic cysts 3 , 4 . Also, OKCs can be completely regressed following decompression and the lining of decompressed cyst changed more like oral mucosa histologically unlike neoplasms 5 …”

Bringing benign ectomesenchymal odontogenic tumours to the lab: An in vitro study using an organotypic culture model

“…These lesions are characterized by morphological and molecular similarities to the tissues that originate and/or associate with the dental apparatus during the process of odontogenesis. Moreover, such tumours demonstrate a variety of inductive and reciprocal interactions between the epithelium and odontogenic ectomesenchyme, reflecting their origin in the formative components of the teeth …”

“…Moreover, such tumours demonstrate a variety of inductive and reciprocal interactions between the epithelium and odontogenic ectomesenchyme, reflecting their origin in the formative components of the teeth. [2][3][4] Most of the work on the odontogenic tumours is based on immunohistochemical analysis and, more recently, molecular pathology approaches have been used to investigate the molecular basis of these lesions. [4][5][6][7][8][9][10][11][12] However, there are scarce published papers that address cell and tissue cultures of odontogenic tumours.…”

A Recent Update on Histogenesis of Adenomatoid Odontogenic Tumor: A Review

“…There are legitimate reasons for characterizing and renaming an entity, and foremost among these is when it can be established that it behaves and can be managed differently from other members of its original group. In most cases, it will be recognized as having distinguishable histopathological features also [33]. Thus, it becomes a new clinicopathological entity.…”