Any dental board exam will ask about bony tumors of the head and neck. I created this study aid when studying for three different dental board examinations.

1. BENIGN TUMORS
ODONTOGENIC TUMORS
AMELOBLASTOMA:
Benign but aggressive and infiltrative. Of epithelial origin (dental lamina and dental
organ). Most common epithelial odontogenic tumor. Unicystic in adolescents. Others 20 to 40 years.
Honeycomb, soap bubble appearance. Typically lower third molars but can be anywhere, maxilla and
mandible.
Unicystic – 6%
Multicystic – 92%
Peripheral – 2%
Can go malignant to:
MALIGNANT AMELOBLASTOMA – Metastatic lesions resemble 1° lesion
AMELOBLASTIC CARCINOMA – Metastatic lesions do not resemble 1° lesion
ADENOMATOID ODONTOGENIC TUMOR (AOT) / ADENOAMELOBLASTOMA
Benign, non-invasive but will displace teeth.. Technically a harmartoma. Mild swelling
with clinically missing tooth. Originates from residual odontogenic epithelium of the dental follicle.
Called the “two thirds” tumor.
Occurs in second and third decade (12 to 20 yo.)
90% incisor region (2/3 maxilla, 1/3 mandible)
2/3 females
2/3 Follicular (associated with impacted tooth)
1/3 Extra-follicular (w/o impacted tooth)
CALCIFYING EPITHELIAL ODONTOGENIC TUMOR (CEOT) / PINDBORG TUMOR
Originates from reduced enamel epithelium of stratum intermedium. Benign but locally
invasive and expansive. 50% associated with unerupted teeth. 66% mandible. Premolar/molar area.
Mixed radiolucent and radiopaque foci. Snow driven appearance.

2. ODONTOGENIC MYXOMA / MYXOFIBROMA
Benign but invasive and destructive. Looks the same clinically as Ameloblastoma.
Almost exclusively in jaw bones. Originates from mesenchymal tissue. Radiographically, fine
intralesional trabeculation with soap bubble or tennis racket appearance. Can cause exopthalamos if
invades the maxilla.
AMELOBLASTIC FIBROMA
Benign but expansive. Unilocular or bilocular. 70% under 20 y/o. A Mixed tumor arising
from both epithelial and mesenchymal tissues. Premolar/molar area associated with missing tooth.
Looks the same as unicystic ameloblastoma.
AMELOBLASTIC FIBRO-ODONTOMA
Benign well encapsulated tumor. Pericoronal to imbedded tooth. Initially radiolucent but
develops radiopaque foci as hard tooth structures begin to develop. Most under 20 y/o. Premolars.
COMPLEX ODONTOMA
Associated with an unerupted tooth. Sunburst radiopacities. Do not resemble teeth but
are made of tooth structure. Histodiferentation but not morphodifferentation. Demarcated borders. No
pain. Benign. Lower Posterior teeth.
COMPOUND ODONTOMA
Most common odontogenic tumor. Upper anterior teeth. Morphodifferentation.
“Toothlets”. Associated with unerupted tooth.
AMELOBLASTIC ODONTOMA / ODONTOAMELOBLASTOMA
Combined ameloblastoma and compound odontoma. Missing tooth. Less than 20 y/o.
Boys, mandible.
CEMENTOBLASTOMA
Benign derived from PDL. Lower first molar. Vital tooth. Well defined radiopacity
attached to root of tooth. NOT a cementoma.

3. NON-ODONTOGENIC TUMORS
OSTEOMA
Originate from cartilage and periosteum. Exclusive to skull. Mandible on side of ramus
and inferior border. Seen in Gardner's Syndrome.
HEMANGIOMA
Benign tumor. Female mandible, body and ramus. Loose and migrating teeth. Bruae are
heard. Traumatic in origin. Radiographically – Soap bubble / honeycomb. Sun ray, sunburst.
CHONDROMA
Benign tumor of cartilagenous origin. Locally invasive. Can resorb teeth.
ATRIOVENOUS FISTULA
Vascular defect. Pulse is felt. Surgical repair.
NEUROLEMMOMA / SCHWANNOMA
Originates from neuroectodermal Schwann cells. Round or oval radiolucent lesion
posterior to the mental foramen. Parasthesia distal to and pain at site.
NEUROMA / TRAUMATIC NEUROMA / AMPUTATION NEUROMA
Not a neoplasm. Overgrowth of severed nerve. Painful. Radiolucent.
NEUROFIBROMA
Originates from both Schwann cells and peripheral nerves including axons. Malignant
potential. Enlarges inferior alveolar and mental nerve foramen.

4. NEUROFIBROMATOSIS
Von Recklinghausen's disease. Generic. Neurofibromas, Cafe au Lait spots and freckled
in armpits.
KERATOCANTHOMA
Sebaceous gland tumor of skin. Self healing cancer.
BENIGN TUMORS OF SALIVARY GLAND TISSUE
PLEOMORPHIC ADENOMA
Most common salivary gland tumor. At tail of the parotid gland. When in minor
salivary glands, hard palate is most common site. Mixed tumor (epithelial and connective tissue
components). Benign
ADENOLYMPHOMA / WARTHIN'S TUMOR / PAPILLARY CYSTADENOMA
LYMPHOMATOSUM
Parotid. Well encapsulated. Contains multiple cysts. Benign.
INTRADUCTAL PAPILLOMA
Small, tan, smooth lesion found in submucosal layer.
ONCOCYTOMA / OXYPHIL ADENOMA
Small, slow growing spherical masses in parotid of females over 50 y/o.
HEMANGIOMA
Most common SGT in children. Parotid. Rapid growth age 1 to 6 months.
Spontaneous involution ages 1 to 12 years.
LYMPHANGIOMA / CYSTIC HYGROMA
Parotid and submndibular of infants and children. From embryonic lymph ducts.
They are spongy, multiloculated masses with a yellowish or bluish surface and are formed by
endothelial-lined spaces

5. LIPOMA
From fat cells. Smooth round yellow masses.
NECROTIZING SIALOMETAPLASIA
Painless solitary lesion of hard palate. Benign and self healing.
LYMPHOEPITHELIAL HYPERPLASIA / SICCA SYNDROME / MIKULICZ
DISEASE
This disorder can manifest as a diffuse enlargement of all or part of the parotid
gland, or it may manifest as a discrete mass. 40 to 50 y/o.
FIBRO-OSSEOUS LESIONS
FIBROUS DYSPLASIA
Benign skeletal developmental deformity of bones. Maxilla. Replaces medullary bone
with fibrous tissue. Expansion and weakening of bone. Seen in Albright's syndrome along with
endocrine disorders (Precocious Puberty) and skin pigmentation. NO radiation therapy.
FIBROUS DYSPLASIA OSSIFICANS PROGESSIVA / MYOSITIS OSSIFICANS
PROGRESSIVA
Fibrous tissue (muscle, tendon and ligaments) are ossified without injury in predictable
patterns. Genetic disorder. Stone Man Disease. Deformed big toe.
MYOSITIS OSSIFICANS
Fibrous tissue (muscle, tendon and ligaments) are ossified as a result of trauma.
CHERUBISM
Inherited fibro-osseous disease of only the jaws. Bilateral mandibular involvement.
Disease of kids. Starts 2-6 y/0. Multiple cyst like radiolucencies. Displaces lower 7 and 8's. Premature
loss of baby teeth.
CEMENTIFYING FIBROMA,
OSSIFYING FIBROMA – only one bone

6. CEMENTOOSSIFYING FIBROMA
A tumor of fibroblastic tissue containing masses of cementum-like tissue, usually in the
mandible of older person. Overgrowth of gingival tissues containing microscopically fibrous tissue and
mineralized products (bone, cementum)
CEMENTOOSSEOUS DYSPLASIA
Originates from odontogenic cells in PDL. The following are the same pathological process.
PERIAPICAL CEMENTOOSSEOUS DYSPLASIA / CEMENTOMA / PERIAPICAL
OSTEOFIBROSIS
Apexes of lower anterior teeth. Black females over 40. Vital teeth. Early stage
radiolucent. Late stage radiopaque.
FOCAL CEMENTOOSSEOUS DYSPLASIA
Lower premolar and molar. Single lesions. Caucasians. Margins not so discrete.
FLORID CEMENTOOSSEOUS DYSPLASIA
Multiple sclerotic symmetrical masses. Blacks 90%.
GIGANTIFORM CEMENTOMA
Rare. Young Children. Inherited
MALIGNANT INTRAORAL TUMORS:
SQUAMOUS CELL CARCINOMA
90% of oral carcinoma is SCC. Epithelial origin. Posterior lateral border of tongue and
lower lip. Older men.
METASTATIC CARCINOMA
Most common malignant tumor in skeleton. Mandible, premolar. Metastasize from other
areas in body.

7. MALIGNANT TUMORS OF SALIVARY GLANDS
50% Sub mandibular gland.
MUCOEPIDERMOID CARCINOMA
Most common salivary gland tumor in children. Three cell types – mucous cells,
intermediate cells and squamous cells. The more mucous cells in the tumor the better.
ADENOCYSTIC CARCINOMA
Well differentiated and slow growing. Specific to salivary glands. Most common
malignant SGT in palate area. Also called Cylindroma. Honeycomb ans Swiss cheese histological
patterns.
ADENOCARCINOMA
Tumor of glands. Epithelial in origin. Malignant cells have secretory properties.
MALIGNANT MIXED TUMOR
SARCOMAS
Bone tumors. Origin within connective tissue. Spread through blood stream.
OSTEOGENIC SARCOMA / OSTEOSARCOMA
Second most common tumor of long bone. Young (under 20) and very old. Moth
eaten, sunburst, onion peel. Widened PDL space.
CHONDROSARCOMA
Cartilaginous origin. Third most common tumor of long bone. Maxilla males.
Increasing gap between adjacent teeth.

8. FIBROSARCOMA
Periosteal / endosteal origins. Mandible. Seen in Paget's disease.
EWING'S SARCOMA
Male teenagers. Round cell tumor of bones. Onion skin appearance.
LEUKEMIAS
Children less than 5 years old. gingival hyperplasia. Loosening of teeth.
BURKITT'S LYMPHOMA / BURKITT'S LEUKEMIA
B-lymphocyte malignancy. Epstein Barr Virus association. African variety. Jaw
bone. Gross distortion of face. Starry Sky. Loss of lamina dura.
MULTIPLE MYELOMA
Cancer of plasma cells (white blood cells) in bone marrow. Men 40 to 70 y/o.
Bence Jones protein. Posterior mandible. Punched out radiolucencies. Migration of teeth. Punched out
radiolucencies in premolar area of lower jaw. Cartwheel and checkerboard patterns histologically.
REACTIVE LESIONS
CENTRAL GIANT CELL GRANULOMA (CGCG)
Benign. Age less then 20 y/o. Female. Intraosseous lesion usually mandible
anterior to 1st molar. Crosses symphysis. Expansive. Parasthesia is common. The aggressive version
resorbs roots and moves teeth. Multilocular radiolucencies. Soap Bubble. Contains giant cells.
OSTEITIS DEFORMANS / PAGET'S DISEASE
Slow virus infection (paramyxovirus). Disordered bone metabolism. Results in
enlarged and deformed bones. Over 40 years old and mostly men. Osteogenic Sarcoma is a RARE

9. complication. Cotton wool appearance on radiographs. Migration of teeth, dentures don't fit. Loss of
lamina dura and hypercementosis. Increased alkaline phosphatase on blood tests.
OSTEOPETROSIS/ MARBLE BONE DISEASE
Rare, inherited. Increased bone density. Osteoclastic dysfunction. Narrow
marrow space. Delayed tooth eruption. Poorly calcified teeth. Early loss of crowns. Brittle bones,
stunted growth. Anemia. Very radiopaque dental x-rays.
SCLEROSTEOSIS
Generalized skeletal overgrowth, mostly pronounced in the skull and large
mandible; facial distortion; tall stature; syndactyly; radial deviation of the terminal phalanges – cigar
shaped; dysplastic or absent nails.
INFANTILE CORTICAL HYPEROSTOSIS / CAFFEY – SILVERMAN DISEASE
Self limiting within 6 to 9 months.. Mandible, clavicle. Bone changes, soft tissue
swelling and irritability. Increased ESR.