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Benign Tumors
Characteristic features of benign
tumors
• Slow growing
• Well differentiated
• Remain localized
Histology
•Infrequent mitoses
•Little cytological variation
Tumor - an abnormal mass of
tissue whose growth exceeds and
is uncoordinated with that of
surrounding tissues.
Abnormal growth continues after the
stimulation which initiated it has
ceased
Characteristic features of
malignant tumors
• Fast growing
• Poorly differentiated
• Spread
• Metastasize (distant metastases via blood,
lymphatic or body cavities)
•High mitotic rate•Nuclear and cellular pleomorphism
•Abnormal mitoses
Characteristic features of locally
invasive tumors
• Slow or faster grow (benign type)
• invasion into surrounding tissues.
Example:
ameloblastoma
basal cell carcinoma („rodent ulcer”)
Benign tumors
• Fibroma
• Pyogenic granuloma
• Papiloma
• Peripherial giant cell granuloma
• Epulis
• Lipoma
• Odontoma
• Cementoma
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Fibroma• A benign tumor
consisting of fibrous
connective tissues
• Asymptomatic, pale, firm,
slow growing in form of
dense sparsely cellular
fibrous connective tissue
resulting from low
intensity, prolonged
chronic irritation.
Fibroma
• Typical localization:
– tongue, – lip,
– cheek,
tumor “mirors” places in
oral cavity where
excessive trauma
during biting can be
observed
• Treatment:
– removal of the irritant
– surgical removal of the
lesion – exsional biopsy
Fibroma Treatment
• Lenticular incision
Fibroma excision by means of
laserPyogenic granuloma
• An exuberant
proliferation of granulation tissue as an
exaggerated response to
irritation.
• Asymptomatic Red,
delicate tissue lesion
with tendency to
bleeding when
traumatized
Typical localization: interdental papillae, lip, cheek
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Pyogenic granuloma
• No pus !
• Not a granulomatictissue (histopathology-
reactive inflammatory
process)
• When multiple
traumatization
occurred vascular,
focally ulcerated parts
can be seen
Pyogenic granuloma
• Treatment
– removal of the irritant
– Surgical removal of the
lesion
– Gingival lesions:
• Excision + scaling of
adjacent teeth
TreatmentSquamous papilloma
• Squamous papilloma is a
benign tumor of squamous
epithelium.
• In response to irritation.
• Pedunculated papillary
growth from the mucosal
surface
• Cauliflower-like surface
Papilloma
• Broad base and afairly smooth surface
forms of tumor can be
observed in rare cases
• Remain benign.
• In some cases
papilloma virus has
been demonstrated in
region of tumor
Papilloma
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Inflammatory Papillary
Hyperplasia• Bubble-like configuration of
the mucosa over the hardpalate.
• Tissues are erythematous,edematous, with some densefibrous connective tissue
• Condition associated with apoorly fitting denture - pooradaptation to the mucosaallowing tissue to fill thespace possibly as a result of asuction effect.
Giant cell granuloma• Lesions is composed of giant
cells, fibroblasts andendothelial cells
• Two forms cental and
periphelial• Pale or red , asymptomatic
localized in atatched gingivaregion
• Sometimes rapid expantionwith swelling and pain
• May loose and/or displaceteeth.
Peripherial giant cell granuloma
• Clinically, may
resemble pyogenic
granuloma or they
may be quite vascular
and closely resemble
pyogenic granuloma.
• Hemorrhagic
appearance
• Superficial erosion to
bone
Peripherial giant cell granuloma
Lipoma
• Soft broad based swelling
occurring in the buccal
mucosa.
• yellowish appearance or
similar to the normal
mucosa
• Soft , fluctuant to palpation
• Slow-growing
Lipoma
• Treatment
– Surgical removal
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Lipoma -treatmentEpulis fissuratum
• Hyperplastic mass of
mucosa, proliferating
as a response to long-
term mechanicalirritation from an ill-
fitting denture
• Dense collagenous
connective tissue
Epulis fissuratum
• Typical localization:
vestibule
• Asymptomatic
• ulceration may be seen
when irritated locally
• must be removed prior
to making prosthesis
Pregnancy tumor• Local proliferation of very
vascular granulation tissue
• observed in 15% of pregnant women togetherwith diffuse gingival enlargement (proliferation of granulation tissue).
• Treatment postponed untilthe end of pregnancy;
• when traumatized or withtendency to excessive bleed,must be removed
Hemangioma
• Local vascularization
occur in young people,
often congenital.
• Asymptomatic, dark
discoloration, in response
to mechanical irritation
• Lesion blanches upon
pressure.
Hemangioma
• Unencapsulated and generally
extend into the surrounding
tissues.
• When traumatized significant
hemorrhage may occur
• tretment: chemical or surgical
remove
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Odontoma
• Complex odontoma is
disorganized mass of calcified material appearing
radiopaque on x-ray. These
are usually asymptomatic
lesions or may feature
slight expansion of the
cortical plates.
Odontoma
• Compond odontoma
small anomalous teethcan be seen sometimes
together with
unerupted tooth
Cementoma or Osteous Dysplasia
• Self-limiting fibro-osseous
process - abnormal bone
reaction to irritation or
stimulation.
• Typically multiple
radiolucencies at the apices
without oral manifestations
• The lesions may show
progressive calcification or
the same over many years.
Mixed tumor
• Asymptomatic of slowl growh,
rarely cause ulceration of the
overlying mucosa.
• Although they may appear to be
encapsulated clinically, the capsule
is usually found to be incomplete,
and any attempt at enucleation may
result in recurrence.
• Surgical excision with a border of
normal surrounding tissue.