Occasionally an odontome will become infected when partially erupted and surgical
excision is required. Similarly, removal is indicated if an odontome is interfering with
the eruption of a neighbouring tooth or is needed as part of an orthodontic treatment
plan.
JUVENILE OSSIFYING FIBROMA
This benign lesion differs from the adult ossifying (or cemento-ossifying) fibroma in
that growth is rapid. It consists of fibrous tissue with a varying amount of mineralized
material. It usually affects the mandible. Radiographs show a wellcircumscribed
radiolucency with 'speckling'. Surgical excision is required.
CENTRAL GIANT-CELL GRANULOMA
This swelling of bone usually affects the mandible (1038HFig. 15.20). Radiographically
there is a well-defined radiolucency with occasional resorption of associated teeth.
Histologically there are large numbers of osteoclast-like cells in a vascular stroma.
Surgical curettage is curative.
HISTIOCYTOSES
Langerhans' cell histiocytosis, formerly known as histiocytosis X is a condition that
predominantly affects children (1039HChapter 11). Bone is replaced by Langerhans' cells, so
producing sharply defined radiographic radiolucencies.
AMELOBLASTOMA
Although more commonly found in adults, this locally invasive neoplasm can occur in
children. It is usually found in the mandible. It is slow growing, and is often
symptomless in the early stages. As it progresses it causes a bony swelling, which
appears as a multilocular radiolucency in the jaw. Surgical resection to sound bone is
necessary for a cure.
AMELOBLASTIC FIBROMA
This rare lesion usually affects a younger age group than the ameloblastoma. The
average age of patients at diagnosis is 14 years. It is a benign tumour. A related lesion
is the ameloblastic fibro-odontoma. This lesion contains dentine and enamel and
occurs in children under 10 years of age.
PRIMARY INTRAOSSEOUS CARCINOMA
This is a very rare tumour but when it occurs it is usually in children. It is thought to
arise from odontogenic epithelium and shows rapid growth.
SARCOMAS
Sarcomas of the jaws are rare; however, the highly malignant Ewing's sarcoma occurs
in children between the ages of 5 and 15 years of age. The mandible is usually the
bone affected and the prognosis is poor.