Mandible & maxilla

Other benign tumors / tumor-like conditions


Topic Completed: 1 December 2017

Minor changes: 30 September 2020

Copyright: 2004-2021,, Inc.

PubMed Search: Odontoameloblastoma

Anthony Martinez, M.D.
Kelly Magliocca, D.D.S., M.P.H.
Page views in 2020: 1,071
Page views in 2021 to date: 1,095
Cite this page: Magliocca K, Martinez A. Odontoameloblastoma. website. Accessed October 22nd, 2021.
Definition / general
  • Odontoameloblastoma (OA) is / was viewed as an extremely rare mixed odontogenic tumor with both epithelial and mesenchymal components
    • Epithelial component represented by ameloblastoma
    • Mesenchymal component - a compound or complex odontoma
  • Not considered an entity in the current 4th edition WHO (El-Naggar: WHO Classification of Head and Neck Tumours, 4th Edition, 2017)
Essential features
  • Odontoblastoma
  • Adamant-odontoma
  • Calcified mixed odontogenic tumor
  • Soft and calcified odontoma
  • Ameloblastic odontoma
  • Molar / premolar region of maxilla or mandible
Clinical features
  • Swelling, dull pain, delayed eruption of teeth, bone expansion
  • Diagnosis dependent on clinical, radiologic and pathologic correlation
Radiology description
  • Radiolucent lesion that can be destructive
    • Contains calcified structures resembling mature dental tissue
Radiology images

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Cystic lesion

Diffuse foci of radiopacities

Prognostic factors
  • Known to recur after curettage
  • No long term prognostic data, given so few cases
Case reports
Gross images

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Surgical specimens

Microscopic (histologic) description
  • Proliferating odontogenic epithelium portion identical to that of an ameloblastoma with peripheral palisading, reverse polarization and stellate reticulum
    • Generally presenting as plexiform or follicular pattern
  • This epithelial portion appears intermingled with dental tissues of variable degrees of maturity
    • Can show resemblance to the developing rudimentary teeth, as in a compound odontoma
    • Can also show conglomerate masses of enamel, dentin and cementum, as seen in complex odontoma
Microscopic (histologic) images

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Case of the Week #367

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Various images

Odontogenic epithelial cells

Irregular masses of dysplastic dentin

Differential diagnosis
  • Ameloblastic fibroma
    • Composed of odontogenic epithelial component strands, cords and islands that may exhibit peripheral palisading, reverse polarization and stellate reticulum
    • Primitive appearing stroma that is delicate and lobular in appearance
    • Should not have the mesenchymal (odontoma) component
  • Ameloblastic fibro-odontoma
    • Has soft tissue component that is similar to ameloblastic fibroma
    • Also contains a calcifying component composed of enamel and dentin structures
  • Ameloblastoma
    • Same histologic epithelial features with peripheral palisading, reverse polarization and stellate reticulum
    • Should not have mixed mesenchymal component (odontoma)
  • Calcifying cystic odontogenic tumor (CCOT)
    • Benign cystic tumor of odontogenic origin, also known as Gorlin cyst or calcifying odontogenic cyst
    • Can have ameloblastic features: columnar or cuboidal basal cells with lumen lined by tissue resembling stellate reticulum
    • Will have ghost cells or anucleate epithelial cells
    • Can also have dentinoid materal resembling odontoma in around 20% of cases
  • Odontoma
    • Compound odontoma: cluster of denticles of varying sizes
    • Complex odontoma: conglomerate of dentin admixed with enamel matrix
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