Because the mouth and jaws are composed of many different types of tissues, such as bone, muscle, glands and mucosa, they are more susceptible to developing abnormal growths than other parts of the body. Lesions developing within the jaws can arise from the dental elements, bone, nerves, or blood vessels. Primary jaw cyst and tumors are generally considered either odontogenic (from the tooth developing tissues) or non-odontogenic. Examples of odontogenic tumors include ameloblastomas and odontomas and odontogenic cyst such as Radicular cyst, dentigerous cyst and odontogenic keratocysts. Non-odontogenic tumors may be considered either benign or malignant. Examples of benign tumors include fibro-osseous lesions, giant cell lesions and fibromyxomas. Malignant tumors include osteosarcoma and fibrosarcoma. Tumors may develop from the blood cell forming bone marrow including multiple myeloma.
Many primary jaw tumors are found incidentally on x-rays that may be taken for other reasons including sinusitis and dental exams. Jaw tumors may initially have no symptoms until much larger and involving other structures. Other early symptoms may include pain, swelling, numbness, jaw asymmetry, changes in occlusion and even tooth shifting. Rarely, un-erupted or impacted teeth are associated with development of lesions.
Many jaw tumors require surgery for management. The recommended treatment is dictated based on the biologic behavior of the tumor. Tumors that infiltrate into local tissues with a high rate of recurrence may require resection of a region of the jaw for eradication. This may require reconstruction to replace the lost tissue. Other tumors can be enucleated or “scooped out” since they have a low rate of recurrence following removal. Occasionally teeth will have to be removed in location to these tumors which can be replaced later with dental prosthetics and possibly dental implants. Depending on the pathology of the tumor, radiation and chemotherapy may be necessary. A thorough dental evaluation and management of dental problems prior to treatment is crucial to health after therapy.