 Hello everyone, welcome back to a new session on dentistry and more today. We have a different tumor that is a denomatoid Orantogenic tumor or AOT. So last class We have covered a C E O T that is calcifying epithelial orantogenic tumor From the name itself, we will get an idea about the tumor. So this is adenomatoid Orantogenic tumor anyway, orantogenic is something related to tooth or tooth forming tissues that is clear So adenomatoid is adenom means something related to gland. So this tumor has specular gland like Appearance or gland like structures. That is why this got adenomatoid orantogenic tumor Now, let's get into details of AOT. So adenomatoid orantogenic tumor as a name suggests It is a gland like structure formation in histological features That's why it got this specular name. So we'll come to that later. Now, let's see the basic introduction of this So it is also known as adenomatoid or amyloblastic adenomatoid tumor. So it is always or sometimes in the previous time Misdiagnosed as amyloblastoma. That is why it got this name that is adenomatoid and amyloblastic adenomatoid tumor So the one of the differential diagnosis is amyloblastoma AOT or adenomatoid or endogenic tumor, which is benign in nature a non-invasive type but progressive lesion Which is most commonly associated with unerupted maxillary canine So I also mentioned it as hamato matis Lesion hamato matis is nothing but a disorganized growth, which is mimicking a Neoplasm, but the difference between hamatoma and a benign neoplasm is like It's growth rate. We cannot measure. There is no measurable growth rate is there whereas a benign tumor has growth rate measurable growth rate and it is basically composed of tissues of origin Within it is found. So it is not a particularly benign lesion hamato matis is little different from benign lesion So it is most commonly seen. I mentioned it is most commonly seen with maxillary canine uninterrupted maxillary canine And it is the fourth most common odendogenic tumor so Among odendogenic tumor. It is a fourth most Common one and it can be divided into two variants. Basically one is central that is intraoshes and peripheral which is Extraoshes, okay, so it has basically two types central intraoshes and peripheral extraoshes so the central variant that is the intraoshes type has follicular and extra follicular subtypes follicular and extra follicular the follicular type will be associated with an impacted tooth and is the one which Commonly get confused with the dentiger assist So it has central and peripheral that is intraoshes intraoshes and extraoshes intraoshes again has subtypes which is follicular and extra follicular follicular is the one which is associated with an impacted tooth and which is commonly Get confused as dentiger assist. So sometimes it is also seen that cases with both aot and Dentiger assist Sometimes you get confused. So sometimes very rarely both aot and dentiger assist will be there in the same place in the 2 to 3 decade that is 20 to 30 years Or the 10 to 20 or 20 to 30 years that is a second and third decade And it is most commonly or mostly seen in anterior part of maxilla It is slowly enlarging a swelling type Sometimes the gums will be very swollen the ginger will be very swollen and it is associated with an impacted tooth and mostly a maxillary canal So females are most commonly affected than males maxilla is Affected than mandible anterior part is affected than the posterior jaw So it is seen in second and third decade anterior maxilla is mostly affected It is a slowly enlarging swelling, which is associated with impacted tooth So when you are studying aot that is adenomatoid ordentogenic tumor the two key points are it is like a Adenomatoid that is a gland like structures are present and another thing is it is associated with uneruptured maxillary canal So these two are the take away points of aot. It has The adenomatoid structures that is gland like structures adeno is nothing but a gland like And it is associated with uneruptured maxillary canal Now we will move on to the radiographic features So radiographic features basically it is a radio-lucent lesion and well-defined radio-lucent lesion and Sometimes it gets calcified in some areas or some cases it get calcified few areas The those areas will be shown in radiograph as radio capacities And it is associated with as we know An uneruptured tooth and it sometimes looks like a denturus cyst So denturus is also associated with an eruptured tooth. So it sometimes misdiagnosed as denturus cyst Now move on to the histology histology part is the most important part There we have this adenomatoid structures So it is a well-encapsulated Solid or partly cystic lesions. So it is well-encapsulated Solid or partly cystic lesion. So on histology it shows sheets strands and whole masses of epithelium which differentiate into columnar amyloblast like cells so Can roughly seen the columnar type cells Columnar type cells. This is not a very good picture. I Just want to show the duct like structures with columnar cells Aligned at the periphery So sheets strands or whole masses of epithelium. So epithelium is differentiated So epithelium is changed into columnar amyloblast like cells Which forms it so these columnar cells forming the duct or tubular like structures So this is a tubular like structure So that's why it got the specular name that is adenomatoid Tumor because of its tubular like structures how this tubular like structure forming because the columnar cells differentiated or arranged to themselves Like this making a duct like or tubular like structures. So it has a central space containing homogenous ismophilic rim of various thickness. So that ring is Particularly known as hyaline ring. So it forms as a hyaline ring and the other features like stellate reticulum like spindle cells Occasional round or polygonal epithelial cell which dominate the tissue between cell rich No duals. So that is just a histological characteristics the stellate reticulum like spindle cells Occasional round or polygonal epithelial cells which dominate the tissue between cell rich nodules And small amount of ismophilic material or Calcification also may be present between the cells. So little bit of calcification or ismophilic material also seen between the cells So this is the duct like structure. So this is the duct like structures Lined by one or two columnar cells. So these are the columnar cells Which is lining the duct like structures though. This is the characteristic feature of aot So this is a key point. This is a takeaway point that is a duct like structure in Histology, so if you are seeing a histology slide also, it is very easy to understand aot. So there will be a duct like structure how this is warming this is by differentiation of columnar cells columnar cells arranged at the periphery One or two columnar cells making a duct like structure So adenomatoid adendogenic tumor is also known as adeno amyloblastoma or amyloblastic adenomatoid tumor So the two key points are which is associated with uneructed maxillary canine and it has adeno duct like or tubular like structures with columnar cells at the borders and The treatment is most commonly it is enucleated It is basically a conservative surgical accession rather than the radical one and it is most commonly it does not