Radiological Features of the Adenomatoid Odontogenic Tumor

Objectives: The aim of this study was to evaluate the radiological and clinical features of the Adenomatoid Odontogenic Tumor (AOT). Methods: A total of 273 cases (267 from the English-language literature and six new cases) were studied and critically evaluated with emphasis on the radiological features. Results: Age at time of initial diagnosis ranged from 3 to 82 years (mean 18.4 years, median 16 years). The distribution between females and males was 3:2. The ratio between the maxilla and mandible was 3:2. Mandibular lesions were significantly more frequent among subjects older than 16 years of age. Lesions were dominantly radiolucent in 90.6% ; of them, small opacities were present in 76%. Of all lesions, 90.2% were unilocular. Borders were well-defined in 91.5% of cases. The lesions were round or oval in shape in 75.5% and irregular in 24.5%. The most common AOT variant was the intra-follicular with significant priority to maxillary canines.The extra-follicular variant was less common. Tooth displacement was noted in 81.2% of all cases. Tooth resorption was described in 18.9% of the lesions and was significantly more prominent among subjects who were older than 16 years of age. Expansion of cortex was noted in 67.3% of cases and was significantly more prominent among subjects who were older than 16 years of age. Conclusions: Some radiological features are characteristics to most cases of AOT (radiolucency presented with opacities, unilocularity, well-defined borders, and tooth displacement). Other features are more variable and are influenced by the age of the patient. Patients older than 16 years of age are more likely to present mandibular AOT, the extra-follicular variant of AOT, tooth resorption and expansion of cortex. Hence, AOT should be considered more often in the differential diagnosis of radiolucent or mixed lesions of the jaws.