Radiological and clinical features of calcifying epithelial odontogenic tumour

Objectives: To analyse systematically the radiographic features of the calcifying epithelial odontogenic tumour (CEOT). Method: Clinical and radiological features of 67 cases of CEOT (four new and 63 from the literature) were analysed. Results: There were 27 (41%) males and 39 (59%) females with a male-to-female ratio of 1 : 1.5. Age ranged from 13 77 years (mean 43.5 years), with a peak in the fourth and fifth decades. The mandible was involved in 74% of the cases and 69% of all lesions were in the posterior area. The mixed radiolucent-radiopaque pattern was the most frequent (65%), with 32% radiolucent and 3% radiopaque. Coronal clustering of the radiopaque material was found in 12% and in one case, a 'driven snow' pattern of the radiopaque material was clearly recognizable. Lesions were unilocular in 58%, multilocular in 27% and not loculated in 15%. The unilocular type was more frequent in the maxilla than in the mandible. Borders were well defined and corticated in 20%, defined but not corticated in 59% and diffuse in 21%. Sixty per cent were associated with impacted teeth. Lesions larger than 3 cm tended to be more frequent in the mandible, mixed radiolucent-radiopaque and to have a higher proportion of diffuse borders than the smaller lesions. Conclusion: Radiographic features which have been considered characteristic of CEOT, coronal clustering and 'driven snow' patterns, are seen in only a small percentage of cases.