Ameloblastoma and their management : A review. J Surg Pak. 2009;14 (3): 136-142 (original) (raw)
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Effective management of ameloblastoma: A review
International Journal of Contemporary Dental and Medical Reviews, 2015
In order to evaluate typically the relevant literature as well as fi gure out the best modality of cure pertaining to ameloblastomas. An electronic literature seeks utilizing Medline was fi rst performed regarding released articles about management of ameloblastomas. Terms utilized in the browse were ameloblastoma and treatment method; ameloblastoma as well as surgical management. An endeavor was done to execute an organized critique about the subject; however because of inconsistency in vocabulary, treatment method process, insuffi cient randomized controlled trial and insuffi cient follow-up and analysis in the majority of the articles researched, a narrative imperative overview of chosen pertinent literature concerning treatments for ameloblastoma was performed. It is extensively documented that the recurrence of an ameloblastoma mainly displays the ineff ectiveness or perhaps lack of success of the main surgical treatment. Recent reports have unquestionably indicated that every time an analysis of ameloblastoma is done, the method has to be intense as well as radical in order to steer clear of recurrence. The recurrence rates of 55-90% regarding solid or multicystic lesions handled through conventional strategy (enucleation or curettage) and in many cases metastases have been documented. Concerning unicystic ameloblastoma, methodical overview of the literary works indicates that the extreme method of treatment led to minimum recurrence rate. For ameloblastomas, the initial surgical treatment (particularly radical) off ers the best chance to the patient. There is actually a lack of agreement over the most suitable treatment method with regard to ameloblastomas. Yet, much more radical strategy (whenever feasible) defi nitely seems to be the most eff ective method for the control over these benign, however locally aggressive, lesions having inclination for numerous repeated episodes.
Ameloblastoma: A Surgeon’s Dilemma
Journal of Oral and Maxillofacial Surgery, 2006
Purpose: To investigate whether there were any significant differences in the mode of presentation, treatment, and outcome of patients presenting with a primary diagnosis of ameloblastoma in Glasgow, Scotland and San Francisco, CA. Materials and Methods: All cases of ameloblastoma seen in both institutions between January 1, 1980 and December 31, 1999 were included in this study. Mode of presentation, radiographic appearance, histologic appearance, treatment, and follow-up were recorded. Results: There were no significant differences in the clinical features on presentation (swelling, followed by pain, and altered sensation), the radiographic appearance (unilocular approximately 30% and multilocular 70%), or management with either local treatment (enucleation and/or curettage in just over 50% of cases) or radical treatment (a form of resection in under 50%) in the 50 cases included in this study. Primary care by conservative treatment led to a recurrence in approximately 80% of cases and this included cases of unicystic ameloblastoma. Conclusion: The mode of presentation, diagnosis, and management of the ameloblastoma was remarkably similar in Glasgow and San Francisco. The recurrence rate following local enucleation and curettage was unacceptably high, and this included the cases of unicystic ameloblastoma, which should be treated more aggressively than has been recommended in the past.
Ameloblastoma: A retrospective analysis of 31 cases
Journal of Oral Biology and Craniofacial Research, 2017
To evaluate the surgical treatment given and do a regular follow up to study the recurrence rate and complications of ameloblastoma in our institution. Materials and methods: A total of 31 cases of various subtypes of ameloblastoma, treated with different modalities, in the Department of OMFS, were recalled for a follow up & radiographs were taken along with the clinical examination for any recurrence or complications such as fracture/exposure of the reconstruction plate, loosening of the screw, infection of the graft, any draining sinus/signs of infection. Results: Two of our patients had fractured reconstruction plate, one patient developed infection, one patient complained of screw exposure and two other patients had infection of the iliac graft. Conclusion: We conclude that an adequate resection with a safe margin could be a treatment option and can be undertaken depending on the extent, location of the lesion and histopathologic variant.
Oral Surgery, 2008
Aim: The aim of this study is to review the pertinent literature and determine the most appropriate method of treatment for ameloblastomas. Methods: A computerized literature search using MEDLINE was conducted for published articles on treatment of ameloblastomas. Mesh phrases used in the search were: ameloblastoma AND treatment; ameloblastoma AND surgical management. An attempt was made to conduct a systematic review on the subject, but due to inconsistency in terminology, treatment protocol, lack of randomised controlled trial and inadequate follow-up assessment in most of the articles assessed, a narrative critical review of selected relevant literature regarding treatment of ameloblastoma was undertaken. Results: It is widely reported that the recurrence of an ameloblastoma in large part reflects the inadequacy or failure of the primary surgical procedure. Recent studies have unequivocally showed that when a diagnosis of ameloblastoma is made, the treatment must be aggressive and radical to avoid recurrence. The recurrence rates of 55% to 90% for solid or multicystic lesions treated by conservative approach (enucleation or curettage) and even metastases have been reported. Regarding unicystic ameloblastoma, systematic review of the literature has shown that radical approach to treatment resulted in lowest recurrence rate. For ameloblastomas, the first operation (especially radical) affords the best chance for cure. Conclusions: There is a lack of consensus on the most appropriate treatment modality for ameloblastomas. However, a more radical approach (whenever possible) appears to be the best method for the management of these benign, but locally aggressive, lesions with propensity for multiple recurrences.
Management of Ameloblastoma – An Insight
2018
DOI: 10.21276/sjodr.2018.3.4.1 Abstract: Ameloblastoma is the most frequent odontogenic tumor ascending from dental epithelium, and is branded by its histological resemblance to the enamel organ of the developing tooth germ. Although defined as a benign neoplasm, ameloblastomas are locally disparaging and a high recurrence rate is observed if the lesions are not entirely expurgated. Management should be built on precise clinical details, radiographs, special imaging and a illustrative biopsy, followed and reviewed by an oral pathologist and a maxillofacial surgeon. Each case is distinctive and has to be considered in the clinical context and the relationship of the lesion to its surrounding tissues, histological type, and recurrence rate. The present article is a review of the existing literature concerning management of ameloblastoma.
Comparison of long-term results between different approaches to ameloblastoma
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2002
Objective. The long-term results of different surgical approaches to ameloblastoma were compared to develop a more rational surgical approach to this tumor. Study design. Seventy-eight primary ameloblastomas, including 27 unicystic, 21 multicystic, and 30 solid-type tumors, were examined in this study. The methods of treatment consisted of radical surgery (ie, resection-both segmental and marginal) and conservative treatments (ie, marsupialization alone, marsupialization followed by enucleation with sufficient bone curettage if necessary, and enucleation with bone curettage). The effect of marsupialization on recurrence data after a follow-up period of at least 5 years was evaluated with respect to clinical type and histologic pattern.
Ameloblastoma: Our clinical experience with 68 cases
Journal of Orofacial Sciences, 2014
In this environment, previous workers have reported on the challenges of managing large sized ameloblastoma of the jaws with less than adequate facilities. The aim of this review is to present the management of 68 cases of ameloblastoma with emphasis on surgical care. Materials and Methods: Retrospective survey of case notes of patients with histopathologic diagnosis of ameloblastoma (using the criteria of seen between January 2006 and August 2010 at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria was undertaken. Data collected includes histopathological diagnosis, age, gender, clinical information on site of lesion, form of intubation and surgical procedure performed. Results: Out of 94 patients, 68 with histological diagnosis of ameloblastoma (59 mandibular and 9 maxillary) were operated within the study period. The remainder (26) was not treated in hospital. Among 68 patients treated, more were males (38) than females (30), giving a male to female ratio of 1.3:1. The age range was between 14 and 74 years (mean-standard deviation). The duration of the symptoms ranged from 7 months to 24 years, most were follicular ameloblastoma (n = 13) followed by acanthomatous type (n = 7). Endotracheal intubation was the most common (n = 55) followed by fiber optic laryngoscopy (n = 8). The surgical approach most used was extended Risdon with intraoral (n = 24) followed by extended Risdon with lip split and intraoral (n = 17). Segmental resection (en block) formed the bulk of our procedures (n = 22) followed by subtotal mandibulectomy (n = 16). Conclusion: The treatment of ameloblastoma remains controversial. Its destructive nature has left patients with wide defects difficult to reconstruct.
Clinicopathological study and treatment outcomes of 121 cases of ameloblastomas
International journal of oral and maxillofacial surgery, 2010
The aim of this paper is to evaluate the clinical, radiographic, and histopathological findings and treatment modalities in all cases of ameloblastomas treated at the Sao Paulo Cancer Hospital, between 1953 and 2003. 121 case reports were retrieved from the medical files. Data were reviewed and statistical analysis was performed using Kaplan-Meyer method and Cox proportional risk model. The patients' age ranged from 2 to 82 years (mean 33.2 years), with a slight female prevalence. Most cases were located in the posterior mandible (80%). Radiographically, 60% showed a multilocular pattern. 113 casees were solid ameloblastomas, and plexiforme subtype was the most common. Solid tumours were treated by wide resection, curettage and criosurgery, or curettage alone, and unicystic tumours by curettage and/or cryotherapy. The global mean recurrence rate was 22%, with a mean follow-up of 9.7 years. The ameloblastomas were predominantly solid, affecting the posterior mandible. Important f...
Ameloblastoma: an evidence based study
Journal of Maxillofacial and Oral Surgery, 2010
Objective The purpose of this study is to present a series of 46 cases of ameloblastoma-38 in mandible and 8 in maxilla treated in the Oral and
Ameloblastoma: A Clinicopathological Retrospective study
Objectives: The aim of the present study was to analyze the clinicopathological features from a series of ameloblastomas diagnosed and treated in our department. Study Design: The records of all ameloblastoma patients were revisited and their clinical and radiological and histological information were obtained. Data were descriptively analyzed and a compared with respect to different ameloblastoma subtypes. Results: Thirty ameloblastomas composed the final sample, including 24 (72.5%) solid/multicystic, 4(12%) uni-cystic, 1 (3%) desmoplastic and 1 (3%) peripheral ameloblastomas. Mean age of the affected patients was 38 years of life an. Most tumors presented as multilocularradiolucencies and were located in the posterior mandible and showed the follicular and plexiform histological patterns.. Conclusions: The clinicopathological features of the ameloblastomapatients in our study group were almost similar to the studies done on other worldwide populations.