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Demir E, Gunhan O. Conservative treatment of a unicystic ameloblastoma by marsupialization with a favorable response: A case report and review of the literature. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.367909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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2
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Muacevic A, Adler JR, Thosar NR, Khubchandani M. The Diagnostic Dilemma of an Odontogenic Jaw Lesion in a Pediatric Patient: A Case Report. Cureus 2022; 14:e31225. [PMID: 36514574 PMCID: PMC9733780 DOI: 10.7759/cureus.31225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
This paper presents a case report of a 10-year-old child patient reported with the chief complaint of a painless, hard swelling in the lower right back region of the jaw. The clinical and radiographic examination, including intraoral periapical radiograph (IOPA) and cone-beam CT (CBCT), was performed. Conservative treatment was planned based on the clinical and radiological diagnosis of the cyst. But the histological examination revealed unicystic ameloblastoma (UA). This clinical case of UA, which was misdiagnosed as a combination of a radicular cyst and a dentigerous cyst, is being presented to highlight the importance of histopathologic investigation of all tissue specimens retrieved after surgery, particularly when the clinical and radiological findings are insignificant.
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da Silva YS, Sohal KS, Stoelinga PJW, Grillo R. A meta-analysis on the presentation of Unicystic Ameloblastoma in the jaws and the consequences for their treatment. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e433-e438. [PMID: 35017129 DOI: 10.1016/j.jormas.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/17/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This meta-analysis provides reliable data on the prevalence of unicystic ameloblastomas (UA's) among solid/multicystic ameloblastomas (SMA's), as well the ratio of their presence in the maxilla and mandible and in the tooth-bearing area versus the posterior regions of the mandible, including the third molar region and ascending ramus. MATERIAL AND METHODS A systematic review and meta-analysis was performed according to PRISMA guideline using the strategy ((unicystic ameloblastoma) OR (((ameloblastoma) OR (solid ameloblastoma)) OR (multicystic ameloblastoma))) NOT ((((systematic review) OR (literature review)) OR (case report)) OR (Immunohistochemical)). DISCUSSION The study included 3856 SMA's and 1537 UA's, which amounted to 28.5% UA's. Of the 380 cases of UA from twelve articles that mentioned the involved jaws, 355 were in the mandible and 25 in the maxilla. The preponderance for the mandible is much higher than reports from previous studies of smaller series. Only five articles mentioned the location within the mandible. The vast majority was in the posterior area. CONCLUSION The consequences for treatment were discussed, with an emphasis on the approach to unicystic lesions in the posterior part of the mandible for which a protocol is suggested.
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Affiliation(s)
| | - Karpal Singh Sohal
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paul J W Stoelinga
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen, the Netherlands
| | - Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, School of Dentistry, Rua Dr. José Rocha Junqueira 13 Ponte Preta - Campinas, São Paulo 13045-755, Brazil.
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Surgical treatment of ameloblastoma: How does it impact the oral health-related quality of life? A systematic review. J Oral Maxillofac Surg 2022; 80:1103-1114. [DOI: 10.1016/j.joms.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022]
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Ajila V, Hegde S. Ameloblastomas vs recurrent ameloblastomas: a systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2021044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Ameloblastoma is an odontogenic tumour with high recurrence rate. The objective of the present study was to evaluate existing literature regarding clinical, radiographic, histopathologic features, treatment, and recurrence rate of ameloblastomas and compare it with features of recurrent ameloblastomas. Materials and methods: A systematic review was done based on the PRISMA statement. Search was performed in “Pubmed” database with search terminology “recurrent ameloblastoma”, “ameloblastoma recurrence” for articles published between 2010 and 2020. Data were extracted from full‐text articles and discussed. Results: Out of 515 articles, 16 articles fulfilled the inclusion and exclusion criteria. Data was analysed in two sections. The first with 10 publications assessed features of ameloblastoma in general and their recurrence rate while the second section evaluated features of only recurrent ameloblastomas in 6 publications. There were 234 recurrences in 936 cases with recurrence rate of 23.50%. Male predominance was noted and mandible was commonly affected. Solid/multicystic ameloblastomas formed 74.5% of the tumours and unicystic formed 23.3%. The recurrence rate after conservative treatment was 64.9% and after radical treatment was 12%. Conclusions: The main factors for recurrence were multilocular ameloblastomas, follicular histopathology and conservative treatment.
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Guo T, Zhang C, Zhou J. Unicystic ameloblastoma in a 9-year-old child treated with a combination of conservative surgery and orthodontic treatment: A case report. Clin Case Rep 2022; 10:e05241. [PMID: 35079382 PMCID: PMC8777162 DOI: 10.1002/ccr3.5241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/02/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
Unicystic ameloblastoma (UAM) in the pediatric population is a rare clinical entity that has not been well addressed in the literature. Radical approaches affect a growing young patient's physical and psychological development, so conservative approaches are widely used for management in children. This report describes the case of a 9-year-old girl with UAM of the mandible, which also involved the impaction of the first and second premolars. Marsupialization with orthodontic treatment was performed to shrink the lesion and upright the first premolar involved in the tumor. Ten months after marsupialization, the lesion had healed entirely. The combination of conservative surgery and orthodontic treatment effectively shrank the lesion, preserving mandibular growth, preserving the involved first and second premolars, and promoting the eruption of the teeth.
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Affiliation(s)
- Tingting Guo
- Department of General Dentistry and Emergency Dental CareBeijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Ci Zhang
- Department of OrthodonticsBeijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Jian Zhou
- Department of General Dentistry and Emergency Dental CareBeijing Stomatological HospitalCapital Medical UniversityBeijingChina
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7
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Titinchi F, Brennan PA. Unicystic ameloblastoma: analysis of surgical management and recurrence risk factors. Br J Oral Maxillofac Surg 2021; 60:337-342. [PMID: 34996630 DOI: 10.1016/j.bjoms.2021.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
Unicystic ameloblastoma is a distinct pathological variant with varying evidence published about its behaviour and surgical management. Due to a paucity of large studies in the literature with long-term follow up, the aim of this study was to analyse its surgical management and identify clinicopathological features associated with recurrences. All histopathologically confirmed lesions diagnosed at two referral centres between 1995 and 2020 were retrospectively analysed. Demographic, clinical, radiological, and histopathological features were analysed along with surgical methods and follow-up data. Univariate regression analyses were performed to identify risk factors for recurrence. Sixty-three patients were included in the study with mean age of 26.3 years and a male to female ratio of 1:0.75. The majority of lesions occurred in the posterior mandible (57.1%) and were unilocular (88.9%). Most lesions were managed with enucleation followed by application of Carnoy's solution (ferric chloride: 1g; chloroform: 3 mL; glacial acetic acid: 1 mL; ethyl alcohol 96%: 6 mL) and burring of the peripheral bone margin which resulted in the lowest recurrences (9.1%) besides resection. Significantly associated clinicopathological features with recurrences included patients who were male, large lesions (>90 mm), presence of root resorption, cortical perforation, mural subtype, and retention of associated teeth. In conclusion, decision making in the management of unicystic ameloblastoma should be based on the clinicopathological features and not be solely based on the histopathological subtype. Enucleation followed by application of Carnoy's solution and burring of the peripheral bone margin was demonstrated to be the least invasive method with an acceptable low recurrence rate.
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Affiliation(s)
- Fadi Titinchi
- Department of Maxillo-Facial and Oral Surgery, Faculty of Dentistry and WHO Collaborating Centre, University of the Western Cape, Cape Town, South Africa.
| | - Peter A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK
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Müller S. Developmental Odontogenic Lesions Associated with the Crown of an Impacted Tooth: A Guide to the Distinct Histologic Features Required for Classification. Head Neck Pathol 2021; 15:107-112. [PMID: 33723765 PMCID: PMC8010055 DOI: 10.1007/s12105-020-01279-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 10/21/2022]
Abstract
Odontogenic cysts are categorized as inflammatory and developmental. Of the developmental odontogenic cysts, the dentigerous cyst is the most common and by definition is attached to the cervical region of an unerupted tooth. The cyst envelops the crown forming a sac. However, there are other developmental cysts, and rarely, odontogenic tumors, that can have a similar clinical and radiographic presentation as dentigerous cyst, including odontogenic keratocyst, orthokeratinized odontogenic cyst and ameloblastoma, unicystic type. Understanding the key histologic differences of these cysts will aid the pathologist to correctly diagnose these lesions, ensuring appropriate clinical management.
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Affiliation(s)
- Susan Müller
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Atlanta Oral Pathology, Decatur, GA 30033 USA
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Clinicopathological Profile of 80 Cases of Unicystic Ameloblastoma Aided by a Histopathological Comparison Using Modified Philipsen-Reichart Classification and Marx-Stern Classification. Head Neck Pathol 2021; 15:875-881. [PMID: 33638761 PMCID: PMC8384931 DOI: 10.1007/s12105-021-01307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
Unicystic ameloblastoma (UA) is an uncommon variant of ameloblastoma and behaves totally different from the solid multicystic variant of ameloblastoma (SMA); furthermore the histological subgroups of UA also show varied behavior regarding proliferation. The present multi-centric study was designed to present the clinicopathological features of unicystic ameloblastoma (UA) and to compare the two popular histological classifications systems. 80 satisfactory cases of UA were retrieved and evaluated for clinicopathological parameters from four teaching dental schools of North India. The cases were classified using modified Reichart and Philipsen system and Marx and Stern system followed by comparison of inter-observer variability. The results were analyzed using SPSS software. The mean age of occurrence was 30.79 ± 16.49 years. Males outnumbered females (M:F::1.67:1). The majority of cases occurred in the third decade irrespective of the gender. Most cases were found in body-angle-ramus region of the mandible. The modified Reichart and Philipsen classification yielded better interobserver agreement (kappa value 0.845). The modified Reichart and Philipsen classification yields better inter-rater agreement and is easy to reproduce amongst oral pathologists. Being simpler it may easily be understood by the operating surgeon for better treatment outcome.
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Zlotogorski-Hurvitz A, Soluk Tekkeşin M, Passador-Santos F, Martins Montalli VA, Salo T, Mauramo M, Kats L, Buchner A, Vered M. Conceptual changes in ameloblastoma: Suggested re-classification of a "veteran" tumor. Oral Dis 2021; 28:703-710. [PMID: 33403703 DOI: 10.1111/odi.13770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/04/2020] [Accepted: 12/29/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The merging of ameloblastoma (AM) with mural unicystic ameloblastoma (UAM-M) was suggested by the 2017 WHO based on similar treatment needs. In an international multicenter study, we investigated the characteristics of their merged product (merged-AM) and raised the possibility of unifying AM and UAM (total-AM). MATERIALS AND METHODS AM and UAM (luminal/intraluminal/mural), separate and combined, were analyzed for demographic/clinical/radiological features. ANOVA and chi-square tests were followed by univariate and multivariate analyses, and significance was set at p < .05. RESULTS The patients' mean age was 39.6 ± 20.3 years in merged-AM (147 AM, 76 UAM-M), 45.1 ± 19.4 years in AM (p = .009). Merged-AM comprised 51.3% multilocular/48.7% unilocular tumors, AM comprised 72.5%/27.5%, respectively (p < .001). Merged-AM was associated with impacted teeth in 30.8%, AM in 18% (p = .023). The probability of merged-AM for multilocularity increased by 2.4% per year of age (95%CI 0.6-4.2, p = .009). Association with impacted teeth decreased by 7.9% per year of age (95%CI 1.9-14.39, p = .009). Merged-AM did not differ from total-AM (p > .05). CONCLUSIONS Merged-AM partially differed from AM, but differences appeared to diminish in an age/time-wise manner. Merged-AM and total-AM were nearly indistinguishable. Therefore, AM and UAM may be considered a continuous spectrum of one type of tumor, further necessitating revision of the treatment approaches.
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Affiliation(s)
- Ayelet Zlotogorski-Hurvitz
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Merva Soluk Tekkeşin
- Department of Tumour Pathology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | | | | | - Tuula Salo
- Translational Immunology Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.,Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Pathology, HUSLAB, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Matti Mauramo
- Department of Pathology, HUSLAB, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.,University Central Hospital, Helsinki, Finland
| | - Lazar Kats
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amos Buchner
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marilena Vered
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel
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11
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de Arruda JAA, Noronha MS, Abreu LG, de Lacerda JCT, Silva TA, Mesquita RA. Adenoid ameloblastoma in the posterior maxilla: a case report and review of the literature. Oral Maxillofac Surg 2020; 24:243-249. [PMID: 31925581 DOI: 10.1007/s10006-020-00830-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/03/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Adenoid ameloblastoma is a rare benign odontogenic tumor that favors a slight predilection for male patients, fourth and fifth decades of life, and posterior regions of the jaws. To date, less than 40 cases have been reported in the English language literature. The radiographic aspects of adenoid ameloblastoma vary from unilocular and well-defined lesions to diffuse and multilocular lesions. Most of the lesions exhibit a radiolucent image and are usually large, with a mean size of 3.5 cm. Microscopically, pseudoductal structures composed of columnar cells in a palisaded arrangement formed from the parenchyma of the tumor were observed. CASE PRESENTATION We describe a case of adenoid ameloblastoma in a 54-year-old woman, who presented with no symptoms. Panoramic radiography showed a well-circumscribed, unilocular radiolucency in the left posterior maxilla. CONCLUSION As odontogenic tumors are rare, some entities are infrequently encountered, making the diagnosis more difficult. Clinicians, oral and maxillofacial surgeons and oral pathologists should be familiar with the adenoid ameloblastoma and its differential diagnosis for accurate diagnosis and management.
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Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Mariana Saturnino Noronha
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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12
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Costa DC, de O Silveira L, Queiroz SI, Dantas WR, Da Silva JS, Germano AR. Relapses after using Carnoy's solution in treating aggressive benign odontogenic lesions. MINERVA STOMATOLOGICA 2019; 68:242-248. [PMID: 31822048 DOI: 10.23736/s0026-4970.19.04230-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chemical curettage has become popular in the definitive treatment of benign aggressive odontogenic lesions. Therefore, this study aims to verify the relapse rate and associated factors after the enucleation protocol, peripheral ostectomy and Carnoy's solution. METHODS This is a retrospective sectional study with 30 patients, selected by non-probabilistic convenience sampling, submitted to the protocol from 2008 to 2018. The study was composed by the data collection phase of the medical records and clinical and radiographic analysis of the patients in order to verify the presence of relapses. Descriptive and statistical analyzes were performed using the Stata/IC version 14.0 program (StataCorp, College Station, TX, USA). The Mann-Whitney Test, Fisher's Exact Test and the χ2 Test, as well as the Kaplan Meier method and the Log-rank Test were used to verify the possible prognostic factors for relapses, adopting P<0.05. RESULTS The sample consisted of 22 patients with odontogenic keratocysts (73.3%), 3 odontogenic myxomas (10%) and 5 ameloblastomas (16.7%). Relapses affected 7 patients (23.3%), all in odontogenic keratocysts, and the relapse time was between 12-34 months. There was no statistical difference between the evaluated factors and relapse development. Patients who remained with teeth adjacent to the lesion after treatment had an earlier relapse time, a cumulative risk of more than 80% for relapse after 29 months postoperatively, and a 5.5 times greater chance of developing relapses than patients who had their teeth extracted. CONCLUSIONS The protocol is advantageous when compared to isolated treatments and can be used as an alternative to resection.
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Affiliation(s)
- Danielle C Costa
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Larissa de O Silveira
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Salomão I Queiroz
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Wagner R Dantas
- Unit of Oral and Maxillofacial Surgery, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José S Da Silva
- Unit of Oral and Maxillofacial Surgery, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Adriano R Germano
- Unit of Oral and Maxillofacial Surgery, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil -
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13
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Morice A, Neiva C, Fabre M, Spina P, Jouenne F, Galliani E, Vazquez MP, Picard A. Conservative management is effective in unicystic ameloblastoma occurring from the neonatal period: A case report and a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:e234-e242. [PMID: 31562035 DOI: 10.1016/j.oooo.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/28/2019] [Accepted: 08/26/2019] [Indexed: 12/28/2022]
Abstract
Unicystic ameloblastoma (UA), a benign odontogenic tumor of the jaw, represents less than a third of all ameloblastomas and seems less aggressive than other types of ameloblastoma. We present here the first case of UA that developed prenatally and was successfully managed in the early neonatal period with marsupialization and curettage performed carefully to avoid injury to the tooth germ. BRAF and SMO mutations were not detected. After 2 years of follow-up, complete reossification and normal eruption of deciduous teeth were noted, and there was no recurrence of UA. We recommend conservative treatment of UA in the pediatric population to avoid loss of and/or injury to the tooth germ, provided close follow-up is carried out all through the individual's growth for early detection of potential recurrences, growth impairments, or tooth eruption disorders. The intratumoral somatic mutational status of BRAF, SMO, RAS family, and FGFR2 may help determine personalized targeted treatment, particularly in case of recurrence.
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Affiliation(s)
- Anne Morice
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France.
| | - Cecilia Neiva
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Monique Fabre
- Department of Pathology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, and Université Paris Descartes, Paris, France
| | - Paolo Spina
- Cantonal Institute of Pathology, Locarno, Switzerland; Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Fanélie Jouenne
- Genomic of Solid Tumors Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | - Eva Galliani
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Marie-Paule Vazquez
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Arnaud Picard
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France
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14
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Unicystic Ameloblastoma in a Child Treated with a Combination of Conservative Surgery and Orthodontic Treatment: A Case Report. J Clin Pediatr Dent 2019; 43:121-125. [PMID: 30730804 DOI: 10.17796/1053-4625-43.2.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Unicystic ameloblastoma (UAM) is a variant of intraosseous ameloblastoma that occurs as a single cystic cavity. This report describes a case of UAM of the mandible in a seven-year-old girl. The lesion radiographically mimicked a dentigerous cyst. Under the primary diagnosis of a dentigerous cyst, marsupialization was performed to erupt the first molar involved in the cystic lesion and to obtain a definitive diagnosis. The biopsy specimen revealed ameloblastoma. During careful observation, orthodontic treatment, which was performed to upright and promote the eruption of the first molar involved in the tumor, maintained the space needed for enucleation of the tumor. Finally, the second primary molar was extracted, and the lesion was enucleated at 3 years and 4 months after marsupialization. The results of the histological examination revealed UAM. Conclusively, the treatment course not only avoids a resection of the mandible but also induces eruption of the teeth involved in the tumor. Thus, the combination of conservative surgery and orthodontic treatment was effective in the management of UAM that mimics a dentigerous cyst.
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15
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Zheng CY, Cao R, Hong WS, Sheng MC, Hu YJ. Marsupialisation for the treatment of unicystic ameloblastoma of the mandible: a long-term follow up of 116 cases. Br J Oral Maxillofac Surg 2019; 57:655-662. [PMID: 31230852 DOI: 10.1016/j.bjoms.2019.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 06/05/2019] [Indexed: 12/01/2022]
Abstract
Unicystic ameloblastoma is a unique histopathological type of ameloblastoma, and treatment is controversial. Marsupialisation is effective in reducing the size of cystic lesions and their complications. We have retrospectively analysed the clinical, histopathological, and prognostic data of affected patients who were treated by marsupialisation between 2003 and 2013 in three Chinese hospitals. Our aim was to evaluate the effects and prognosis, and the factors associated with outcome. A total of 116 patients with mandibular unicystic ameloblastomas were included, and 74, 26, and 16 patients were histopathologically classified as being luminal, intraluminal, and mural subtypes, respectively. Most responded well to marsupialisation, with an overall recurrence rate of 12%. Resorption of the root (p<0.001), perforation of the cortical bone (p=0.005), and histopathological subtype (p=0.013) were the main factors that predicted the outcome. Perforation of the cortical bone was the only reliable predictor of recurrence (p<0.001). Disease-free survival function curves indicated that patients with the mural subtype were at a higher risk of recurrence than patients with the other two subtypes (p=0.003). Poor outcomes of marsupialisation were treated surgically and, to date, no subsequent recurrences have been reported. Marsupialisation is effective for these patients, with a recurrence rate similar to that of radical treatment. The outcomes can be predicted using characteristics of the lesion such as resorption of the root, perforation of the cortical bone, and histopathological subtypes. However, additional studies are required to corroborate these findings.
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Affiliation(s)
- C Y Zheng
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China.
| | - R Cao
- Department of Oral and Maxillofacial Surgery, Second People's Hospital of Changshu, Haiyunan Road No. 68, Yushan District, Changshu, 215500, Jiangsu, PR China
| | - W S Hong
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China
| | - M C Sheng
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Huzhou University, Guangchanghou Road No. 158, Wuxing District, Huzhou, 313000, Zhejiang, PR China
| | - Y J Hu
- Department of Oral-Maxillofacial Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road, No. 639, Huangpu District, Shanghai, 200011, PR China.
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Mandibular Regeneration With Autologous Human Bone Marrow Derived Mesenchymal Stem Cells to Treat Unicystic Ameloblastoma. J Craniofac Surg 2019; 30:e187-e189. [DOI: 10.1097/scs.0000000000004917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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17
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Rikhotso RE, Premviyasa V. Conservative Treatment of Ameloblastoma in a Pediatric Patient: A Case Report. J Oral Maxillofac Surg 2019; 77:1643-1649. [PMID: 30902604 DOI: 10.1016/j.joms.2019.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
Ameloblastomas typically occur in adults and are considered a rarity in the pediatric patient population. We report on the treatment outcome of a pediatric patient who presented with a unicystic ameloblastoma in the mandible. A 15-year-old boy presented with a large, expansile lesion in the ramus-angle region of the mandible. Incisional biopsy findings confirmed the lesion was a type II unicystic ameloblastoma. Treatment consisted of unroofing of the bone overlying the lesion followed by enucleation with peripheral ostectomy. A 10-mL disposable Luer-lock syringe was cut and modified to fit into the window of the lesion to facilitate irrigation with saline solution. The disposable syringe was held in position with 0.18-mm stainless steel wire for 3 months. Modification of the conservative treatment using the syringe allowed for complete regeneration of bone in the large cavity without the need for bone graft or resection of the lesion. At the 3-year follow-up, there was no sign of recurrence.
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Affiliation(s)
- Risimati Ephraim Rikhotso
- Department Head, Department of Maxillofacial and Oral Surgery, Wits School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Vinayagie Premviyasa
- Consultant, Department of Maxillofacial and Oral Surgery, Wits School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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18
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Management of large pediatric ameloblastoma: Conservative approach with 4-years follow up. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2018.100093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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19
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Hendra FN, Natsir Kalla DS, Van Cann EM, de Vet HCW, Helder MN, Forouzanfar T. Radical vs conservative treatment of intraosseous ameloblastoma: Systematic review and meta-analysis. Oral Dis 2019; 25:1683-1696. [PMID: 30548549 DOI: 10.1111/odi.13014] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/22/2018] [Accepted: 12/07/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the present study was to assess the outcomes of radical and conservative treatment approaches of solid/multicystic and unicystic ameloblastoma in terms of recurrence rates. MATERIAL AND METHODS A systematic review and meta-analysis was conducted based on the PRISMA statement. Search was performed using PubMed, Embase, SCOPUS, and Web of Science for articles published from January 1969 until March 2018. Quality assessment of the selected articles was conducted using the Quality Appraisal of Case Series Studies Checklist. The meta-analysis was performed using the MedCalc program. RESULTS The search strategy yielded 6,984 articles; 20 studies met the eligibility criteria and were included in the meta-analysis. The pooled recurrence rate of solid/multicystic ameloblastomas following radical treatment was 8%, while conservative treatment caused recurrences in 41%. For unicystic ameloblastomas, these values were 3% and 21%, respectively. The risk of recurrences in both types of ameloblastomas following radical treatment was lower than following conservative treatment. CONCLUSIONS The present study showed statistically significant differences in recurrence favoring radical treatment for both unicystic and solid/multicystic ameloblastoma. The solid/multicystic type showed more recurrences than the unicystic type. Unfortunately, since only retrospective studies were available, the evidence is less strong as wished for.
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Affiliation(s)
- Faqi Nurdiansyah Hendra
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Diandra Sabrina Natsir Kalla
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Ellen M Van Cann
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henrica C W de Vet
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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20
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Gil JL, Guillen Rivera GJ, Ortega-Pertuz AI, Espina Suárez ML. Ameloblastoma uniquístico intramural, reconstrucción tardía y rehabilitación con implantes dentales. Reporte de caso. ACTA ODONTOLÓGICA COLOMBIANA 2018. [DOI: 10.15446/aoc.v8n2.73893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: el ameloblastoma uniquístico es considerado una variante del ameloblastoma, con características clínico-radiográficas e histológicas particulares, mostrando un mejor pronóstico que la forma sólida. Objetivo describir el manejo y procederes de un paciente con ameloblastoma uniquístico intramural (AUIM) en línea media mandibular con énfasis en la reconstrucción tardía y su rehabilitación. Materiales y métodos: se presenta un varón de 18 años con una lesión indolora en la zona anterior de la mandíbula, relacionada con un diente retenido. Radiográficamente, mostraba imagen unilocular, corticalizada, que causaba expansión de las corticales óseas. Se realizó la resección segmental y ajuste de placa de reconstrucción; en un segundo tiempo quirúrgico se colocó injerto óseo autólogo y, posteriormente, se procedió a la rehabilitación con implantes. Discusión: en el artículo se discute la elección del tratamiento basado en el comportamiento biológico del AUIM, así como la necesidad de restablecer la estética y la función después de una cirugía radical.
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21
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Siriwardena BSM, Tennakoon TMPB, Hunter KD, Tilakaratne WM. Unicystic ameloblastoma: Analysis of 370 cases in a single center in Sri Lanka. J Oral Pathol Med 2018; 47:706-709. [DOI: 10.1111/jop.12740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Keith D. Hunter
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery; School of Clinical Dentistry; University of Sheffield; Sheffield UK
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22
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Kim J, Nam E, Yoon S. Conservative management (marsupialization) of unicystic ameloblastoma: literature review and a case report. Maxillofac Plast Reconstr Surg 2017; 39:38. [PMID: 29302587 PMCID: PMC5742318 DOI: 10.1186/s40902-017-0134-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background In this study, we present a case of unicystic ameloblastoma (UA) treated by marsupialization followed by surgical enucleation as a conservative approach. UA is a rare, benign, less aggressive, and less invasive variant of ameloblastoma that is observed quite often in younger patients. Radical approaches have effects on the physical and psychological development of a growing young patient; therefore, conservative approaches are widely used for UA management in children. Case presentation This report described a case of an 11-year-old girl with UA of the mandibular molar–ramus area, which also involved impaction of the second and third molars. The lesion was marsupialized, and 31 months after marsupialization, surgical enucleation was performed with extraction of the impacted third molar. The second molar, which was preserved, spontaneously and completely erupted. No recurrence was observed during a 49-month follow-up. Conclusions Conservative treatments for UA in young patients have more advantages. Our results provide evidence that marsupialization is effective in regressing the lesion size to ease complete removal, preserving mandibular growth, maintaining involved second molar, and promoting the eruption of the tooth.
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Affiliation(s)
- Jwayoung Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Medical Center, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Eunkyung Nam
- Department of Oral and Maxillofacial Surgery, Hallym University Medical Center, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Sukho Yoon
- Department of Oral and Maxillofacial Surgery, Hallym University Medical Center, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
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23
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Dredging—A conservative treatment for odontogenic tumor of jaws. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2017. [DOI: 10.1016/j.ajoms.2017.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
OBJECTIVE AND IMPORTANCE Ameloblastoma is a locally aggressive benign tumor, commonly occurring in the mandible. While giant ameloblastoma of multicystic or plexiform variant have been reported, the authors report a rare case of giant unicystic ameloblastoma of luminal variant, which was treated by compartmental resection and planned for delayed reconstruction. CLINICAL PRESENTATION A 46 year old male patient reported to the oral surgery out-patient department with a swelling of the left side mandible region of 2 years duration. He had undergone ayurvedic treatment for the same with no improvement. The size of the lesion on presenting was approximately 9 × 12 cm. INTERVENTION Compartmental resection with plan for secondary reconstruction, after adequate follow up period. CONCLUSION While conservative management is being explored as a treatment option for unicystic ameloblastoma, resection is still the standard of care regardless of the histopathological subtype for giant lesions.
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Affiliation(s)
- Adarsh Kudva
- a Department of Oral and Maxillofacial Surgery , Manipal College of Dental Sciences , Manipal , India
| | - Abhay T Kamath
- a Department of Oral and Maxillofacial Surgery , Manipal College of Dental Sciences , Manipal , India
| | - Nirmala N Rao
- b Department of Oral Pathology , Manipal College of Dental Sciences , Manipal , India
| | - Jyotsna Rajan
- a Department of Oral and Maxillofacial Surgery , Manipal College of Dental Sciences , Manipal , India
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25
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Sanz-Alonso J, Martínez-Rodríguez N, Martín-Ares M, Barona-Dorado C, Cortés Bretón-Brinkmann J, Martínez-González JM. Unicystic Ameloblastoma: Rehabilitation with Chin Graft Harvested and Implant-Supported Fixed Prosthesis. ORAL & IMPLANTOLOGY 2017; 10:448-456. [PMID: 29682262 DOI: 10.11138/orl/2017.10.4.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective The objective is to present a clinical case of a 38-year-old male with a maxillary unicystic ameloblastoma treated by means of tumor block resection followed by chin-harvested graft placement in order to place two dental implants for esthetic and functional rehabilitation. Methods Ameloblastoma is a benign odontogenic tumor characterized by local aggression and a high rate of recurrence; the latter partly depends on how it is treated. Complete resection of the tumor, which usually prevents recurrence, produces bone defects of varying size that must be reconstructed later on. In most cases this is done using bone grafts and implant-supported prostheses. Grafts harvested from the chin are relatively easy to obtain and enjoy a fairly uneventful post-operative with few complications; they are suitable for cases in which the defect generated by resection is of small size. Results Functional and esthetic rehabilitation and the tumor has not relapsed during a 7-year follow-up. Conclusion Tumor block resection followed by chin-harvested graft placement and dental implants is a safe treatment for patients with unicystic ameloblastoma.
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Affiliation(s)
- J Sanz-Alonso
- PhD, Associates lecturers in Oral Surgery, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - N Martínez-Rodríguez
- PhD, Lecturer in Oral Surgery, Hospital Virgen de la Paloma, Madrid, Madrid, Spain
| | - M Martín-Ares
- PhD, Lecturer in Oral Surgery, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - C Barona-Dorado
- PhD, Associates lecturers in Oral Surgery, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - J Cortés Bretón-Brinkmann
- PhD, Lecturer in Dental Prothesis, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - J M Martínez-González
- Senior Lecturer in Oral and Maxillofacial Surgery, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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Sánchez-Romero C, Bologna-Molina R, Mosqueda-Taylor A, Paes de Almeida O. Immunohistochemical Expression of GLUT-1 and HIF-1α in Tooth Germ, Ameloblastoma, and Ameloblastic Carcinoma. Int J Surg Pathol 2016; 24:410-8. [PMID: 27020375 DOI: 10.1177/1066896916640359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hypoxia-inducible factor-1α (HIF-1α) promotes proteins that enable cell survival during hypoxia, such as glucose transporter 1 (GLUT-1). Their coexpression has been associated with aggressiveness in malignancies and has not been studied in odontogenic tumors. Immunohistochemical expression of HIF-1α and GLUT-1 was analyzed in 13 tooth germs (TGs), 55 ameloblastomas (AMs), and 3 ameloblastic carcinomas (ACs). HIF-1α was negative in all TGs, and just 1 case of AM and 1 of AC had nuclear positivity. GLUT-1 expressed in ameloblastic cells of all TGs, AMs, and ACs, with an increasing intensity, respectively, and was significantly higher in solid AM than in unicystic AM (P = .041). Absence of nuclear HIF-1α in TGs and most AMs suggest that GLUT-1 may be induced by alternative pathways to hypoxia. However, in ACs, HIF-1α may be activated; however, to confirm this, additional cases are needed. GLUT-1 overexpression could be related to aggressiveness in AMs and ACs and must represent a normal metabolite in TGs.
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27
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Salami A, Anzouan-Kacou E, Assouan C, N'Guessan ND. Giant ameloblastoma. Br J Oral Maxillofac Surg 2016; 54:1054-1055. [PMID: 26948706 DOI: 10.1016/j.bjoms.2016.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
Affiliation(s)
- A Salami
- Department of Stomatology and Maxillofacial Surgery Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire, BPV 3 Abidjan.
| | - E Anzouan-Kacou
- Department of Stomatology and Maxillofacial Surgery Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire, BPV 3 Abidjan
| | - C Assouan
- Department of Stomatology and Maxillofacial Surgery Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire, BPV 3 Abidjan
| | - N D N'Guessan
- Department of Stomatology and Maxillofacial Surgery Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire, BPV 3 Abidjan
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28
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Okada T, Fujitsu K, Ichikawa T, Miyahara K, Tanino S, Niino H, Yagishita S. Unicystic Ameloblastomatoid Cystic Craniopharyngioma: Pathological Discussion and Clinical Significance of Cyst Formation in Adamantinomatous Craniopharyngioma. Pediatr Neurosurg 2016; 51:158-63. [PMID: 26795029 DOI: 10.1159/000442992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/01/2015] [Indexed: 11/19/2022]
Abstract
An 8-year-old boy presented complaining principally of headache and vomiting. A single large cystic lesion extending from the suprasellar region to the ventral brainstem was identified, and total extirpation was performed via a right orbitozygomatic, transtemporal transchoroidal fissure approach. The cyst contents resembled motor oil, and no strong adhesions were identified between the tumor and the surrounding tissue except at the site of origin of the tumor, allowing easy dissection. The tumor originated at the junction of the adenohypophysis and the pituitary stalk. Although the histopathological diagnosis was adamantinomatous craniopharyngioma, the cyst walls comprising the majority of the tumor were not thin, fragile tissues formed by squamous metaplasia, but were thick and robust, bearing a close resemblance to unicystic ameloblastoma mixed with solid tissue. The existence of this type of cyst wall represents corroborating evidence that craniopharyngiomas are derived from the oral primordium. The existence of such tumors that can be totally extirpated in a single procedure while preserving hypothalamo-pituitary function may be taken as a warning not to rush at random to perform treatments that might encourage recurrence or regrowth by carrying out cyst fenestration and drug injection with the addition of stereotactic radiotherapy.
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Affiliation(s)
- Tomu Okada
- Department of Neurosurgery, Yokohama Medical Center, National Hospital Organization, Yokohama, Japan
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29
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Masuda K, Kawano S, Yamaza H, Sakamoto T, Kiyoshima T, Nakamura S, Nonaka K. Complete resolution of a calcifying cystic odontogenic tumor with physiological eruption of a dislocated permanent tooth after marsupialization in a child with a mixed dentition: a case report. World J Surg Oncol 2015; 13:277. [PMID: 26376974 PMCID: PMC4574018 DOI: 10.1186/s12957-015-0697-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/08/2015] [Indexed: 12/03/2022] Open
Abstract
Here, we report the complete resolution of a calcifying cystic odontogenic tumor (CCOT) in the right mandible after marsupialization in an 8-year-old girl with a mixed dentition. Clinical, radiographic, and histopathological findings showed a simple cystic variant of CCOT in the region of the deciduous second molar, with dislocation of the permanent second premolar tooth germ. Initial treatment involved marsupialization, including extraction of the involved deciduous tooth, incision of pathological tissue, and creation of a window in the extraction socket. The crown of the dislocated second premolar was exposed at the base of the cystic cavity after marsupialization. One year and nine months later, complete bone healing and spontaneous eruption of the second premolar were observed, providing evidence of the bone regeneration capacity and tooth germ eruption potential in children. No recurrence was observed after 7 years. The findings from this case suggest that marsupialization can be successfully applied for the treatment of CCOT in children with a mixed dentition.
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Affiliation(s)
- Keiji Masuda
- Department of Pediatric Dentistry and Special Needs Dentistry, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Shintaro Kawano
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Haruyoshi Yamaza
- Section of Pediatric Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Taiki Sakamoto
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Seiji Nakamura
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Kazuaki Nonaka
- Section of Pediatric Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
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Apajalahti S, Kelppe J, Kontio R, Hagström J. Imaging characteristics of ameloblastomas and diagnostic value of computed tomography and magnetic resonance imaging in a series of 26 patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e118-30. [DOI: 10.1016/j.oooo.2015.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/25/2015] [Accepted: 05/06/2015] [Indexed: 12/11/2022]
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Antonoglou GN, Sándor GK. Recurrence rates of intraosseous ameloblastomas of the jaws: A systematic review of conservative versus aggressive treatment approaches and meta-analysis of non-randomized studies. J Craniomaxillofac Surg 2015; 43:149-57. [DOI: 10.1016/j.jcms.2014.10.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/08/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022] Open
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de Paulo LFB, Oliveira MTF, Rodrigues ÁR, Zanetta-Barbosa D. Treatment of an extensive unicystic ameloblastoma in a 7-year-old child: the best approach? Br J Oral Maxillofac Surg 2014; 53:292-4. [PMID: 25542283 DOI: 10.1016/j.bjoms.2014.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 11/28/2014] [Indexed: 11/15/2022]
Abstract
Ameloblastoma is a benign, slow-growing neoplasm of the jaw that arises from odontogenic epithelium. We present the case of a 7-year-old girl with a unicystic ameloblastoma of the mandible, and describe our approach to treatment.
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Affiliation(s)
- L F B de Paulo
- Department of Oral and Maxillofacial Surgery and Implantology, Federal University of Uberlândia - UFU, Brazil; Program of Specific Care of Oral Diseases - PROCEDE, Federal University of Uberlândia - UFU, Brazil.
| | - M T F Oliveira
- Department of Oral and Maxillofacial Surgery and Implantology, Federal University of Uberlândia - UFU, Brazil
| | - Á R Rodrigues
- Department of Oral and Maxillofacial Surgery and Implantology, Federal University of Uberlândia - UFU, Brazil
| | - D Zanetta-Barbosa
- Department of Oral and Maxillofacial Surgery and Implantology, Federal University of Uberlândia - UFU, Brazil
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Bilateral glandular odontogenic cyst of mandible: a rare occurrence. J Maxillofac Oral Surg 2014; 14:443-7. [PMID: 25848155 DOI: 10.1007/s12663-014-0668-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/06/2014] [Indexed: 10/24/2022] Open
Abstract
Glandular odontogenic cysts (GOCs) of the jaw are rare with well-defined limits radiologically, unusual histopathological features and a high recurrence rate. The radiographic appearance of GOCs vary and are not pathognomonic. Definitive diagnosis of the GOC is established only by histopathological examinations. Histologically, GOC is characterized by a thin nonkeratinized squamous epithelial lining, with papillary projections, nodular thickenings, mucous (goblet) cells with intraepithelial mucous pools and intraepithelial glandular, microcystic or duct-like structures. We present an unusual case of a bilateral GOC in the mandible. This case report is also the first documented case of bilateral GOC in the mandible.
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