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Inthong P, Upalananda W, Saepoo J. Factors Associated with Recurrence of Ameloblastoma: A Scoping Review. Head Neck Pathol 2024; 18:82. [PMID: 39177897 PMCID: PMC11343934 DOI: 10.1007/s12105-024-01686-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
PURPOSE This scoping review aimed to identify factors associated with the recurrence of ameloblastoma. METHODS Systematic searches were conducted in PubMed, Scopus, and EMBASE, based on the board research question: "What factors are related to the recurrence of ameloblastoma?". English-language observational studies addressing the risk and preventive factors associated with recurrent ameloblastoma were included and data were extracted. RESULTS Eighty-three retrospective observational studies met the inclusion criteria. The identified prognostic factors for recurrence included: (1) Tumor size/diameter/volume, (2) cortical bone perforation/ soft tissue invasion, (3) multilocular radiolucency, (4) impacted tooth-involving lesions, (5) root resorption, (6) WHO classification - conventional (solid/multicystic) ameloblastoma, (7) histological subtype - mural invasion of unicystic ameloblastoma, (8) conservative treatment modalities - simple enucleation, curettage, and marsupialization, and (9) non-extraction/preservation of involved teeth. No strong evidence linked immunohistochemical expression to recurrence. Interestingly, BRAF p.V600E remained controversial in terms of recurrence, despite being a frequent finding in ameloblastoma. CONCLUSION Certain clinical characteristics, radiographic findings, histological subtypes, and treatment choices of ameloblastoma can help identify patients at high risk of recurrence. Further prospective studies to evaluate the prognostic factor model and research on immunohistochemistry are required.
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Affiliation(s)
- Pornnutcha Inthong
- Section of Oral and Maxillofacial Pathology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Witsarut Upalananda
- Section of Oral and Maxillofacial Radiology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Jay Saepoo
- Section of Oral and Maxillofacial Pathology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
- Section of Oral Medicine, Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand.
- , Kanjanavanich Rd., Hatyai, Songkhla, 90110, Thailand.
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Yamashita J, Kimoto A, Teraoka S, Hiraoka Y, Takeda D, Kakei Y, Shigeoka M, Hasegawa T, Akashi M. Photodynamic therapy with verteporfin accelerates apoptotic bleb formation in human ameloblastoma. Oral Dis 2024; 30:3261-3271. [PMID: 37890051 DOI: 10.1111/odi.14775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/11/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE Although benign, ameloblastoma is a locally aggressive lesion in some patients and the development of additional treatments is needed. Verteporfin (VP) is a photosensitizer exhibiting considerable photocytotoxicity in various tumor cells. We aimed to investigate the effects of verteporfin photodynamic therapy (VP PDT) on ameloblastoma. METHODS Eighteen patients who underwent surgery for ameloblastoma were randomly selected. We performed an immunohistochemical assessment to investigate the expression of low-density lipoprotein receptor (LDLR) and Yes-associated protein (YAP), targets of VP, in human ameloblastoma tissues and cultured human ameloblastoma cell line (HAM1). The effect of VP PDT on cell proliferation and apoptosis in HAM1 was analyzed. RESULTS The expression of LDLR and YAP were detected in human ameloblastoma tissues and HAM1. LDLR expression was significantly higher in patients who had previously undergone surgery than in patients who were receiving it for the first time. The cytotoxic effect of the combination of low-concentration VP administration and laser irradiation was comparable to high-concentration VP administration with and without laser irradiation. The addition of laser irradiation to VP administration significantly accelerated apoptotic bleb formation compared with VP administration alone. CONCLUSION VP PDT has the potential to become an additional treatment for large-sized ameloblastoma.
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Affiliation(s)
- Junya Yamashita
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Kimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Teraoka
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yujiro Hiraoka
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Manabu Shigeoka
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Xiong G, Xie N, Nie M, Ling R, Yun B, Xie J, Ren L, Huang Y, Wang W, Yi C, Zhang M, Xu X, Zhang C, Zou B, Zhang L, Liu X, Huang H, Chen D, Cao W, Wang C. Single-cell transcriptomics reveals cell atlas and identifies cycling tumor cells responsible for recurrence in ameloblastoma. Int J Oral Sci 2024; 16:21. [PMID: 38424060 PMCID: PMC10904398 DOI: 10.1038/s41368-024-00281-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Ameloblastoma is a benign tumor characterized by locally invasive phenotypes, leading to facial bone destruction and a high recurrence rate. However, the mechanisms governing tumor initiation and recurrence are poorly understood. Here, we uncovered cellular landscapes and mechanisms that underlie tumor recurrence in ameloblastoma at single-cell resolution. Our results revealed that ameloblastoma exhibits five tumor subpopulations varying with respect to immune response (IR), bone remodeling (BR), tooth development (TD), epithelial development (ED), and cell cycle (CC) signatures. Of note, we found that CC ameloblastoma cells were endowed with stemness and contributed to tumor recurrence, which was dominated by the EZH2-mediated program. Targeting EZH2 effectively eliminated CC ameloblastoma cells and inhibited tumor growth in ameloblastoma patient-derived organoids. These data described the tumor subpopulation and clarified the identity, function, and regulatory mechanism of CC ameloblastoma cells, providing a potential therapeutic target for ameloblastoma.
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Affiliation(s)
- Gan Xiong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Nan Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Min Nie
- Department of Periodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Rongsong Ling
- Institute for Advanced Study, Shenzhen University, Shenzhen, China
| | - Bokai Yun
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jiaxiang Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Linlin Ren
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yaqi Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Wenjin Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Chen Yi
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Ming Zhang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiuyun Xu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Caihua Zhang
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Leitao Zhang
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiqiang Liu
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongzhang Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Demeng Chen
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Cao
- Department of Oral and Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- National Center for Stomatology, National Clinical Research Center for Oral diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
| | - Cheng Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
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Nivya SJ, Dain CP. Clinicopathologic Profile and Surgical Modalities in Mandibular Ameloblastoma: A Descriptive Study. J Craniofac Surg 2024; 35:158-162. [PMID: 37691573 DOI: 10.1097/scs.0000000000009706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Ameloblastoma is a benign neoplasm composed of epithelial tissue with invasive and infiltrative behavior at the local level and a high recurrence rate, with various histopathologic patterns and clinical forms. Approximately 85% of conventional ameloblastomas occur in the mandible, most often in the body, angle, and ascending ramus area. The treatment modalities include both conservative and radical treatments. Postoperative follow-up is most important in the treatment of ameloblastoma. AIMS AND OBJECTIVES To describe the clinicopathologic profile of mandibular ameloblastoma in patients undergoing different surgical modalities. The primary objective was to describe the clinicopathologic profile and surgical management of mandibular ameloblastoma in patients aged ≥18 years, who had reported to a tertiary dental care center for follow-up during the study period. The secondary objective was to describe the distribution of comorbidities associated with different surgical modalities and reconstructive methods. SUBJECTS AND METHODS A total of 34 patients with mandibular ameloblastoma who underwent various surgical modalities between 2011 and 2021 were studied. Information was collected using a predesigned proforma and statistically analyzed. RESULTS Thirty-four review cases of ameloblastoma were included in the study. The patients were analyzed concerning age, sex, site, size, clinical presentation, radiographic pattern, histopathologic subtype, type of surgery, and associated comorbidities. Most cases of mandibular ameloblastoma involve the age of 16 to 55 years. The mean age of occurrence was found to be 35.5±13.2. A female preponderance, a tumor size range of 2 to 4 cm, a multicystic variant, involvement of the mandibular body in the premolar-molar area, root resorption, cortical perforation, and a follicular type of histopathologic pattern were the common presentations. Isolated anterior tumors restricted to the incisor/canine region were not found. The common surgical modalities undertaken were conservative methods such as enucleation, and chemical cauterization, and radical methods such as marginal mandibulectomy and segmental resection. Reconstruction using a titanium plate or free fibular graft was performed in the indicated cases. The common comorbidities included difficulty in chewing and loss of facial contour. Recurrence after surgical treatment was rare. Only 9% of cases developed a recurrence within 5 years. No recurrence was noted in cases treated with radical treatment, whereas 50% of cases treated with conservative methods showed recurrence. CONCLUSION The age of occurrence, site, and size of the tumor, cortical perforation, root resorption, histopathologic type, and radiographic patterns are widely considered factors in devising a treatment plan for mandibular ameloblastoma. However, there may be rare instances where these tumors behave differently regardless of their innocuous clinicopathologic presentation. Surgical procedures such as segmental resection and marginal mandibulectomy were found to be promising for the eradication of the tumor, and prevention of recurrences and metastasis. However, conservative measures such as enucleation and chemical cauterization were fraught with an increased risk of tumor recurrence and metastasis. Future studies with a larger sample size should focus on the clinicopathologic characteristics of ameloblastoma to elucidate its varied behavior and develop newer and advanced treatment modalities that would provide better surgical and postsurgical outcomes in affected patients.
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Affiliation(s)
- Selvaraj Jaya Nivya
- Department of Oral and Maxillofacial Surgery, Government Dental College, Medical College Campus, Thiruvananthapuram, Kerala, India
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Singh AK, Alagarsamy R, Chaulagain R, Singh A, Sapkota D, Thavaraj S, Singh RP. Does BRAF mutation status and related clinicopathological factors affect the recurrence rate of ameloblastoma? A systematic review, meta-analysis and metaregression. J Oral Pathol Med 2023; 52:895-903. [PMID: 37872712 DOI: 10.1111/jop.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES This review aims to analyse the recurrence rate in BRAFv600e+ and BRAFv600e- ameloblastomas and explore its association with clinicopathological variables. METHODS A comprehensive search was conducted using databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, Google Scholar and grey literature, without any limitation on start date or language up to 20 June 2023. A random effect meta-analysis was conducted and Metaregression analyses were performed based on available clinicopathological factors. RESULTS Fifteen studies met the criteria for meta-analysis of outcomes. There was no significant difference in overall recurrence rates between the two groups (risk difference = 0.001, p-value = 0.987). Increasing male:female ratio in the BRAFv600e+ group was associated with a lower reported recurrence, suggesting a higher recurrence rate in females. The odds of having mandibular lesion were four times higher in BRAFv600e+ cases compared to BRAFv600e- cases (confidence interval: 2.121-7.870, p < 0.001, I2 = 28.37%). CONCLUSION Within the BRAFv600e+ group, females showed a higher reported recurrence rate. This specific clinical group may benefit from BRAFv600e mutation investigation and potential upscaled surgical treatment and additional BRAF inhibitor therapy, which needs validation in future studies.
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Affiliation(s)
- Ashutosh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, Safdarjung Hospital, New Delhi, India
| | - Rajib Chaulagain
- Department of Oral Biology, Chitwan Medical College, Bharatpur, Nepal
| | - Abanish Singh
- Department of Community Dentistry, National Medical College, Birgunj, Nepal
| | - Dipak Sapkota
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Rabindra P Singh
- Department of Oral and Maxillofacial Surgery, University Hospital Southampton, Southampton, UK
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Amaral EC, Javaroni JB, Silveira HA, Trivellato AE, Sverzut CE, León JE. Pseudocarcinomatous Squamous Hyperplasia After Surgical Management Of Pediatric Ameloblastoma: An Immunohistochemical Study. J Maxillofac Oral Surg 2023; 22:741-745. [PMID: 37534340 PMCID: PMC10390451 DOI: 10.1007/s12663-023-01912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/26/2023] [Indexed: 08/04/2023] Open
Abstract
Pseudocarcinomatous squamous hyperplasia (PSH) affecting the jaws is uncommon. The mandible is the most common location, usually as a complication associated with osteomyelitis, medication-related osteonecrosis or osteoradionecrosis. Herein, we report an 8-year-old male patient presenting a solid ameloblastoma, plexiform type, who was treated by segmental mandibulectomy with bone grafting. Three months later, on the underlying graft, a sinus tract was observed, and a small bone fragment was resected which was diagnosed as bone sequestration associated with PSH. After 7-year follow-up, the patient is well, without alterations. To our knowledge, for the first time, we report in detail the immunohistochemical features of PSH which, in addition to epithelial component profile and chronic inflammatory cells, revealed a diffuse infiltration by dendritic cells, suggesting that epithelial cell-immune cell interactions in PSH pathogenesis should also be considered.
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Affiliation(s)
- Eloísa Costa Amaral
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Julia Biliato Javaroni
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 Brazil
| | - Heitor Albergoni Silveira
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 Brazil
| | - Alexandre Elias Trivellato
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cássio Edvard Sverzut
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jorge Esquiche León
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, 14040-904 Brazil
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Hendra FN, Helder MN, Ruslin M, Van Cann EM, Forouzanfar T. A network meta-analysis assessing the effectiveness of various radical and conservative surgical approaches regarding recurrence in treating solid/multicystic ameloblastomas. Sci Rep 2023; 13:8445. [PMID: 37231111 DOI: 10.1038/s41598-023-32190-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 03/23/2023] [Indexed: 05/27/2023] Open
Abstract
Multiple treatment approaches have been undertaken to reduce the incidence of recurrence in solid/multicystic ameloblastoma (SMA), both conservative and radical. A network meta-analysis (NMA) was conducted to assess and compare the effectiveness of these various treatment approaches concurrently. This study was reported based on the Preferred Reporting Items for Systematic Reviews for Network Meta-Analysis (PRISMA-NMA) statement. PubMed (MEDLINE), ScienceDirect, Scopus, and Web of Science were searched until August 10, 2021. The NMA was conducted using the STATA program. Of 1153 records identified in the search, seven observational studies with 180 patients were included. Six different treatment approaches were identified. Segmental resection ranked highest for reducing the recurrence rate with the highest SUCRA score (77.7), followed by curettage with cryotherapy (66.9) and marginal resection (49.3). Network inconsistencies and publication bias appeared to be absent. According to the Confidence in Network Meta-Analysis (CINeMa) method, the evidence's certainty was low for all comparisons due to imprecision and within-study bias. In conclusion, this study is the first NMA in the field of ameloblastoma. Segmental resection seemed to be the most effective treatment approach for minimizing recurrence in SMA patients. Nevertheless, weak certainty of evidence makes that the results must be regarded with caution.
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Affiliation(s)
- Faqi Nurdiansyah Hendra
- Department of Oral and Maxillofacial Surgery/ Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
- Department of Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery/ Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Ellen M Van Cann
- Department of Oral and Maxillofacial Surgery/ Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/ Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Anyanechi CE, Shetty SS. Ameloblastoma of the jaws in adult: A retrospective review of local recurrent lesions based on the resection margin in the adjacent apparent healthy tissues. Heliyon 2023; 9:e16243. [PMID: 37251853 PMCID: PMC10209404 DOI: 10.1016/j.heliyon.2023.e16243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Background The surgical treatment of ameloblastoma of the jaws remains contentious due to the variable recurrence rate amongst its variants, the tumor's local invasive behavior, and the lack of consensus among surgeons concerning the extent of resection in the contiguous healthy tissues. Objective To determine the recurrence rate of ameloblastoma and its association with the resection margins. Materials and methods This is a retrospective cohort study of the medical records of patients who underwent surgical resection of the jaws as the primary modality of treatment for ameloblastoma. Clinical data over the 26 years were analyzed for age, gender, site of the lesion, size, radiographic appearance, histopathological sub-type, and the incidence of recurrence post-treatment. Descriptive and bivariate statistics were computed. Results A retrospective audit of 234 cases was included in the study that was typical (solid/multicystic) ameloblastoma. The age of patients ranged from 20 to 66 years with a mean age of 33.4 ± 9.6 years, and a male-to-female ratio of 1.2: 1 (P = 0.52). The follicular and plexiform types accounted for the majority of histopathological variants (89.8%; P = 0.000). Overall, 6.8% of cases relapsed after the initial primary surgery. The rate of recurrence was high with a resection margin of 1.0 or 1.5 cm than 2.0 cm (P = 0.001). No case of recurrence was seen with a resection margin of 2.5 cm margin. Conclusion A low recurrence rate of 6.8% was noted in our series of cases. A wide 2.5 cm resection margin is recommended in the adjacent healthy tissues.
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Affiliation(s)
- Charles Ezechukwu Anyanechi
- Department of Oral and Maxillofacial Surgery, University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Sameep S. Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, 575001, India
- Manipal Academy of Higher Education, a Constituent of MAHE, Manipal, India
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Singh CA, Devaraja K, Kumar R. Recurrent Ameloblastoma: Long Term Outcomes with Free Fibular Bone Graft. Indian J Otolaryngol Head Neck Surg 2022; 74:1773-1779. [PMID: 36452534 PMCID: PMC9702040 DOI: 10.1007/s12070-020-01790-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/04/2020] [Indexed: 10/25/2022] Open
Abstract
Ameloblastoma is a locally aggressive benign neoplasm of jaw that has high propensity to recur. Pathological subtype and intent of surgical excision during primary surgery are two factors that are known to affect the prognosis in these cases. Nevertheless, there are hardly any studies which have studied recurrent ameloblastoma cases. Apart from sharing a tertiary care cancer center's experience in managing a series of recurrent ameloblastoma cases, we discuss some of the recent literature related to pathophysiology and principles related to their surgical management. Retrospective chart review of all those recurrent ameloblastoma cases which were operated between October 2013 and January 2016 and were subsequently followed up for minimum of 3 years. Total of 9 recurrent ameloblastoma cases were operated in the study period. All our patients had less-radical or non-curative intent surgical treatment in the past, and current treatment consisted wide excision of the involved segment of mandible with free fibular reconstruction. Among the 6 patients who were followed up for more than 3 years, none developed recurrence at 56.5 months of mean follow up duration. Almost all these patients had optimal results with good quality of life in terms of oral speech intellectuality and cosmetic perception of self. Complete excision of the involved segment of bone with reconstruction using the composite free fibular graft can provide optimal functional outcomes and can significantly lessen the chances of further recurrences.
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Affiliation(s)
- Chirom Amit Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - K. Devaraja
- Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
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Sozzi D, Cassoni A, De Ponti E, Moretti M, Pucci R, Spadoni D, Canzi G, Novelli G, Valentini V. Effectiveness of Resective Surgery in Complex Ameloblastoma of the Jaws: A Retrospective Multicenter Observational Study. Cancers (Basel) 2022; 14:cancers14194608. [PMID: 36230531 PMCID: PMC9559477 DOI: 10.3390/cancers14194608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Ameloblastoma is a rare, benign, odontogenic tumor of epithelial origin, characterized by locally aggressive, expansive growth. Treatment is controversial due to the risk of relapse. The aim of this multicenter retrospective study was to evaluate the effectiveness of complete resection in cases of complex ameloblastoma, which is considered at a higher risk of recurrence. Patients who met at least one of these criteria were included: recurrence, soft-tissue involvement, complete erosion of internal/external cortical walls with involvement of the inferior margin of the mandible, and invasion of the maxillary sinus or nasal cavity. Demographic data, tumor site, type of surgery, histological features, and follow-up information were collected for each patient. The cohort included 55 patients with a mean follow-up of 108 ± 66 months. A multivariate logistic model was used to evaluate variables independently associated with relapse. There were six soft-tissue or maxillary sinus relapses, with a recurrence rate of 10.9%. Most of them arose in patients previously treated. The statistical analysis identified the maxillary location as a fundamental relapse risk factor. En bloc resection with large surgical safety margins seemed to be effective in preventing the relapses. However, complete resection was less effective in preventing recurrences in the soft tissues or maxillary sinus.
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Affiliation(s)
- Davide Sozzi
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-039-233-3535 or +39-039-233-3538; Fax: +39-039-233-3536
| | - Andrea Cassoni
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, 00161 Rome, Italy
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena De Ponti
- Department of Medical Physics, ASST Monza—San Gerardo Hospital, University of Milano Bicocca, 20900 Monza, Italy
| | - Mattia Moretti
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Postgraduate School of Maxillofacial Surgery, University of Milan, 20122 Milan, Italy
| | - Resi Pucci
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Davide Spadoni
- Maxillofacial Surgery Unit, ASST Santi Paolo e Carlo—Ospedale San Paolo, 20142 Milan, Italy
| | - Gabriele Canzi
- Maxillofacial Surgery Unit, Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Giorgio Novelli
- Maxillofacial Surgery Unit, ASST Monza—San Gerardo Hospital, 20900 Monza, Italy
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Valentino Valentini
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, 00161 Rome, Italy
- Department of Oral Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
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11
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Recurrent Ameloblastoma: Clinical Manifestation and Disease-Free Survival Rate. JOURNAL OF ONCOLOGY 2022; 2022:2148086. [PMID: 35983087 PMCID: PMC9381261 DOI: 10.1155/2022/2148086] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
Objectives Ameloblastoma is a slow-growing epithelial odontogenic neoplasm of the jaws with a high recurrence rate. The main treatment strategies for this lesion are radical or conservative surgical approaches. The aim of the present study was to analyze clinical presentations, histological types, and treatment strategies of recurrent ameloblastoma and to define its disease-free survival (DFS) rate. Materials and Methods Twenty-four cases of recurrent ameloblastomas, treated between January 2009 and July 2021, were enrolled in this study. Medical files from each patient, including gender, age, size of the lesion, localization, patient complaints, clinical manifestation, radiographic appearance, histological type, surgical management, and treatment results were reviewed and analyzed retrospectively. Result Out of 69 operated primary ameloblastomas, the rate of recurrence was 35%. Out of 24 recurrent cases, 21 developed after conservative treatment and 3 after radical treatment. In most cases, recurrences were found in the mandible (n = 20). A unilocular pattern was predominant in radiographic examination (44%). Estimated 3-year DFS was 84.5 ± 4.8%, and the 5-year and 10-year DFS were 73.0 ± 6.3% and 43.9 ± 8.343.9 ± 8.3%, respectively. Conclusion Results obtained in the present retrospective study proved the necessity of long-term follow-up after both conservative and radical treatment approaches. The DFS median in our study was 8 years (95% CI 6 years–10 years). For recurrent cases, radical resection with histologically free margins after exact MRI determination of the ameloblastoma border within the soft tissues should be considered as the method of choice to avoid secondary recurrence.
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12
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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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13
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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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14
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Boffano P, Cavarra F, Tricarico G, Masu L, Brucoli M, Ruslin M, Forouzanfar T, Ridwan-Pramana A, Rodríguez-Santamarta T, Rui Ranz M, de Vicente JC, Starch-Jensen T, Pechalova P, Pavlov N, Doykova I, Konstantinovic VS, Jelovac D, Barrabé A, Louvrier A, Meyer C, Tamme T, Andrianov A, Dovšak T, Birk A, Hresko A, Chepurnyi Y, Kopchak A, Snäll J, Hagström J, Rasmusson L, Rocchetti V. The epidemiology and management of ameloblastomas: A European multicenter study. J Craniomaxillofac Surg 2021; 49:1107-1112. [PMID: 34583885 DOI: 10.1016/j.jcms.2021.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023] Open
Abstract
The present study aimed at assessing the epidemiology including demographic variables, diagnostic features, and management of ameloblastomas at several European departments of maxillofacial and oral surgery. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, site, size, radiographic features, type, histopathological features, kind of treatment, length of hospital stay, complications, recurrence, management and complications of the recurrence. A total of 244 patients, 134 males and 110 females with ameloblastomas were included in the study. Mean age was 47.4 years. In all, 81% of lesions were found in the mandible, whereas 19% were found in the maxilla. Mean size of included ameloblastomas was 38.9 mm. The most frequently performed treatment option was enucleation plus curettage/peripheral ostectomy in 94 ameloblastomas, followed by segmental resection (60 patients), simple enucleation (46 patients), and marginal resection (40 patients). A recurrence (with a mean follow up of 5 years) was observed in 47 cases out of 244 ameloblastomas (19.3%). Segmental resection was associated with a low risk of recurrence (p = 0003), whereas enucleation plus curettage/peripheral ostectomy was associated with a high risk of recurrence (p = 0002). A multilocular radiographic appearance was associated with a high risk of recurrence (p < .05), as well as the benign solid/multicystic histologic type (p < .05). Within the limitations of the study it seems that the management of ameloblastomas will probably remain controversial even in the future. Balancing low surgical morbidity with a low recurrence rate is a difficult aim to reach.
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Affiliation(s)
- Paolo Boffano
- Division of Dentistry, Vercelli Hospital, Vercelli, Italy.
| | | | | | - Lavinia Masu
- Division of Pathology, Vercelli Hospital, Vercelli, Italy
| | - Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Angela Ridwan-Pramana
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Marta Rui Ranz
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Petia Pechalova
- Department of Oral Durgery, Faculty of Dental medicine, Medical University of Plovdiv, Bulgaria
| | - Nikolai Pavlov
- Clinic of Maxillofacial Surgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Iva Doykova
- Department of Maxillofacial Murgery, Faculty of Dental Sedicine, Medical University of Plovdiv, Bulgaria
| | | | - Drago Jelovac
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Aude Barrabé
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon, France
| | - Aurélien Louvrier
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon, France; University of Franche-Comté, INSERM, EFS BFC, UMR 1098 Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besançon, France
| | - Christophe Meyer
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon, France; University of Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, 25000, Besançon, France
| | - Tiia Tamme
- Department of Stomatology, University of Tartu, Estonia
| | | | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | | | | | - Andrii Kopchak
- O. Bohomolets National Medical University, Kyiv, Ukraine
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Hagström
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland; Department of Pathology, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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15
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Niu X, Huang B, Qiao X, Liu J, Chen L, Zhong M. MicroRNA-1-3p Suppresses Malignant Phenotypes of Ameloblastoma Through Down-Regulating Lysosomal Associated Membrane Protein 2-Mediated Autophagy. Front Med (Lausanne) 2021; 8:670188. [PMID: 34124097 PMCID: PMC8187618 DOI: 10.3389/fmed.2021.670188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: Several clinical trials have suggested that autophagy inhibition is a promising approach for cancer therapy. However, the implications of autophagy in ameloblastoma (AB) remain undiscovered. This study investigated the dysregulated autophagy and its regulatory mechanisms in AB. Methods: The expression and distribution of autophagy-related proteins including B-cell lymphoma-2-interacting protein-1 (Beclin1), microtubule-associated protein 1 light chain 3 (LC3) II/I and lysosomal associated membrane protein 2 (LAMP2) were detected in AB and normal oral mucosa (NOM) tissues by immunohistochemistry and western blot analyses. Under transmission electron microscopy, the autophagy of AB was observed. LAMP2 was a potential target mRNA of miR-1-3p. Quantitative Real-time PCR (qRT-PCR) analysis was utilized for examining LAMP2 and miR-1-3p in AB tissues as well as AM-1 cells. The correlation between LAMP2 and miR-1-3p was analyzed in AB. After transfection with miR-1-3p mimic or inhibitor, LAMP2 expression, proliferation, migration, and invasion were separately detected in AM-1 cells. Rescue assays were finally presented. Results: Our results showed that Beclin1 was lowly expressed as well as LC3II/I and LAMP2 were highly expressed in AB. Autophagosomes were observed in AB. MiR-1-3p was lowly expressed in AB, which exhibited negative correlations to LAMP2 expression. MiR-1-3p up-regulation significantly lowered LAMP2 expression in AM-1 cells. Furthermore, miR-1-3p overexpression restrained proliferative, migrated, and invasive capacities of AM-1 cells, which were ameliorated by LAMP2 overexpression. Conclusion: Our findings demonstrated that miR-1-3p suppressed malignant phenotypes of AB through down-regulating LAMP2-mediated autophagy, which could become an underlying target for AB therapy.
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Affiliation(s)
- Xing Niu
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, China.,Department of Oral Histopathology, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Biying Huang
- Department of Oral Histopathology, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Xue Qiao
- Department of Central Laboratory, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Jinwen Liu
- Department of Oral Histopathology, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Lijie Chen
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, China.,Department of Oral Histopathology, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Ming Zhong
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, China.,Department of Oral Histopathology, Liaoning Province Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang, China
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16
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Qiao X, Shi J, Liu J, Liu J, Guo Y, Zhong M. Recurrence Rates of Intraosseous Ameloblastoma Cases With Conservative or Aggressive Treatment: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:647200. [PMID: 34094934 PMCID: PMC8170394 DOI: 10.3389/fonc.2021.647200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/26/2021] [Indexed: 11/24/2022] Open
Abstract
Objective This study aimed to systematically investigate and compare the post-treatment recurrence of intraosseous ameloblastoma in patients treated with conservative or aggressive approaches. Methods Systemic searches of PubMed, Medline, Cochrane Library, and Embase databases from inception to October 28, 2020, were conducted. Studies that aimed to evaluate the recurrence of intraosseous ameloblastoma by conservative and aggressive treatment approaches were included. Results A total of 20 studies with 942 ameloblastoma cases were included. Fourteen studies included patients with ameloblastoma who received conservative treatment, and 16 studies reported the overall recurrence rate for patients undergoing aggressive treatment. The pooled results indicated that the recurrence rate for aggressive treatment [0.12, 95% confidence interval (CI) = 0.09–0.16] was significantly lower than that for conservative treatment, with a recurrence rate of 0.30 (95% CI = 0.23–0.39). Similar results were obtained when stratifying the participants by the histological classification. When trying stratification analysis following the original included studies, multicystic ameloblastoma presented a much higher recurrence rate than solid and unicystic ameloblastomas. Conclusion These findings supported the hypothesis that aggressive treatment might lead to a lower recurrence rate than conservative treatment. More studies and meta-analyses following the new histological classification of ameloblastomas are needed to validate and support the findings.
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Affiliation(s)
- Xue Qiao
- Department of Central laboratory, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China.,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - Junxiu Shi
- Department of Developmental Cell Biology, Cell Biology Division, Key Laboratory of Cell Biology, Ministry of Public Health, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Jiayi Liu
- Department of Oral Histopathology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - Jinwen Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - Yan Guo
- Department of Central laboratory, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China.,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China
| | - Ming Zhong
- Department of Central laboratory, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China.,Department of Oral Histopathology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, China.,Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, China
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17
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Berretta LM, Melo G, Mello FW, Lizio G, Rivero ERC. Effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions: a systematic review. Br J Oral Maxillofac Surg 2021; 59:E17-E42. [PMID: 34749963 DOI: 10.1016/j.bjoms.2021.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/12/2021] [Indexed: 11/26/2022]
Abstract
In this study, we aimed to systematically review and critically appraise the available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines were followed and the study protocol was registered at the 'International Prospective Register of Systematic Reviews' (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science. Searches were complemented with three grey literature sources: Google Scholar, ProQuest, and Open Grey. Any reduction measures, compared with preoperative status or other procedures, were considered. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thirty-one studies were included, of which five were judged with low, 24 with moderate, and two with high risk of bias. Considering surgical approach, 20 studies assessed the decompression and 11 the marsupialisation technique. Most studies considered these techniques as preliminary treatments, followed by enucleation. From 1088 lesions found, most were odontogenic keratocysts (33.8%), followed by unicystic ameloblastomas (21.0%), dentigerous cysts (20.6%), and radicular cysts (8.4%). Large lesions and younger individuals frequently presented more favourable responses to treatment and anatomical location was not associated with lesion reduction overall. The intervention duration generally ranged between one to two years. In conclusion, marsupialisation and decompression were mostly considered as preliminary treatments, followed by enucleation. Lesion reduction was generally considered insufficient for these techniques to be used as definitive therapies, although benefits concerning the diminished invasiveness of the secondary surgery were often proposed.
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Affiliation(s)
- L M Berretta
- Dental School, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Melo
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - F W Mello
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Lizio
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna - Bologna, Italy.
| | - E R C Rivero
- Department of Pathology, Health Sciences Centre, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
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18
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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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19
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Hresko A, Burtyn O, Pavlovskiy L, Snisarevskyi P, Lapshyna J, Chepurnyi Y, Kopchak A, Karagozoglu KH, Forouzanfar T. Controversies in ameloblastoma management: evaluation of decision making, based on a retrospective analysis. Med Oral Patol Oral Cir Bucal 2021; 26:e181-e186. [PMID: 33037802 PMCID: PMC7980285 DOI: 10.4317/medoral.24104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The ameloblastoma management is still challenging to the high recurrence rates and significant morbidity associated with radical treatment. The purpose of this 10-year retrospective study was to analyze the influence of ameloblastoma type and treatment strategy on the long-term outcomes and recurrence rates. MATERIAL AND METHODS The retrospective analyses of 64 histologically-confirmed ameloblastoma cases was performed. The possible risk factors for recurrence and the development of complications were estimated statistically. RESULTS The treatment strategy applied for this group of patients was the following: thirty-four patients (53.1%) were treated conservatively with enucleation or extended bone curettage. Radical treatment (bone resection) was applied in 30 (46.9%) cases. The follow-up period ranged from 2 to 10 years (mean value 4.28 ± 3,26). General recurrence rate consisted 32.8%. This study did not find significant correlations between clinical or histopathological features of the ameloblastoma and the recurrence rate. The only factor that significantly influence recurrence rate was the treatment strategy (41% in conservative treatment vs 15% in radical treatment, p<0.05). Postoperative complications were observed in 42 patients (65.6%) and included face asymmetry and disfigurement (17.2%), temporary paresthesia of the inferior alveolar nerve (IAN) - 23.4%, permanent paresthesia of IAN - 20.3%, paresis of a marginal branch of the facial nerve - 6.3%, infection 12.5%, and swelling - 20.3%. The complication rates, esthetic and functional deficiency were significantly higher in radically treated patients (p<0.05) Conclusions: Our study confirms that higher recurrence rate is associated with conservative treatment for ameloblastoma, while radical treatment leads to an increased number of postoperative complications that affect the patient's quality of life.
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Affiliation(s)
- A Hresko
- Centre of maxillo-facial surgery and dentistry Kyiv regional clinical hospital Sholudenka street, 1A, ap 45. 04116, Kyiv, Ukraine
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20
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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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21
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Owosho AA, Ladeji AM, Adebiyi KE, Olajide MA, Okoye ISI, Kehinde T, Nwizu NN, Summersgill KF. BRAF V600E mutation-specific immunohistochemical analysis in ameloblastomas: a 44-patient cohort study from a single institution. Eur Arch Otorhinolaryngol 2020; 278:3065-3071. [PMID: 33231757 DOI: 10.1007/s00405-020-06491-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this study is to investigate the presence and prevalence of BRAF V600E mutation in ameloblastomas using anti-BRAF V600E monoclonal antibody (VE1 clone) and to identify any clinicopathologic correlation with BRAF V600E mutation in ameloblastoma. MATERIALS AND METHODS The pathology files of the Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria, were searched for the diagnosis of ameloblastoma from 2016 to 2020. Archived non-decalcified formalin-fixed paraffin-embedded tissue underwent immunohistochemistry using anti-BRAF V600E antibody at the University of Pittsburgh, Pennsylvania. Clinicopathologic data such as age at diagnosis, gender, jaw bone involved (mandible or maxilla), tumor location (anterior or posterior) and histologic subtype were collected. The clinicopathologic parameters were analyzed using Chi-square test and Fisher's exact test according to the BRAF status. RESULTS Forty-four cases of ameloblastoma were retrieved. The male to female ratio was 1.32:1. The average age of patients at diagnosis was 33.3 years. Thirty-nine cases were located in the mandible and 5 cases in the maxilla. Only cases in the mandible were positive for anti-BRAF V600E antibody (n = 15/39; 38.5%). There was a significant correlation between BRAF V600E expression in mandibular tumors and histologic subtype (p = 0.02); however, no significance was observed for gender, age and tumor location. CONCLUSION BRAF V600E mutation preferentially occurs in mandibular ameloblastomas, especially in non-plexiform ameloblastomas. These patients may benefit therapeutically from the use of BRAF inhibitors.
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Affiliation(s)
- Adepitan A Owosho
- Missouri School of Dentistry and Oral Health, A.T. Still University, 800 W Jefferson Street, Kirksville, MO, USA.
| | - Adeola M Ladeji
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Kehinde E Adebiyi
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Mofoluwaso A Olajide
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Ikechukwu S I Okoye
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Temitope Kehinde
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV, USA
| | - Ngozi N Nwizu
- Department of Diagnostic and Biomedical Science, School of Dentistry, The University of Texas, Health Science Center at Houston, Houston, TX, USA
| | - Kurt F Summersgill
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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22
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Awadalkreem F, Abdoun O. Enucleation and surgical stent as a treatment strategy for a large unicystic ameloblastoma: Case report and review of literature. Int J Surg Case Rep 2020; 77:371-377. [PMID: 33217656 PMCID: PMC7683291 DOI: 10.1016/j.ijscr.2020.11.025] [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: 09/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022] Open
Abstract
Ameloblastoma has a locally invasive and aggressive nature and high recurrence rate. A conservative approach and a radical resection approach have been suggested. Radical resection may lead to esthetic, functional, and psychological sequelae. First use of surgical stent with conservative management for ameloblastoma.
Introduction Ameloblastoma is a benign neoplasm of odontogenic origin with local invasive characteristics and a high recurrence rate. It compromised 1% of the jaw's cysts and tumors with only 10–15% in children. Presentation of case A 14-year-old boy sought treatment for a painless swelling involving the right side of the face started one year ago. The intra-oral examination displayed a firm mass associated with 46, 47 teeth, and the angle of the mandible. The radiographic examination revealed a large well-defined homogeneous radiolucency extending from the 46 region to involve the angle and extending towards the coronoid and condylar processes. An incisional biopsy confirmed the diagnosis of unicystic ameloblastoma. Treatment was planned according to the patient’s age: Phase I: Surgical enucleation. Phase II: Construction and insertion of a surgical stent. Phase III: Construction of a transitional acrylic Kennedy class II partial denture. Phase IV: the patient is scheduled for a definitive implant-supported prosthesis at 18 years old. Discussion The management of ameloblastoma is influenced by the age of the patient, the extension, duration, and position of the lesion, and the histopathological variants. Several authors recommended enucleation as a conservative treatment approach to eliminate the esthetical, functional, and psychological squeals associated with the radical approach. The use of a surgical stent protects the enucleated cavity and promote tissue healing. Conclusion Enucleation and subsequent surgical stent not only eliminates the disease, but also preserves the bone structure, prevents the facial disfigurement, and significantly improve the patient’s esthetic, mastication, oral health, and quality of life.
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Affiliation(s)
- Fadia Awadalkreem
- Department of Oral Rehabilitation, Prosthodontics Division, Faculty of Dentistry, University of Khartoum, Sudan.
| | - Omer Abdoun
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, University of Khartoum, Sudan.
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Kalwagadda S, Kumar B, Nair SC, Shah AK, Shroff SS. Management of Ameloblastoma with Free Tissue Flap in Comparison with Other Reconstructive Options Available. J Maxillofac Oral Surg 2020; 19:283-288. [PMID: 32346241 DOI: 10.1007/s12663-019-01203-2] [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: 05/26/2018] [Accepted: 02/13/2019] [Indexed: 11/25/2022] Open
Abstract
Aim To review the management and reconstruction of ameloblastoma of mandible in different age groups over a period of 11 years. Methodology This retrospective study includes 51 cases operated in the Maxillofacial Unit, Bhagwan Mahaveer Jain Hospital, Bangalore, from the year 2007 to 2017. The data of these patients were collected to record demographic data such as age, gender with site of tumour and type of reconstruction after resection, follow-up period and incidence of complications. This study evaluated the outcome in terms of aesthetics, function and choice of reconstruction in different age groups. Results Most patients were of 21-40 age group. 37 (72.5%) were found to be unicystic ameloblastoma. 41 (80.3%) patients underwent reconstruction following the resection. There was a change in trend seen over a period of time with free grafts and reconstruction plate being historical, except in special situations like old age and unfit patients. According to one-way ANOVA and Tukey's post hoc analysis, free flaps were known to take a longer duration (mean = 503 min) compared to other modes of reconstruction. However, free grafts and free flaps were demonstrated to have a good facial contour and speech with most cases dentally rehabilitated with implants. Among the complications, 1 (16%) case with reconstruction plate showed screw loosening, 2 (28%) cases with free grafts showed graft exposure, and 1 (3.5%) case with free flap had venous congestion, making free flaps the most reliable option. Conclusion Free fibula is the gold standard of mandible reconstruction, but depending on age, medical condition, economic status and size of the defect other modes of reconstruction can be chosen with the acceptance of suboptimal results.
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Affiliation(s)
- Sowjanya Kalwagadda
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Balasubramanya Kumar
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sanjiv C Nair
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Anjan Kumar Shah
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sunil S Shroff
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
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24
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Yew CC, Ismail RB, Md Zin MNB, Yap HF, Chan HK. Modified conservative management of mandibular ameloblastoma: a 13‐year experience in a Malaysian tertiary care centre. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/ors.12486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. C. Yew
- Oral and Maxillofacial Surgery Department Hospital Sultan Abdul Halim Ministry of Health Kedah Malaysia
| | - R. B. Ismail
- Oral and Maxillofacial Surgery Department Hospital Tuanku Fauziah Ministry of Health Perlis Malaysia
| | - M. N. B. Md Zin
- Oral and Maxillofacial Surgery Department Hospital Sultanah Bahiyah Ministry of Health Kedah Malaysia
| | - H. F. Yap
- Oral and Maxillofacial Surgery Department Hospital Sultanah Bahiyah Ministry of Health Kedah Malaysia
| | - H. K. Chan
- Clinical Research Center Hospital Sultanah Bahiyah Ministry of Health Kedah Malaysia
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25
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Abstract
Benign cysts and neoplasms of the maxillofacial region can vary in behavior, with some growing rapidly and resulting in destruction of surrounding structures. Despite their benign histology, many require often-morbid treatment to prevent recurrence of these lesions. Several less invasive and adjunctive medical treatments have been developed to lessen the morbidity of surgical treatment. As the molecular and genomic pathogenesis of these lesions is better understood, more directed treatments may lessen the burden for patients.
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Affiliation(s)
- Zachary S Peacock
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street Warren 1201, Boston, MA 02421, USA.
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26
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Ohiro Y, Yamada T, Kakuguchi W, Kobayashi I, Kitamura T, Tei K. Modified “Dredging Method” for complicated solid/multicystic ameloblastoma in the mandible: Report of a case treated by fractionated enucleation. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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27
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Ding Z, Liu J, Wang J, Huang B, Zhong M. Upregulation of eukaryotic translation initiation factor 3 subunit a promotes cell survival in ameloblastoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:146-153. [PMID: 31078505 DOI: 10.1016/j.oooo.2019.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/01/2019] [Accepted: 02/13/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to detect the expression of eukaryotic translation initiation factor 3 subunit a (eIF3a) in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate the roles of eIF3a in the immortalized ameloblastoma cell line (AM-1) cell proliferation and apoptosis. STUDY DESIGN We performed immunohistochemistry to determine the expression of eIF3a in AB tissues (n = 83) and NOM tissues (n = 20). Real time-quantitative polymerase chain reaction and Western blot analyses were conducted with AB tissues (n = 30) and NOM tissues (n = 6). The correlation between eIF3a expression and the clinical/pathologic features of patients with AB is also presented. The functional role of eIF3a in AM-1 cells was assessed with lentiviral vector-mediated shRNA (small hairpin RNA). RESULTS Our results indicated that eIF3a was significantly upregulated in AB. Additionally, eIF3a knockdown in AM-1 cells significantly inhibited cell proliferation and promoted apoptosis. CONCLUSIONS These data indicate that eIF3a facilitates the survival of AB cells and may serve as a promising therapeutic target in AB.
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Affiliation(s)
- Zhenjiang Ding
- Department of Pediatric Dentistry, School of Stomatology, China Medical University, Shenyang, Liaoning, China; Department of Oral Histopathology, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Jie Liu
- Department of Central Laboratory, China Medical University, Shenyang, Liaoning, China
| | - Junting Wang
- Department of Oral Histopathology, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Biying Huang
- Department of Oral Histopathology, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Ming Zhong
- Department of Oral Histopathology, School of Stomatology, China Medical University, Shenyang, Liaoning, China.
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28
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Pai A, Singhavi H, Mair M, Nair S, Nair D, Chaturvedi P. Surgical excision with the negative margins offers best cure rates for ameloblastoma: A case series and review of literature. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2019. [DOI: 10.4103/jhnps.jhnps_1_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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29
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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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Slusarenko da Silva Y, Tartaroti NA, Sendyk DI, Deboni MCZ, Naclério-Homem MDG. Is conservative surgery a better choice for the solid/multicystic ameloblastoma than radical surgery regarding recurrence? A systematic review. Oral Maxillofac Surg 2018; 22:349-356. [PMID: 30191338 DOI: 10.1007/s10006-018-0715-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Determine if conservative surgery of primary solid/multicystic ameloblastoma (SMA) is capable of decreasing the recurrence rate as effectively as radical surgery. METHODS We searched in MEDLINE, Web of Science, Scopus and Cochrane Library for original studies reporting on the conservative or radical treatment of primary SMA and the related recurrence rate. All selected data were independently assessed. Meta-analysis was performed and the Relative Risk (RR) of recurrence with a confidence interval of 95% was the effect measure. P value for the summary effect of < 0.05 was considered statistically significant. RESULTS The 2647 records retrieved were reduced to 7 studies to be qualitatively assessed and 4 studies were included in the meta-analysis. RR of 1.88 [0.59, 5.95] of the pooled values pointed that recurrence rate after the conservative surgery is neither comparable nor lower than the radical surgery (P = 0.28). CONCLUSIONS Conservative surgery does not reduce the recurrence rate as efficiently as radical surgery for primary SMA. However, there is not enough evidence to support this statement.
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Affiliation(s)
- Yuri Slusarenko da Silva
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil.
| | - Natalia Aguiar Tartaroti
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Daniel Isaac Sendyk
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Maria Cristina Zindel Deboni
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
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Distraction Osteogenesis of Fibula Graft for Mandibular Reconstruction Following Ameloblastoma Ablation. J Craniofac Surg 2018; 30:202-204. [PMID: 30480630 DOI: 10.1097/scs.0000000000004970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Resection of maxillofacial may cause a series of complications such as loss of facial deformity, dysfunction, and psychological distress. Mandibular reconstruction following resection still remains difficult. METHODS A 18-year-old male patient with mandibular ameloblastoma was admitted in the hospital of stomatology. The tumor was dissected and the defect was reconstructed using vascularized fibula graft. One year later, distraction osteogenesis (DO) was performed on the fibula graft to augment the alveolar bone for dental implants. Panoramic radiographs, computed tomography, and clinical photographs were taken. Five months after completion of distraction, the distraction device was removed. RESULTS Panoramic radiographs, computed tomography, and clinical photographs showed the good healing after fibula graft for mandibular reconstruction following ameloblastoma ablation and satisfied alveolar bone with good width and height for dental implants after DO. CONCLUSIONS This report suggests that DO of fibula graft following mandibular reconstruction was an efficient method to augment the alveolar bone for dental implants.
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Abstract
Introduction Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. Methods Patients who had histologically proven ameloblastoma between 1991 and 2009 were identified from the database of Aga Khan University Hospital. A review of all medical records, radiological images, operative reports and pathology reports was undertaken. Results A total of 15 patients with histologically confirmed ameloblastoma were identified. Out of 15 patients nine were males and six were females with age range from 20 to 60 years (mean age 43 years). The most common symptom found in our patient group was painless facial swelling. In 13 patients the origin of tumor was mandible and in the remaining two the tumor originated from maxilla. Eleven out of 15 patients underwent segmental mandibulectomy, two had maxillectomy and two had enucleation. All patients who underwent segmental mandibulectomy required reconstruction. Reconstruction was done with microsurgical free tissue transfer in eight patients, non-vascularized iliac crest bone graft was used in one patient and two had plating only. All free flaps survived with no evidence of flap loss. The mean follow-up was eight years. There was no evidence of graft failure which was used in one patient. Complication was seen in only one of our patients in the form of plate exposure. Recurrence was seen in two of our cases who primarily underwent enucleation. All patients had satisfactory speech, cosmesis and mastication. Conclusion The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.
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Affiliation(s)
- Mohammad Adeel
- Head and Neck Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | | | - Asif Ali Arain
- Otolaryngology, Head & Neck Surgery, The Indus Hospital, Karachi, PAK
| | - Maqbool Baloch
- Otolaryngology, Aga Khan University Hospital, Karachi, PAK
| | - Mumtaz Khan
- Otolaryngology, Aga Khan University Hospital, Karachi, PAK
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Biological profile of ameloblastoma and its location in the jaw in 1246 Nigerians. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:424-431. [PMID: 30126803 DOI: 10.1016/j.oooo.2018.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/15/2018] [Accepted: 06/23/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Ameloblastoma is a benign, slow-growing, locally invasive epithelial tumor of odontogenic origin, with unlimited growth capacity and a strong tendency to recur. This multicentric study analyzed ameloblastoma diagnosed in Nigeria among different ethnic groups. STUDY DESIGN This retrospective study included ameloblastoma cases diagnosed from 1964 to 2017 at 10 hospitals or medical centers in Nigeria. Age, sex, tribe, and location of the ameloblastoma in the jaw were analyzed. Associations between variables were tested by using χ2 and Fisher's exact test. RESULTS A total of 1246 ameloblastoma cases were recorded (mean patient age 32.51 ± 14.54 years; range 4-86 years; male-to-female ratio 1.2:1). Approximately 60% of ameloblastoma cases occurred in young adults (age range 18-40 years). Ninety-eight lesions were located in the maxilla and 1103 in the mandible; the posterior mandible was the most common site (31.3% on the right and 26.5% on the left, respectively), followed by the anterior (26.0%) mandible. No significant differences were noted in the distribution of ameloblastoma within the tribes with respect to age (P = .92) and sex (P = .71). CONCLUSIONS The mandible is a common site of ameloblastoma in patients in Nigeria, and in most cases, it occurs in young adults. Early presentation, diagnosis, and treatment are important to reduce postoperative disfigurement and morbidity.
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Ritchie AC, Schafer DR. Clinical Pathologic Conference Case 6. Oral Surg Oral Med Oral Pathol Oral Radiol 2018. [DOI: 10.1016/j.oooo.2018.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fahradyan A, Odono L, Hammoudeh JA, Howell LK. Ameloblastic Carcinoma In Situ: Review of Literature and a Case Presentation in a Pediatric Patient. Cleft Palate Craniofac J 2018; 56:94-100. [PMID: 29715060 DOI: 10.1177/1055665618774021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Ameloblastic carcinomas are rare malignant lesions with 3 mandibular pediatric cases reported in the literature. We present a case of ameloblastic carcinoma in situ in a 15-year-old male with a right mandibular cystic lesion on computed tomography. The incisional biopsy revealed plexiform ameloblastoma. Due to the infiltrating and aggressive nature of the tumor, the patient underwent hemimandibulectomy and immediate reconstruction with a vascularized osteocutaneous fibula free flap. The final pathology was read as ameloblastic carcinoma in situ. Given the rarity of this disease in the pediatric population, this case report may be a valuable addition to the current literature.
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Affiliation(s)
- Artur Fahradyan
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Lauren Odono
- 2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA
| | - Jeffrey A Hammoudeh
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lori Kathryn Howell
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
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Rate of Relapse After Enucleation of Solid/Multicystic Ameloblastoma Followed by Piezoelectric or Conventional Peripheral Ostectomy. J Craniofac Surg 2018; 29:e291-e293. [DOI: 10.1097/scs.0000000000004322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
PURPOSE OF REVIEW The management of benign, locally aggressive odontogenic tumors, namely, keratocystic odontogenic tumors (KOTs) and ameloblastomas, can be challenging. The purpose of this article is to briefly summarize important features of these lesions and review recent trends in the literature regarding their treatment. RECENT FINDINGS Currently, KOTs are frequently treated with a conservative approach consisting of enucleation and adjuvant decompression or local microablation with peripheral ostectomies, Carnoy's solution, or cryotherapy. Conversely, ameloblastomas generally require marginal or segmental resection followed by reconstruction using local bone regeneration techniques or vascularized osteocutaneous free flaps, respectively. Bone regeneration techniques have improved with the use of autogenous progenitor cells held in place by autogenous or alloplastic scaffolding. Esthetic results for free flap reconstruction have improved with the use of inconspicuous surgical approaches utilizing intraoral or rhytidectomy incisions. Molecular markers for both neoplasms are being investigated as potential targets for chemotherapeutic agents. SUMMARY Excluding hamartomas (i.e., odontomas), KOTs and ameloblastomas are the most common benign odontogenic lesions. Their management is often complicated by their locally infiltrative behavior, responsible for high rates of recurrence. Simple enucleation or excision of these lesions has proven insufficient. When left untreated, these lesions are capable of causing severe disfigurement and loss of function. Knowledge regarding current best practices and potential future therapeutics is imperative to well treated and effective disease management.
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Cho ES, Kim HS, Kim JY. Large bulging mass of the posterior mandible in a child. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:1-5. [DOI: 10.1016/j.oooo.2017.06.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 11/29/2022]
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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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Unicystic Ameloblastoma Revisited: Comparison of Massachusetts General Hospital Outcomes With Original Robinson and Martinez Report. J Oral Maxillofac Surg 2017; 75:2369-2378. [DOI: 10.1016/j.joms.2017.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/16/2017] [Accepted: 03/19/2017] [Indexed: 11/24/2022]
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41
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Peacock ZS. Controversies in Oral and Maxillofacial Pathology. Oral Maxillofac Surg Clin North Am 2017; 29:475-486. [DOI: 10.1016/j.coms.2017.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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42
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Jiang C, Zhang Q, Shanti RM, Shi S, Chang TH, Carrasco L, Alawi F, Le AD. Mesenchymal Stromal Cell-Derived Interleukin-6 Promotes Epithelial-Mesenchymal Transition and Acquisition of Epithelial Stem-Like Cell Properties in Ameloblastoma Epithelial Cells. Stem Cells 2017; 35:2083-2094. [PMID: 28699252 DOI: 10.1002/stem.2666] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/21/2017] [Accepted: 06/29/2017] [Indexed: 01/05/2023]
Abstract
Epithelial-mesenchymal transition (EMT), a biological process associated with cancer stem-like or cancer-initiating cell formation, contributes to the invasiveness, metastasis, drug resistance, and recurrence of the malignant tumors; it remains to be determined whether similar processes contribute to the pathogenesis and progression of ameloblastoma (AM), a benign but locally invasive odontogenic neoplasm. Here, we demonstrated that EMT- and stem cell-related genes were expressed in the epithelial islands of the most common histologic variant subtype, the follicular AM. Our results revealed elevated interleukin (IL)-6 signals that were differentially expressed in the stromal compartment of the follicular AM. To explore the stromal effect on tumor pathogenesis, we isolated and characterized both mesenchymal stromal cells (AM-MSCs) and epithelial cells (AM-EpiCs) from follicular AM and demonstrated that, in in vitro culture, AM-MSCs secreted a significantly higher level of IL-6 as compared to the counterpart AM-EpiCs. Furthermore, both in vitro and in vivo studies revealed that exogenous and AM-MSC-derived IL-6 induced the expression of EMT- and stem cell-related genes in AM-EpiCs, whereas such effects were significantly abrogated either by a specific inhibitor of STAT3 or ERK1/2, or by knockdown of Slug gene expression. These findings suggest that AM-MSC-derived IL-6 promotes tumor-stem like cell formation by inducing EMT process in AM-EpiCs through STAT3 and ERK1/2-mediated signaling pathways, implying a role in the etiology and progression of the benign but locally invasive neoplasm. Stem Cells 2017;35:2083-2094.
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Affiliation(s)
- Chunmiao Jiang
- Department of Oral and Maxillofacial Surgery and Pharmacology.,Key Laboratory of Oral Clinical Medicine, College of Stomatology.,Department of Orthodontics, the Affiliated Hospital of Medical College, Qingdao University, Shandong, People's Republic of China
| | - Qunzhou Zhang
- Department of Oral and Maxillofacial Surgery and Pharmacology
| | - Rabie M Shanti
- Department of Oral and Maxillofacial Surgery and Pharmacology.,Department of Oral and Maxillofacial Surgery, Penn Medicine Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Shihong Shi
- Department of Oral and Maxillofacial Surgery and Pharmacology
| | - Ting-Han Chang
- Department of Oral and Maxillofacial Surgery and Pharmacology
| | - Lee Carrasco
- Department of Oral and Maxillofacial Surgery and Pharmacology.,Department of Oral and Maxillofacial Surgery, Penn Medicine Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | - Faizan Alawi
- Department of Pathology, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Anh D Le
- Department of Oral and Maxillofacial Surgery and Pharmacology.,Department of Oral and Maxillofacial Surgery, Penn Medicine Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
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Goil P, Patil AN, Malhotra K, Chaudhary G. Microvascular reconstruction with free fibula osteocutaneous flap in mandibular ameloblastomas—an institutional experience. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1323-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Effiom OA, Ogundana OM, Akinshipo AO, Akintoye SO. Ameloblastoma: current etiopathological concepts and management. Oral Dis 2017; 24:307-316. [PMID: 28142213 DOI: 10.1111/odi.12646] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 02/06/2023]
Abstract
Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis. Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. Molecular and genetic factors that promote oncogenic transformation of odontogenic epithelium to ameloblastoma are strongly linked to dysregulation of multiple genes associated with mitogen-activated protein kinase, sonic hedgehog, and WNT/β-catenin signaling pathways. Treatment of ameloblastoma is focused on surgical resection with a wide margin of normal tissue because of its high propensity for locoregional invasion; but this is often associated with significant patient morbidity. The relatively high recurrence rate of ameloblastoma is influenced by the type of molecular etiological factors, the management approach, and how early the patient presents for treatment. It is expected that further elucidation of molecular factors that orchestrate pathogenesis and recurrence of ameloblastoma will lead to new diagnostic markers and targeted drug therapies for ameloblastoma.
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Affiliation(s)
- O A Effiom
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - O M Ogundana
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - A O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - S O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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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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Manimaran K, Sharma R, Sankaranarayanan S, Perumal SM. Regeneration of mandibular ameloblastoma defect with the help of autologous dental pulp stem cells and buccal pad of fat stromal vascular fraction. Ann Maxillofac Surg 2016; 6:97-100. [PMID: 27563616 PMCID: PMC4979353 DOI: 10.4103/2231-0746.186128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Ameloblastoma is benign odontogenic tumor, which is locally aggressive in behavior. Till date, the treatment of choice is resection and reconstruction using a variety of modalities. Inadequate resection may lead to many complications such as bone deformity and dysfunction. This report is about a 14-year-old male with ameloblastoma treated with autologous dental pulp stem cells (DPSCs) and stromal vascular fraction (SVF) and evidence of bone regeneration. Marsupialization was performed; tooth was extracted and sent for DPSC cultivation. On the day of surgery, SVF was processed from buccal pad of fat, and platelet-rich fibrin (PRF) was prepared from patient's peripheral blood. During the procedure, labial plate resection and curating of tumor lining were done. After which, a mesh packed with SyboGraft T-plug, prepared SVF, DPSCs, and PRF were placed over lingual cortex and pressure dressing was done. After the 1st month of surgery the postoperative course was uneventful, the wound shrinkage led to exposure of mesh in the intraoral region. Removal of exposed mesh was done. The correction surgery with removal of part of mesh and primary closure was achieved with SyboGraft plug, SVF and PRF. Enhanced bone formation was seen in post-operative OPG and CT Scan after 10th month. In this article, we propose an innovative approach to manage these cases by using a combination of autologous DPSC and buccal pad of fat SVF to regenerate a mandibular defect left by the resection of an ameloblastoma with 1.5 year follow-up. We were able to demonstrate bone regeneration using this technique with no recurrence of tumor.
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Affiliation(s)
- K Manimaran
- Department of Oral and Maxillofacial Surgery, K.S.R. Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Rohini Sharma
- Laboratory of Cell Culture, Mother Cell Regenerative Centre, Trichy, Tamil Nadu, India
| | - S Sankaranarayanan
- Laboratory of Cell Culture, Mother Cell Regenerative Centre, Trichy, Tamil Nadu, India
| | - S Mahendra Perumal
- Department of Oral and Maxillofacial Surgery, K.S.R. Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
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Pereira NB, Pereira KMA, Coura BP, Diniz MG, de Castro WH, Gomes CC, Gomez RS. BRAFV600E mutation in the diagnosis of unicystic ameloblastoma. J Oral Pathol Med 2016; 45:780-785. [PMID: 27084044 DOI: 10.1111/jop.12443] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Unicystic ameloblastoma, an odontogenic neoplasm, presents clinical and radiographic similarities with dentigerous and radicular cysts, non-neoplastic lesions. It is not always possible to reach a final diagnosis with the incisional biopsy, leading to inappropriate treatment. The BRAFV600E activating mutation has been reported in a high proportion of ameloblastomas. The purpose of the study was to assess the utility of the detection of the BRAFV600E mutation in the differential diagnosis of unicystic ameloblastoma with dentigerous and radicular cysts. METHODS Twenty-six archival samples were included, comprising eight unicystic ameloblastomas (UAs), nine dentigerous and nine radicular cysts. The mutation was assessed in all samples by anti-BRAFV600E (clone VE1) immunohistochemistry (IHC) and by TaqMan mutation detection qPCR assay. Sanger sequencing was further carried out when samples showed conflicting results in the IHC and qPCR. RESULTS Although all UAs (8/8) showed positive uniform BRAFV600E staining along the epithelial lining length, the mutation was not confirmed by qPCR and Sanger sequencing in three samples. Positive staining for the BRAFV600E protein was observed in one dentigerous cyst, but it was not confirmed by the molecular methods. Furthermore, 2/9 dentigerous cysts and 2/9 radicular cysts showed non-specific immunostaining of the epithelium or plasma cells. None of the dentigerous or radicular cysts cases presented the BRAFV600E mutation in the qPCR assay. CONCLUSIONS The BRAFV600E antibody (clone VE1) IHC may show non-specific staining, but molecular assays may be useful for the diagnosis of unicystic ameloblastoma, in conjunction with clinical, radiological and histopathological features.
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Affiliation(s)
- Núbia Braga Pereira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil
| | | | - Bruna Pizziolo Coura
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil
| | - Marina Gonçalves Diniz
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil
| | - Wagner Henriques de Castro
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil
| | - Carolina Cavalieri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais-UFMG, Belo Horizonte, Brazil.
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Sharma Lamichhane N, Liu Q, Sun H, Zhang W. A case report on desmoplastic ameloblastoma of anterior mandible. BMC Res Notes 2016; 9:171. [PMID: 26984790 PMCID: PMC4793556 DOI: 10.1186/s13104-016-1961-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Desmoplastic ameloblastoma (DA) is a rare variant that accounts for approximately 4-13% of ameloblastoma, displaying significant differences in anatomical site, imaging, and histologic appearance. It has been included in WHO classification of head and neck tumor (WHO-2005) as a variant of ameloblastoma. The tumor resembles benign fibro-osseous lesion for being frequently occurring in the anterior region of jaws as a mixed radiopaque-radiolucent lesion. CASE PRESENTATION We present a case of DA in a 43-year-old female with a painless swelling in the anterior region of mandible. No fluid was evident on fine needle aspiration. A mixed lesion with multilocular appearance was evident on both panoramic radiographs as well as computed tomography scan. An incisional biopsy confirmed it to be a case of desmoplastic ameloblastoma. Segmental mandibulectomy was performed from teeth 35 to 44. The patient is on routine follow-up and is currently free of ailment. CONCLUSIONS The present case deserves emphasis because of its unfamiliar appearance, potentially aggressive nature and deceptive radiologic appearance maximizing the chances of misdiagnosis. So, the clinician should be alert enough to include desmoplastic ameloblastoma in differential diagnosis of any lesion/growth with mixed radiolucent-radiopaque appearance having ill-defined borders and occurring in anterior maxilla or mandible.
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Affiliation(s)
- Narayan Sharma Lamichhane
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin Province, People's Republic of China.,Department of Oral and Maxillofacial Surgery, Bhaktapur District Hospital, Bhaktapur, Kathmandu, 44800, Nepal
| | - Qilin Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin Province, People's Republic of China
| | - Hongchen Sun
- Department of Oral Pathology, Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin Province, People's Republic of China
| | - Wei Zhang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin Province, People's Republic of China.
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Abstract
PURPOSE OF REVIEW This review focuses on issues in managing ameloblastomas of the mandible and maxilla. We will refer to current practice in the treatment of ameloblastomas based on the available evidence. RECENT FINDINGS Recent reviews have been trying to establish natural history, growth patterns and malignant potential. This provides the clinicians and the patients with useful prognostic information. Controversies in management of ameloblastomas in relation to the type, age and site exist. This paper aims to categorize these issues. More recently, the authors have adopted the staged treatment approach as an additional step to ensure margin clearance. SUMMARY Current evidence favours radical resection to provide better control rates. This applies to maxillary lesions of all ages, and solid mandibular lesions in adults (>18 years) where growth has ceased and the patient has matured enough to withstand the impact of resection and reconstruction. Conservative management is advocated for unicystic lesions with good control rates. In children and adolescents, a conservative approach is recommended. This approach aids to minimize both psychological and the impact on growth. Furthermore, most of the lesions are unicystic and the recurrent lesions have been shown to be much smaller and can be managed promptly within a good healthcare system.
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SILVA FPY, DIAS A, COELHO CA, GUERRA EN, MARQUES AEM, DECURCIO DDA, MANTESSO A, CURY SEV, SILVA BSDF. Expression of CD90 and P75NTR stem cell markers in ameloblastomas: a possible role in their biological behavior. Braz Oral Res 2016; 30:e109. [DOI: 10.1590/1807-3107bor-2016.vol30.0109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 07/25/2016] [Indexed: 01/15/2023] Open
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