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Netto R, Peralta-Mamani M, de Freitas-Filho SAJ, Moura LL, Rubira CMF, Rubira-Bullen IRF. Segmental resection vs. partial resection on treating solid multicystic ameloblastomas of the jaws - recurrence rates: A systematic review and meta-analysis. J Clin Exp Dent 2023; 15:e518-e525. [PMID: 37519315 PMCID: PMC10382164 DOI: 10.4317/jced.60502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/22/2023] [Indexed: 08/01/2023] Open
Abstract
Background The aim of the present study was to compare the recurrence rates of solid multicystic ameloblastomas after segmental resection or marginal resection. Material and Methods PubMed, ScienceDirect, Web of Science, Scopus, Embase were searched for studies published up to July 2022. The gray literature was also searched. Meta-analysis was performed using OpenMeta Software, p< 0.05 considered significant. Results Among the search, 8 studies met all eligibility criteria. The group that underwent marginal resection was 1.1 times more likely to present recurrence of the lesion compared to the group that underwent segmental resection. There was no statistically significant difference between the two groups (segmental resection and marginal resection) in all eight studies regarding reducing ND (95% Confidence interval, 0.339 - 3.705; heterogeneity: Q value= 3.105; I2= 0%). Conclusions The results showed that there was no statistically significant difference between segmental and marginal resection for the treatment of solid multicystic ameloblastomas; however, prospective studies with more rigorous methodological procedures are needed to better compare the surgical techniques. Key words:Ameloblastoma, solid multicystic ameloblastoma, treatment, recurrence.
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Affiliation(s)
- Rafael Netto
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
- Faculdade do Centro Oeste Paulista - FACOP, Piratininga, São Paulo, Brazil
| | | | - Ludimila-Lemes Moura
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Cassia-Maria-Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, SP, Brazil
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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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Ragunathan YT, Kumar SK, Janardhanam D, Ravi A, Santhanam V, Ramdas MN. Prevalence and Epidemiological Profile of Ameloblastoma in India: A Systematic Review and Meta-Analyses. Asian Pac J Cancer Prev 2022; 23:3601-3610. [PMID: 36444570 PMCID: PMC9930951 DOI: 10.31557/apjcp.2022.23.11.3601] [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: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Ameloblastoma is regarded as the second most prevalent odontogenic tumor in the light of its prevalence, clinical characteristics, greater incidence of tumor recurrence, and therapeutic challenges. The aim of this systematic review was to establish the prevalence of ameloblastoma in the Indian subcontinent and to establish a national epidemiologic profile for these lesions. MATERIAL AND METHODS A systematic review was undertaken based on the PRISMA guidelines in search of epidemiologic studies concerning odontogenic tumors and ameloblastoma that are listed by PubMed, EBSCO, and Google Scholar embracing the period from January 2010 to December 2021, to evaluate the prevalence rate in India. A total of 277 publications were retrieved, of which 27 articles were selected, based on the World Health Organization classification of odontogenic tumors. RESULTS The affected individuals were on average in the third decade of life, with a higher male predominance. The majority of the tumors were multilocular radiolucencies in the posterior mandible, with follicular and plexiform histopathological features. The most common type of malignant lesion is ameloblastic carcinoma. Over 60% of follicular ameloblastoma recurred more frequently than the other types of ameloblastoma.The random effect model shows overall point estimate of 4.83 with 95% confidence
interval (4.44 -5.26). CONCLUSION The systematic study indicates a slight male predisposition to ameloblastoma, with a peak incidence in the third decade of life and the mandible as the preferred anatomical site. The solid/multicystic ameloblastoma is the most prevalent histopathologic pattern. More epidemiological research on the prevalence rate of ameloblastoma is required, particularly in India, in an effort to accurately determine the national epidemiological profile of ameloblastoma.
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Affiliation(s)
| | - Srichinthu Kenniyan Kumar
- Department of Oral & Maxillofacial Pathology, KSR Institute of Dental Science and Research, Tamilnadu-637215, India.,For Correspondence:
| | - Dineshshankar Janardhanam
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India.
| | - Aravindhan Ravi
- Department of Oral & Maxillofacial Pathology, SRM Kattankulathur Dental College and Hospital, Chennai, India.
| | - Vidyalakshmi Santhanam
- Department of Oral & Maxillofacial Pathology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Pondicherry, India.
| | - Madhavan Nirmal Ramdas
- Department of Oral & Maxillofacial Pathology, Rajah Muthiah Dental College & Hospital, Annamalai University, Tamil Nadu, India.
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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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Gokdeniz ST, Kamburoğlu K. Artificial intelligence in dentomaxillofacial radiology. World J Radiol 2022; 14:55-59. [PMID: 35432776 PMCID: PMC8966498 DOI: 10.4329/wjr.v14.i3.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 09/05/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Artificial intelligence (AI) has the potential to revolutionize healthcare and dentistry. Recently, there has been much interest in the development of AI applications. Dentomaxillofacial radiology (DMFR) is within the scope of these applications due to its compatibility with image processing methods. Classification and segmentation of teeth, automatic marking of anatomical structures and cephalometric analysis, determination of early dental diseases, gingival, periodontal diseases and evaluation of risk groups, diagnosis of certain diseases, such as; osteoporosis that can be detected in jaw radiographs are among studies conducted by using radiological images. Further research in the field of AI will make great contributions to DMFR. We aim to discuss most recent AI-based studies in the field of DMFR.
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Affiliation(s)
- Seyide Tugce Gokdeniz
- Department of Dentomaxillofacial Radiology, Ankara University Faculty of Dentistry, Ankara 06500, Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Ankara University Faculty of Dentistry, Ankara 06500, Turkey
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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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Deep Learning for Automated Detection of Cyst and Tumors of the Jaw in Panoramic Radiographs. J Clin Med 2020; 9:jcm9061839. [PMID: 32545602 PMCID: PMC7356620 DOI: 10.3390/jcm9061839] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Patients with odontogenic cysts and tumors may have to undergo serious surgery unless the lesion is properly detected at the early stage. The purpose of this study is to evaluate the diagnostic performance of the real-time object detecting deep convolutional neural network You Only Look Once (YOLO) v2—a deep learning algorithm that can both detect and classify an object at the same time—on panoramic radiographs. In this study, 1602 lesions on panoramic radiographs taken from 2010 to 2019 at Yonsei University Dental Hospital were selected as a database. Images were classified and labeled into four categories: dentigerous cysts, odontogenic keratocyst, ameloblastoma, and no lesion. Comparative analysis among three groups (YOLO, oral and maxillofacial surgeons, and general practitioners) was done in terms of precision, recall, accuracy, and F1 score. While YOLO ranked highest among the three groups (precision = 0.707, recall = 0.680), the performance differences between the machine and clinicians were statistically insignificant. The results of this study indicate the usefulness of auto-detecting convolutional networks in certain pathology detection and thus morbidity prevention in the field of oral and maxillofacial surgery.
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A 20-year experience of immediate mandibular reconstruction using free fibula osteocutaneous flaps following ameloblastoma resection: Radical resection, outcomes, and recurrence. Arch Plast Surg 2019; 46:426-432. [PMID: 31550747 PMCID: PMC6759441 DOI: 10.5999/aps.2018.01487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/23/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The mandible is an important structure that is located in the lower third of the face. Large mandibular defects after tumor resection cause loss of its function. This study assessed the outcomes and tumor recurrence after immediate mandibular reconstruction using a free fibula osteocutaneous flap following radical resection of ameloblastoma. METHODS This is a retrospective non-randomized study of outcomes and tumor recurrence of all patients diagnosed with mandibular ameloblastoma from August 1997 until August 2017 (20 years) requiring free fibula osteocutaneous flap reconstruction at a single institution. The patients were identified through an electronic operative database; subsequently, their medical records and photo documentation were retrieved. RESULTS Twenty-seven patients were included in this study. Eighteen patients were male, while nine were female. The majority of the patients (48.1%) were in their third decade of life when they were diagnosed with ameloblastoma. All of them underwent radical resection of the tumor with a surgical margin of 2 cm (hemimandibulectomy in cases with a large tumor) and immediate mandibular reconstruction with a free fibula osteocutaneous flap. Two patients required revision of a vascular anastomosis due to venous thrombosis postoperatively, while one patient developed a flap recipient site infection. The flap success rate was 100%. There was no tumor recurrence during a mean follow-up period of 5.6 years. CONCLUSIONS Mandibular ameloblastoma should be treated with segmental mandibulectomy (with a surgical margin of 2 cm) to reduce the risk of recurrence. Subsequent mandibular and adjacent soft tissue defects should be reconstructed immediately with a free fibula osteocutaneous flap.
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Chutchurru MS, Brusca MI, Palavecino R. Ameloblastoma: Reconstruction Using Titanium Plates adapted Using Stereolithographic Models. Ann Maxillofac Surg 2019; 8:337-341. [PMID: 30693259 PMCID: PMC6327792 DOI: 10.4103/ams.ams_196_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Ameloblastoma is a benign but locally invasive odontogenic tumor that causes significant morbidity. The aim is to study an ameloblastoma treatment with reconstruction using titanium plates adapted using stereolithographic models. A 48-year-old female patient referred due to asymptomatic osteolytic lesion between teeth 47 and 48 discovered during routine radiographic study. The pathoanatomical study described a desmoplastic ameloblastoma. Due to the possibility of it being a malignant lesion, a computerized axial tomography scan was performed, which showed that the tumor was not malignant. A stereolithographic model was prepared to make the cutting guides and facilitate fitting of reconstruction plates. Three-dimensional printing technology enables fast, accurate mandibular reconstruction, helping to shorten operation time.
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Affiliation(s)
| | - Maria Isabel Brusca
- Faculty of Dentistry, Interamericana Abierta University, Buenos Aires, Argentina
| | - Roberto Palavecino
- Faculty of Dentistry, Interamericana Abierta University, Buenos Aires, Argentina
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