Introduction The clinical, histological and radiographic presentation of ameloblastoma is well described in literature. This odontogenic tumour commonly affect the mandible, locally aggressive and destructive resulting in disfigurement. It arises from dental tissues at various phases of tooth development. They are generally asymptomatic, slow growing, locally invasive and rarely malignant with a high recurrence rate. Objective To test the hypotheses that ameloblastomas were predominant in the mandible. among black Africans, male and the young. Study Design Retrospective review of ameloblastoma cases spanned between 1991 and 2022. Methods Data analysis was based on 185 histologically confirmed cases. Appropriate descriptive and inferential statistics were undertaken on, age, gender, clinical, radiographic and histological characteristics. Results The average age was 28.81 (14.53), ranging between 3-75 years. The overall male to female ratio stood at 1.18:1. Ameloblastomas were prevalent in the mandible 174(94.1%), diagnosed as conventional variant 155(83.7%) and acanthomatous subtype. Radiographically, the lesions appeared as multilocular 97(55.4%), radiolucent 100(54.1%) and expansile 129(67.7%). The average size of the lesions was 77.43 ± 33.83 mm, with a range of 184 mm. Conclusion Our results validate the hypothesis that ameloblastoma is highly prevalent among black Africans of younger age. The radiographic, clinical, and histological characteristics of ameloblastoma in our population are comparable to the vast literature.

A 58-year-old male patient was referred for a panoramic radiograph after having presented with a hard swelling of the right mandible. Panoramic radiographic examination (Fig. 1) demonstrated multiples dental anomalies and variable bone densities in both jaws prompting clinicians to “dig” further. Teeth 17, 12, 11, 26 and 27 were missing. Teeth 13, 23, 24, 25, 38, 34, 33 and 43 were unerupted. An unerupted supernumerary left mandibular molar appeared in the region of the mandibular coronoid process. Multiple, small, well-defined radiopacities of density comparable to odontogenic material were evident in the anterior maxilla and mandible. These opacities often demonstrated radiolucent borders consistent with the finding of multiple odontomas. Both jaws demonstrated variable bone density. Cottonwool like opacities partially blending into adjacent trabeculae were evident in the mandible and maxilla posteriorly. The contour of the inferior border of the mandible bilaterally in proximity to the angle was irregular with multiple, well-defined, smooth, lobulated homogenous radiopacities suggestive of osteomas. The radiographic features of multiple osteomas, odontomas, variable bone density, supernumerary and unerupted teeth warranted the referral of the patient for gastroenterological investigation to exclude Gardner Syndrome.