BackgroundAmeloblastoma is an odontogenic tumor that represents 1% of all tumors in the oral cavity and it is clinically classified in three types. Currently, solid and multi-cystic are considered locally aggressive, with high recurrence rates with conservative treatment.Material and MethodsObjective of the present review is to assess whether the surgical treatment should be conservative or radical. English articles published between 2009-2014, with available summary and in humans were included.Results241 articles were found, 188 were excluded because analyzing. 53 articles were analyzed and finally 14 were selected for this review.ConclusionsThe optimal surgical treatment of ameloblastoma should minimize recurrences, restore function and aesthetic and present a minimal morbidity in the donor area. Surgical planning must be performed based on the patient comorbidities, the size and location of the tumor, the techniques available for reconstruction and the surgeon’s experience-Radical surgery appears to be the most recommended option in multicystic / solid and advanced unicystic tumors, along with long-term follow-up for the possibility of recurrence beyond 10 year. Conservative surgery combined with a support technique and long-term follow-up is reserved for the unicystic and multicystic / solid types if small extension. Prospective and randomized studies for ameloblastoma are recommended.
Key words:Ameloblastoma, surgery, enucleation, radical.
Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients.
Aplasia of the lacrimal and the major salivary glands (ALSG) is a rare disorder with scarce cases described in the recent literature. The pattern of genetic inheritance is autosomal dominant with variable expressivity. A 40 years male patient was referred to the Oral and Maxillofacial Service at the Hospital Universitario de A Coruña diagnosed with complete agenesis of all salivary glands. Our case it is the first of ALSG syndrome in the Spanish literature. Imaging tests are necessary to confirm the lack of formation of salivary glands and alteration of lacrimal system. A mutation of FGF10 has been proposed as the responsible of the syndrome. The management of the lacrimal alteration depends of the clinical findings. Clinical suspicion remains the principal tool to diagnose the syndrome.
Key words:ALSG, salivary glands aplasia.
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