Conservative surgical treatment for ameloblastoma: a report of three cases

Abstract

Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.

Giant ameloblastoma with intracranial invasion treated with a pure endoscopic approach

“…The main approved treatment for ameloblastoma is surgery, and overall aim is complete resection. The literature describes two surgical therapy strategies to achieve wide surgical resection; 1) conservative surgical methods like decompression, enucleation, or curettage, and 2) radical procedures like marginal or segmental resection (4,12).…”

“…The treatment of ameloblastoma varies based on clinical, histopathologic, and radiographic characteristics (4). Surgery is the first line of treatment recommended to prevent recurrence and metastasis, and the goal should be complete surgical resection (5).…”

Approach and conservative surgical treatment of jaw ameloblastoma: case report

“…The management of ameloblastoma represents a challenge for surgeons, because it requires not only adequate resection, but also functional and aesthetic reconstruction of the residual defect (21) . Surgical treatment can be separated into conservative and radical methods, depending on histological, radiographic and clinical characteristics, such as location, size of the lesion and age of the patient (22,23) .…”

“…Radical treatment is characterized by mandibulectomy or segmental resection of the lesion with safety margins (4,5) . This form of treatment is associated with low recurrence of the lesion, however it can cause numerous complications, such as facial deformities, dysfunctions, and psychological changes (4,22) . Conservative AU treatment consists of enucleation and/or marsupialization, combined or not with supportive techniques, such as curettage, peripheral ostectomy and cauterization.…”

Tratamento cirúrgico conservador de ameloblastoma: relato de caso

“…No exame radiográfico, tendem a se apresentar como uma imagem radiolúcida multilocular, mas podendo ser manifestar com aspectos unilocular com margens bem definidas. As lesões quando grandes, apresentam aspecto de "bolha de sabão", ou quando pequenas são relacionadas à "favos de mel" [1][2][3] . Reabsorções radiculares dos dentes adjacentes a lesão é comum, podendo estar associada terceiros molares inferiores não erupcionados¹ , ².…”