Management techniques of ameloblastoma: a literature review

Abstract

Ameloblastoma is a benign neoplasm essentially composed of epithelial tissue that has an invasive and infiltrative behavior at local level with a high recurrence rate. The prevalence of tumors and oral cysts is 1%, and the prevalence of odontogenic tumors is about 11%. The etiology is not yet fully known; however, one of the most accepted theories is that the lesion starts developing from remaining cells of the dental lamina, reduced enamel epithelium, Malassez's epithelial rests, or even from a basal cell layer of the epithelium surface. The literature does not report sex-and ethnicity-related occurrence; however, it is known that the most affected anatomical region is the mandible. It is essential to study oral lesions with the purpose of promoting early diagnosis and the most conservative intervention possible. This way, this study is a literature review of works published between 2006 and 2014 conducted to find the existing protocols for the treatment of ameloblastomas.

Enucleation and surgical stent as a treatment strategy for a large unicystic ameloblastoma: Case report and review of literature

“…Management of ameloblastoma presents a challenge amplified in young patients due to the high local morbidity and recurrence rate [ 3 ]. The treatment should aim to eliminate the disease with minimal influence on the patient’s oral health, functions, and quality of life [ 2 , 3 , [24] , [25] , [26] , [27] ].…”

“…The prompt diagnosis and appropriate treatment of ameloblastoma requires the use of orthopantomogram (OPG), cone-beam computed tomography, computed tomography, and/or magnetic resonance imaging [ 3 ]. Furthermore, histopathological examination confirms the diagnosis and differentiates among the distinctive subtypes [ [1] , [2] , [3] ].…”

“…Ameloblastoma is a benign neoplasm of odontogenic origin with locally invasive characteristics and high recurrence rate [ [1] , [2] , [3] , [4] ]. Although it is slow-growing, it tends to attain a considerably large size causing severe facial disfigurement and functional implications [ 3 , [2] , [3] , [4] ]. It was first reported by Cusack in 1827 and named by Ivy and Churchill in 1930 [ 5 ].…”

“…The appropriate management strategy for ameloblastoma remains controversial due to the locally invasive and aggressive nature and high recurrence rate [ [1] , [2] , [3] ]. The treatment modalities are dictated by patient age [ 1 , 3 , 4 ], extension, duration, and location of the tumor [ [2] , [3] , [4] , 6 ], degree of anatomical involvement such as penetration of the cortical bone [ 3 ], and histological classification [ 3 , 4 ].…”

“…The following two surgical approaches have been advocated: a conservative approach (including marsupialization, enucleation, or enucleation with curettage) and a radical resection approach [ [1] , [2] , [3] , [4] ]. Although the conservative approach maintains the integrity of the bone and the consequent growth pattern, it is associated with a high recurrence rate [ 1 ].…”