Study on tooth preservation in patients with ameloblastomas arising in the mandible and treated by the dredging method

Yamada, Tamaki; Ohiro, Yoichi; Ashikaga, Yuichi; Kuribayashi, Kazuyo; Matsuzawa, Yusuke; Nagamine, Kyosuke; Tanaka, Soichi; Kitamura, Tatsuya; Tei, Kanchu

doi:10.5794/jjoms.64.347

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“…In these cases, the surgeon should also evaluate the relationship between the lesion and adjacent tissues by radiographic, histological, and clinical examination which is also advised by other authors. [22][23][24][25] The extension of the healthy adjacent tissues removed will depend on the lesion size, and this decision must be individualized. 14 Based on literature findings and our clinical expertise, the…”

Section: Discussionmentioning

confidence: 99%

“…Although some authors propose a more radical approach for the mural subtype, 6,19–21 our findings still support the hypothesis that this variant can be managed conservatively. In these cases, the surgeon should also evaluate the relationship between the lesion and adjacent tissues by radiographic, histological, and clinical examination which is also advised by other authors 22–25 . The extension of the healthy adjacent tissues removed will depend on the lesion size, and this decision must be individualized 14 …”

Section: Discussionmentioning

confidence: 99%

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A conservative approach for unicystic ameloblastoma: Retrospective clinic‐pathologic analysis of 12 cases

Leite-Lima

Martins‐Chaves

Fonseca

et al. 2023

J Oral Pathology Medicine

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BackgroundUnicystic ameloblastoma is an encapsulated odontogenic neoplasm with a single cyst cavity. The conservative or aggressive surgical approaches used to treat the tumor directly affect recurrence rates. However, there is a lack of a standard protocol that can guide its management.Study DesignWe retrospectively reviewed the clinicopathological findings and therapeutical procedures of 12 unicystic ameloblastoma cases treated by the same surgeon during the past 20 years.MethodsAll cases of unicystic ameloblastoma diagnosed by biopsy and treated by the same surgeon between 2002 and 2022 were reviewed. Eligibility criteria were patients with completely filled‐out charts containing the follow‐up period and confirmation of the diagnoses based on the microscopic findings of the whole excised specimens. Data collected were categorized into clinical, radiographic, histological, surgical, and recurrence aspects.ResultsThere was a female predilection (2:1), and ages ranged between 18 and 61 years (mean: 27.25, ±12.45). Almost all (92%) affected the posterior mandible. Radiographically, the mean length of the lesions was 46.14 mm ± 14.28 mm which 92% were unilocular and 8.3% multilocular. Root resorption (n = 7, 58%), tooth displacement (n = 9, 75%), and cortical perforation (n = 5, 42%) were also observed. The mural histological subtype corresponded to 9 (75%) of the cases. The same conservative protocol was performed in all cases. The follow‐up period ranged between 12 and 240 months (~62 ± 65) and recurrence occurred in only one patient (8%).ConclusionOur findings suggest a conservative approach should be the first option for unicystic ameloblastoma treatment, even for those with mural proliferation.

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