Ameloblastoma: Clinical Features, Diagnosis, and Treatment Strategies

Ameloblastoma: Clinical Features, Diagnosis, and Treatment Strategies

Write in short adamantinoma.

Or

Write Short answer on adamantinoma.

Answer. In 1885, Malassez coined the term adamantinoma. In 1934, Churchill replaced the term adamantinoma with ameloblastoma.

Ameloblastoma is defied as “usually unicentric, nonfunctional, intermittnt growth, anatomically benign and clinically persistent”— By Robinson

“Is Ameloblastoma Cancerous”

Ameloblastoma Pathogenesis

Ameloblastoma originates from:

• Epithelial rest of Malassez.
• Epithelium of odontogenic cysts
• Disturbances in developing enamel organ
• Basal cells of surface epithelium
• Heterotrophic epithelium.

“Causes Of Ameloblastoma In Jaw Bones”

Ameloblastoma Clinical Features

• It occurs during 2nd, 3rd and 4th decades of life.
• Predilection for males is seen.
• Itis seeninmolar ramus area inmandible and inthird molar area including maxillary sinus and flor of nose in maxilla.
• Tumor start as a lesion of bone and later on expands the bone.
• Patient complains of asymmetry of face.
• Teeth in the lesional area are displaced.
• Pain and paresthesia is present if lesion involves any of the nerve.
• As the tumor enlarges palpation leads to crepitus also known as egg shell crackling.

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Ameloblastoma Investigations

• Clinically: Presence of swelling in posterior mandible with expansion as well as egg shell crackling.
• Radiographically: Honey comb or soap bubble appearance in the posterior region of mandible. Labial and lingual plate expansion is also seen.
• Biopsy: Biopsy of the lesion is needed for the confimation of diagnosis so that histological type of ameloblastoma is diagnosed.

“Symptoms Of Ameloblastoma”

Ameloblastoma Treatment

• Ameloblastomas are generally slow growing but locally invasive tumors and have a high recurrence rate after treatment.
• Curettage of ameloblastomas, which was favored in the past, is now not advocated because of the high recurrence rate associated with it.
• Ameloblastomas are best treated by resection of the lesion with a marginal clearance of 1.5–2 cm of normal bone to prevent recurrence.
• The lesion may be resected as block resection with or without continuity defect based on the integrity of inferior cortex.
• Radiologically a minimum of 1 cm residual mandible inferior cortex is required postoperatively to prevent pathologic fracture.
• Inferior alveolar nerve should be sacrificed if it lies within the lesion.
• Maxillary ameloblastomas are particularly dangerous, partly because the bones are considerably thinner than those of the mandible and present less effctive barriers to spread.
  Therefore, radical excision is essential, preferably maxillectomy.
• Peripheral ameloblastomas are treated by excision, as usually there is no alveolar bone involvement.
  If prior biopsy indicates involvement of bone, block resection with continuity defect is the choice of treatment.