• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.4
• /
• pp.498-502
• /
• 2008

Ameloblastoma is the most common aggressive benign odontogenic tumor of the jaws. Because of slow growth and tendency to local invasion of bone and soft tissue, high rates of recurrence are common. The treatment for ameloblastoma is still controversial and poses some special problems in children. Because of growth of the jaw and the different incidence, prognosis of the tumor make the surgical consideration different from adults. Radical resection cause facial deformity, jaw abnormal movement and masticatory disturbance especially to child and adolescents. So conservative treatment as enucleation, curettage is acceptable initial treatment of ameloblastoma in children who can be followed up in a precise, detailed manner. This report describes a case of unilocular plexiform ameloblastoma treated by enucleation and curettage followed by marsupialization.

• Imaging Science in Dentistry
• /
• v.36 no.1
• /
• pp.63-68
• /
• 2006

Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. It shows important differences in anatomic distribution, histologic appearance, and radiographic findings compared with the general type of ameloblastoma. It is histologically characterized by an abundance of densely collagenous stroma and radiographically a mixed radiolucent-radiopaque lesion. We present three cases of desmoplastic ameloblastoma. All the patients complained on buccal swelling with or without pain and the sites of occurrence were the anterior and the premolar region. Plain radiographs showed mixed radiopaque-radiolucent lesion with ill-defined or diffuse sclerotic margin and no external root resorption. Additionally, CT scans revealetl buccal expansion and relatively well-defined margin of the lesions. The clinical and radiographic features of the presented cases were compared with those of the desmoplastic ameloblastoma in the previous literatures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.5
• /
• pp.435-439
• /
• 2011

Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.5
• /
• pp.298-300
• /
• 2003

Ameloblastomas are generally considered to be benign tumors of odontogenic epithelial origin with high local recurrence. Rarely ameloblastomas exhibit malignant behavior with development of metastases. In this report, we present a 19-year-old woman with ameloblastoma in the right ascending ramus and multiple recurrences. Eleven years after first therapy, ameloblastoma metastasized to ipsilateral submandibular lymph node. We also review literature about cause, treatment and work-up of malignant ameloblastoma.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.4
• /
• pp.415-428
• /
• 1995

The author studied on the 115 cases of the ameloblastoma which had been diagnosed with biopsy during the period of 1962 to 1994 at the Kyungpook National University Hospital, Pusan National University Hospital, Youngnam University Hospital, Keimyung University Hospital, Catholic Medical School Hospital, and Maryknol Hospital. This study contains the statistical analysis of the clinico-pathological findings such as sex, age, location, chief complaint, duration,treatment method, size, recurrence and impacted teeth in relation to radiographic findings. The results were as follows : 1. The incidence rate was 60% in male and 40% in female. 2. At the time of diagnosis, the age of the patients ranged from 9 to 69 years old (average 31.4 years old). The cases of 73% were in the 2nd, 3rd and 4th decades of life. 3. The majority of cases, 88.7% occurred in the mandible, especially 59% in the mandibular angle area. 4. The most prevalent chief complaint of swelling was 56.5%. 5. As regards duration, the cases less than 12 months appeared 49.5%, and average duration is 30.45months. 6. Unilocular radiographic findings showed 43.5%, Multilocular radiographic findings appeared 56.5%. 7. Conservative treatment was performed 40.0%, and radical treatment was employed 60.0%. 8. There was the variation of lesional sizes between 2.0cm and 15cm, average size 6.19cm. 9. Recurrent cases were 28.7%, and impacted teeth were shown 30.43%. 10. The radiographic finding has no relationship with the factors of age, location, chief complaint, recurrence and impacted teeth, however there is slight indication that the below 30-year-old patient tend to be related to the multilocular type. 11. The multilocular radiographic findings were shown more frequently in the groups of females, over average of 30.45 months, over average size of 6.19cm and radical treatment.

• Imaging Science in Dentistry
• /
• v.32 no.2
• /
• pp.89-97
• /
• 2002

Purpose: The objective of this study is to find the differentiating characteristics of ameloblastomas and odontogenic keratocysts of the jaw by analyzing computed tomography (CT) images of the lesions, clarify radiological characteristics associated with jaw lesions, and to make a diagnsis based on these findings. Materials and Methods : Test subjects were chosen among the patients who were diagnosed as having an odontogenic keratocyst or ameloblastoma at the Yonsei University Dental Hospital from January 1996 to December 2000 and had CT scans taken preoperatively. The subject pool was comprised of 51 cases of odontogenic keratocyst and 37 cases of ameloblastoma. The following measures were used for image analysis of the lesion: the anatomic location, CT pattern, mesiodistal width, buccolingual width, the ratios between mesiodistal width and buccolingual width, height, CT number, homogeneity of radiodensity, the appearance of a sclerotic rim, continuity of adjacent cortical bone, and displacement and resorption of adjacent teeth. Results: Comparing the CT patten, mesiodistal width, buccolingual width, height, CT number, homogeneity, appearance of sclerotic rim, continuity of adjacent cortical bone, there were statistically significant differences between ameloblastoma and odontogenic keratocyst test subjects (p<0.05). Comparing the ratios between mesiodistal width and buccolingual width, displacement and resorption of adjacent teeth, there were no statistically significant differences (p>0.05). Conclusion: We compared odontogenic keratocysts and ameloblastomas in CT scans. They occurred most frequently in the posterior to the ramus of the mandible. The findings of patterns of the CT images showed that size and border of lesions were more aggressive in ameloblastomas than in odontogenic keratocysts. The internal contents represented an increased attenuation area (IAA) in odontopenic keratocyst. Odontogenic keratocysts were shown to have higher CT numbers than ameloblastomas.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.2
• /
• pp.94-102
• /
• 2007

The ameloblastoma is a common odontogenic tumor of the jaw bone and represents approximately 1% of tumor in the jaw. However, it might be able to infiltrate into the adjacent tissue, causing bony destruction and high recurrent rate. In this study, expression of RANKL and OPG in ameloblastoma in relation to age and gender of patient and recurrence, location of the lesion were examined through immunohistochemisry study. The RANKL and OPG antibody staining were used. The obtained result were as follow. 1. Positive immunoreactivity to RANKL/OPG in all specimens was found. 2. 1n recurrenc, location of ameloblastoma and age, gender of patients using immunohistochemical expression of RANKL. There was not significant difference. 3. 1n recurrence, location of ameloblastoma and age, gender of patients using immunohistochemical expression of OPG. There was not significant difference. In summary, it is suggested that activation of osteoclasts by RANKL is an important mechanism by which ameloblastomas cause bone destruction.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.23 no.2
• /
• pp.255-264
• /
• 1993

The purpose of this study was to obtain some informations for the radiographic differential diagnosis between dentigerous cysts and unicystic ameloblastomas in the mandible. The authors observed and compared the clinico-radiographic features of 38 cases of dentigerous cyst and 32 cases of unicystic ameloblastoma associated with impacted mandibular molar. The obtained results were as follows: Dentigerous cysts occurred the most frequently in the 3rd decade, but unicystic ameloblastomas in the 2nd decade, and both lesions occurred with slight predilection in males. Average of lesional size of unicystic ameloblastomas was larger than that of dentigerous cysts, and lesions of over 25㎠ were only in unicystic ameloblastomas. Cortical thinning and expansion were more frequently observed in unicystic ameloblastomas at 72.9% than in dentigerous cysts at 15.8%. Dentigerous cysts showed smooth border at 89.5%, but unicystic ameloblastomas showed smooth border at 53.1% and scalloped border at 46.9%. Dentigerous cysts showed well-defined outline at 81.6%, but unicystic ameloblastomas showed well-defined outline at 53.1% and moderate-defined outline at 46.9%. In both lesions, the mandibular 3rd molar was the most frequent causative tooth. Average of distance between the cemento-enamel junction and lesional wall attachment of the causative tooth was longer in unicystic ameloblastomas than in dentigerous cysts. Severe displacement of causative tooth was more frequent in unicystic ameloblastomas at 62.5% than in dentigerous cysts at 23.7%. Dentigerous cysts showed homogeneous lesional radiolucency at 89.5%, but unicystic ameloblastomas showed inhomogeneous lesional radiolucency at 53.1%. Root resorption of adjacent tooth and displacement of mandibular canal were more frequent in unicystic ameloblastomas at 65.2% and 61.5% than in dentigerous cysts at 15.8% and 38.1% respectively.

• Imaging Science in Dentistry
• /
• v.35 no.2
• /
• pp.77-82
• /
• 2005

Purpose : To reveal what is the distinct differential diagnostic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma. Materials and Methods : 56 cases of ameloblastoma were retrospectively reviewed and evaluated among the patients who had taken CT scans at the department of Oral & Maxillofacial Radiology in Yonsei University Dental Hospital from January 1996 to December 2003. Results : In 56 cases, 21 cases $(37.5\%)$ were unicystic ameloblastoma, 35 cases $(62.5\%)$ were solid or multicystic ameloblastoma. Only 1 case $(4.8\%)$ of unicystic ameloblastoma and 4 cases $(11.4\%)$ of solid or multicystic ameloblastoma were occurred in maxilla. 13 cases $(61.9\%)$ of unicystic ameloblastoma were observed as unilocular, and 8 cases $(38.1\%)$ as lobulated. 5 cases $(14.3\%)$ of solid or multicystic ameloblastoma were observed as unilocular, 13 cases $(37.1\%)$ as lobulated, and 17 cases $(48.6\%)$ as multilocular. Tn the results from the measurements after correction of the buccolingual widths and heights to the mesiodistal lengths, there is a statistically significant difference between unicystic ameloblastoma and solid or multicystic ameloblastoma in ANCOVA test (p<0.05). Hounsfield units in the lesion were $24.9{\pm}8.8\;HU$ in unicystic ameloblastoma, $31.2{\pm}11.5\;HU$ in solid or multicystic ameloblastoma. There is no statistically significant difference (p>0.05). Conclusion : Characteristic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma is that there is higher prevalence of solid or multicystic ameloblastoma that have lobulated or multilocular patterns. To measure the Hounsfield units in the lesion is helpful, but it is not a differential diagnostic point between unicystic ameloblastoma and solid or multicystic ameloblastoma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.4
• /
• pp.287-294
• /
• 2011

Introduction: Ameloblastoma is a benign but locally invasive tumor with a high recurrence rate. The aim of this study was to make an easier diagnosis and treatment planning of ameloblastoma. Materials and Methods: From January 1993 to October 2009, 139 cases from 123 patients, who had been diagnosed with ameloblastoma through radiologic and biopsy in the department of oral and maxillofacial surgery of Kyunpook National University, were selected as the subjects in this study. According to the medical charts, 9 factors (age, gender, location, chief complaints, duration, radiographic findings, size and recurrence) concerned in deciding the treatment method and the relevance between each factor and the treatment methods were examined.(Conservative treatments were marsu-pialization, enucleation, curettage and lateral decortication. Radical treatments included block excision, resection and hemisection) Results: In the patients under the age of 20, 77.14% had conservative treatments, whereas 22.86% underwent radical treatments. In the patients over the age of 20, 44.23% were treated conservatively treatments, and 55.77% underwent radical treatments. For unilocular types, 28.57% had conservative treatments, whereas 71.43% had radical treatments. For the multilocular types, 66.67% underwent conservative treatments, and 33.33% had radical treatments. For the primary cases, 58.68% were treated conservatively and 41.32% had radical treatments. For the recurrent cases, 16.67% and 83.33% underwent conservative and radical treatments, respectively. Conclusion: There was statistical significance in the factors affecting the treatment methods, such as age, radiographic findings and recurrence.