Surgical Strategies for Multicystic Ameloblastoma

Abstract

Ameloblastoma is the second most common odontogenic tumor arising in the maxillary bones. The WHO classified ameloblastoma in: solid/multicystic (SMA); unicystic; peripheral and desmoplastic. A conservative or radical approach may be performed for SMA treatment to achieve total excision of the lesion.In this case report, a 47-year-old woman, presented a deformation of the left mandibular region and paresthesia of the left hemi-labium, at the ortopanoramic x-ray (OPT) a multilocular osteolytic lesion and the rhizalysis of dental elements 3.7, 3.6, 3.5, 3.4 and the inclusion of 3.8 was appreciated; the CT exam showed erosion of the mandibular canal roof and of the vestibular cortex in the mental nerve region. The patient was subjected to the extraction of the elements in rhizalysis and of 3.8 and subsequently to the enucleation of the lesion followed by an extensive peripheral ostectomy performed with a piezoelectric device. The patient underwent to OPT and CT examinations follow-up and after 5 years was subjected to implant surgery, at the same time of the implant's placement, bone biopsies were performed using core drills in order to evaluate the bone histologically. The patient showed complete clinical and radiographic healing; the histological examination demonstrates the formation of lamellar bone.