OBJECTIVE: The purpose of this study was to evaluate the
experience and results of using a rational radical conservative
approach in the surgical treatment of mandibular
ameloblastomas.Study Design: A retrospective analysis of every
patient with an ameloblastoma of the mandible treated in the
Department of Oral Medicine and Oral Surgery at the Jordan
University of Science and Technology between 1989 and 1999 was
conducted. All were operated on by the author, who used a
uniform surgical protocol in every case. All soft tissues in
contact or overlying the lesion and a wide margin of cancellous
bone related to the tumor were destroyed. The compact bone
comprising the lower border of the mandible and the posterior
border of the ascending ramus together with the nutrient
periosteum attached to them were preserved, thus maintaining the
continuity of the mandible and the facial contours. When teeth,
soft tissues, or both were involved, they were destroyed. All
patients were reviewed annually for a follow-up period of 3 to
10 years (mean, 6.5 years) by the same clinician.
RESULTS: All ameloblastomas were located in the mandible;
21 were in the angle/molar region and the ascending ramus, and 2
cases were in the anterior region. There was no clinical or
radiographic evidence of recurrence observed during the
follow-up period.
CONCLUSION: Ameloblastoma has a high rate of local
recurrence if it is not adequately removed. The findings of this
study to date suggest that the technique of rational radical
conservative resection may have a place in the treatment of
ameloblastoma of the mandible and is worthy of further trial.
[References: 54]
Institution
Jordan University of Science and
Technology, Irbid, Jordan. anwar@just.edu.jo |