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A digital manual for the early diagnosis of oral neoplasia

Ameloblastoma  Search in Medline for Ameloblastoma

Ameloblastoma is the most common odontogenic tumour of the jaws. It is a benign but locally aggressive tumour of ectodermal origin. It may occur anywhere in the jaws, but the mandible is the most frequent site, especially the molar region and ascending ramus. They are more common in persons aged 30–60, except the unicystic variant which occurs in a younger age group. There is no gender predilection. Clinically they appear as bony swellings without many symptoms. The radiographic appearances of ameloblastoma are variable. Unilocular lesions associated with an impacted tooth can often be mistaken for a dentigerious cyst radiographically. It may present as a multilocular cystic lesion with well-defined corticated margins. Scalloping of margins is common. The septae may be coarse or fine. The lesion has a “honeycomb” or “soap bubble appearance”. Root resorption of teeth in the affected area may be seen.

Conservative resection with clear margins is the treatment of choice. Inadequate resection may lead to local recurrence. These tumours rarely exibit a clinical course of malignancy. There are two types of malignant behaviour:



Figures 1: A: Pantomograph of a patient with ameloblastoma. Note the expansile multi locular radiolucency (soap bubble appearance) of the right side of mandible from the apex of the lateral incisor extending posteriorily to involve the ramus up to the condyle. B: Postero-anterior view of the face of the same patient, showing outward, downward and lingual expansion of the mandible.
Figure 2: Ameloblastoma: Panoramic view shows a well-defined radiolucent lesion with scalloped margins extending from the distal aspect of the second mandibular premolar on the left side to the root of right mandibular first molar. Smaller loculation can be seen towards the centre with large loculation towards the periphery.
Figures 3: Clinical photographs of a patient with ameloblastoma of the mandible.
Figure 4: Panoramic view of the same patient demonstrating a multi-locular radiolucency involving the body of mandible extending from left second molar to right second molar area displacing the superior border and destroying the inferior border of mandible.
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