AMELOBLASTAMA

D r . F I R A S K A S S A B

FIRAS AMELOBLASTOMA

FIRAS AMELOBLASTOMA

1. Adamantinoma

2. Mandibular Ameloblastoma

3. Maxillary Ameloblastoma

4. Odontogenic Tumor

FIRAS AMELOBLASTOMA

A benign odontogenic epithelial neoplasm that histologically mimics the embryonal enamel organ but does not differentiate from it to the point of forming dental hard tissues; it behaves as a slowly growing expansile radiolucent tumor, occurs most commonly in the posterior regions of the mandible and tends to recur if inadequately excised.

Ameloblastoma is listed as a "rare disease"

FIRAS AMELOBLASTOMA

Ameloblastoma is a rare disorder that affects males and females in equal numbers. It affects persons of all ethnic age groups.

FIRAS AMELOBLASTOMA

The cause of ameloblastoma is not understood. Causes may include injury to the mouth or jaw, infections of the teeth or gums, or inflammation of these same areas. Infections by viruses or lack of protein or minerals in the persons diet are also suspected of causing the growth or development of these tumors. In general, however, scientists do not understand the cause of cysts and tumors, nor the reasons why they can become malignant.

FIRAS AMELOBLASTOMA

Clinically, ameloblastoma appears as an aggressive odontogenic tumour, often asymptomatic and slow growing, with no

evidence of swelling.

It can sometimes cause symptoms such as swelling, dental malocclusion, pain and paresthesia of the

affected area.

FIRAS AMELOBLASTOMA

It represents approximately 1% of oral tumours; 80% of ameloblastomas occur in the mandible and the remaining 20% in the upper jaw.

The area of the mandible that is most affected is the third molar region.

Usually presents between ages 30 and 50 .

FIRAS AMELOBLASTOMA

Radiografically , ameloplastoma typically form rounded , cyst like , radiolucent area with moderately well defined margins and topically appear multilocular or with a honey comb pattern . Lingual expansion may sometimes be seen, but is not pathognomonic of ameloplastoma . However , differentiation from non-neoplastic cyst and other tumoursor tumour-like lesions of the jaws is not possible by radiography alone .

Lateral oblique radiograph of the mandible shows an expansile, multilocular, lucent

lesion with coarse internal trabeculae and displacement of teeth and adjacent structures.

The differential diagnosis includes odontogenic keratocyst

FIRAS AMELOBLASTOMA

Axial CT image bone window shows expanded ameloblastoma, intact cortical bone

buccally (arrow) and destroyed bone lingually

FIRAS AMELOBLASTOMA

CT-Scan axial projection for mandible:

bone window

showes swelling of the right lower mandible and demonstrate an expansive "cystic"

lesion with some adjacent sclerotic change. The appearance is compatible with a

mandibular ameloblastoma.

FIRAS AMELOBLASTOMA

Pre-apical digital image for right side of mandible Bisecting technique

multilocular radiolucency in posterior region of mandibleBoth second and third molars appear with roots resorption (external resorption)

Well-circumscribed, soap-bubbleAbsent of lamina dura in the area of absorption

FIRAS AMELOBLASTOMA

FIRAS AMELOBLASTOMA

While chemotherapy, radiation therapy, curettage and liquid nitrogen have been effective in some cases of ameloblastoma, surgical resection or enucleation remains the most definitive treatment for this condition. In a detailed study of 345 patients, chemotherapy and radiation therapy seemed to be contraindicated for the treatment of ameloblastomas. Thus, surgery is the most common treatment of this tumor. Because of the invasive nature of the growth, excision of normal tissue near the tumor margin is often required.

FIRAS AMELOBLASTOMA

Some have likened the disease to basal cell carcinoma (a skin cancer) in its tendency to spread to adjacent bony and sometimes soft tissues without metastasizing. While not a cancer that actually invades adjacent tissues, ameloblastoma is suspected to spread to adjacent areas of the jaw bone via marrow space. Thus, wide surgical margins that are clear of disease are required for a good prognosis. This is very much like surgical treatment of cancer. Often, treatment requires . excision of entire portions of the jaw.