Ameloblastoma: A Surgeon’s Dilemma

Ghandhi, Dinaz; Ayoub, Ashraf F.; Pogrel, M. Anthony; MacDonald, Gordon; Brocklebank, Laetitia M.; Moos, Khursheed F.

doi:10.1016/j.joms.2006.03.022

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 7 , Pages 1010-1014, July 2006

Ameloblastoma: A Surgeon’s Dilemma

Dinaz Ghandhi, BDS, FDSRCS
- Assistant Professor Oral and Maxillofacial Surgery, Jinnah Medical and Dental College, Karachi, Pakistan
Ashraf F. Ayoub, PhD, FDSRCS, FDSRCPS, MDS, BDS
- Professor/Honorary Consultant in Oral and Maxillofacial Surgery, University of Glasgow, and Head of Biotechnology and Craniofacial Research Section, Glasgow Dental Hospital and School, Glasgow, United Kingdom
- Address correspondence and reprint requests to Dr Ayoub: Glasgow Dental Hospital and School, 378 Sauchiehall St, Glasgow G2 3JZ, UK
M. Anthony Pogrel, MD, DDS
- Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California, San Francisco, CA
Gordon MacDonald, BDS, PhD, FDSRCPS
- Late Professor of Oral Pathology, University of Glasgow, Glasgow Dental Hospital and School, Glasgow, United Kingdom
Laetitia M. Brocklebank, BDS, MScFRACDS, FDSRCPS
- Senior Lecturer in Oral Radiology, University of Glasgow, Glasgow Dental Hospital and School, Glasgow, United Kingdom
Khursheed F. Moos, MBBS, BDS, FRCSE, FDSRCS, FDSRCPS
- Honorary Senior Research Fellow, Department of Oral and Maxillofacial Surgery, University of Glasgow, Glasgow Dental Hospital and School, Glasgow, United Kingdom

Purpose

To investigate whether there were any significant differences in the mode of presentation, treatment, and outcome of patients presenting with a primary diagnosis of ameloblastoma in Glasgow, Scotland and San Francisco, CA.

Materials and Methods

All cases of ameloblastoma seen in both institutions between January 1, 1980 and December 31, 1999 were included in this study. Mode of presentation, radiographic appearance, histologic appearance, treatment, and follow-up were recorded.

Results

There were no significant differences in the clinical features on presentation (swelling, followed by pain, and altered sensation), the radiographic appearance (unilocular approximately 30% and multilocular 70%), or management with either local treatment (enucleation and/or curettage in just over 50% of cases) or radical treatment (a form of resection in under 50%) in the 50 cases included in this study. Primary care by conservative treatment led to a recurrence in approximately 80% of cases and this included cases of unicystic ameloblastoma.

Conclusion

The mode of presentation, diagnosis, and management of the ameloblastoma was remarkably similar in Glasgow and San Francisco. The recurrence rate following local enucleation and curettage was unacceptably high, and this included the cases of unicystic ameloblastoma, which should be treated more aggressively than has been recommended in the past.