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1.
J Stomatol Oral Maxillofac Surg ; 125(3S): 101846, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38556167

ABSTRACT

Oral and maxillofacial tumors pose a significant clinical challenge due to their tendency to recur, despite advancements in surgical removal techniques. The jaw's intricate structure further complicates treatments and affects patient quality of life. Consequently, emphasis has shifted towards pharmacological interventions, to potentially reduce invasive surgical procedures. One promising approach targets BRAF mutations, specifically the common V600E mutation. BRAF, a critical protein kinase, regulates cell growth and differentiation via the RAS-RAF-MEK-ERK-MAP kinase pathway. A specific nucleotide change at position 1799, swapping Thymine (T) for Adenine (A), results in the V600E mutation, causing unchecked cell growth. This mutation is common in certain oral and maxillofacial tumors like ameloblastoma. A recent neoadjuvant therapy targeting BRAF, involving the use of dabrafenib and trametinib, has showcased a promising, safe, and effective strategy for organ preservation in the treatment of mandibular ameloblastoma. This convergence of molecular insights and targeted therapies holds the key to managing BRAF-mutated oral and maxillofacial tumors effectively, promising improved patient outcomes.


Subject(s)
Ameloblastoma , Mutation , Proto-Oncogene Proteins B-raf , Humans , Proto-Oncogene Proteins B-raf/genetics , Ameloblastoma/genetics , Ameloblastoma/therapy , Ameloblastoma/diagnosis , Imidazoles/therapeutic use , Oximes/therapeutic use , Pyridones/therapeutic use , Pyridones/administration & dosage , Pyrimidinones/therapeutic use , Antineoplastic Agents/therapeutic use , Mouth Neoplasms/therapy , Mouth Neoplasms/genetics , Mouth Neoplasms/pathology , Neoadjuvant Therapy/methods , Molecular Targeted Therapy
2.
J Racial Ethn Health Disparities ; 11(1): 92-100, 2024 Feb.
Article in English | MEDLINE | ID: mdl-36596981

ABSTRACT

Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and inconclusive. The role of race and ethnicity on ameloblastoma growth characteristics, genetic mutational profile, and recurrence is also still unclear. The primary aim of this systematic review was to assess genetic, racial, and ethnic distribution of primary and recurrent ameloblastoma from published literature. The secondary aim was to assess potential correlations between ethnicity, genetic mutation, and disparities in ameloblastoma treatment outcomes in Afro-descendants and non-Afro-descendants. Twenty-three eligible articles were selected based on preferred reporting items for systematic review and meta-analysis (PRISMA), and a total of 169 ameloblastoma cases were evaluated. Data on patient demographics, ameloblastoma growth characteristics, and genetic status were collected for quantitative analysis. Among a total of 169 ameloblastoma cases, Afro-descendant patients had higher primary and recurrent ameloblastomas at 15.5% and 4.7% respectively compared to non-Afro-descendant at 10.7% and 1.8% respectively. Additionally, BRAF V600E was positively associated with 48.8% of all ameloblastomas and strong predilection for Afro-descendants. Despite the paucity of information on genetic profile of ameloblastomas in the Afro-descendant patient cohort, this ethnic group still accounted for 2.95% of all BRAF V600E-positive tumors. These suggest that Afro-descendants are understudied regarding ameloblastoma characteristics, genetic profile, and recurrence profile. Mutational analysis of ameloblastoma tumors in Afro-descendants should be promoted.


Subject(s)
Ameloblastoma , Jaw Neoplasms , Humans , Ameloblastoma/genetics , Ameloblastoma/pathology , Ameloblastoma/therapy , Proto-Oncogene Proteins B-raf/genetics , Jaw Neoplasms/genetics , Jaw Neoplasms/pathology , Jaw Neoplasms/therapy , Treatment Outcome , Mutation
3.
Oral Oncol ; 146: 106585, 2023 11.
Article in English | MEDLINE | ID: mdl-37816291

ABSTRACT

Although complete excision is the standard of care for ameloblastoma, a subset of recurrent and/or metastasizing ameloblastomas are difficult to treat surgically. Over the past decade, several recurrent mutations in the mitogen-activated protein kinase pathway genes have been identified in ameloblastoma, based on which the efficacy of targeted therapy has been investigated. However, most of the literature has focused on BRAF V600E mutations, the most common oncogenic mutations in ameloblastoma. Hence, this study aims to review the current knowledge of targetable genetic alterations in ameloblastoma from a broader perspective. In addition, the therapeutic potential of immunotherapy for ameloblastoma will be briefly discussed in the context of tumoral PD-L1 expression and the tumor immune microenvironment.


Subject(s)
Ameloblastoma , Jaw Neoplasms , Humans , Ameloblastoma/therapy , Ameloblastoma/drug therapy , Precision Medicine , Jaw Neoplasms/therapy , Jaw Neoplasms/drug therapy , Proto-Oncogene Proteins B-raf/genetics , Mutation , Tumor Microenvironment
4.
Head Neck ; 45(4): 816-826, 2023 04.
Article in English | MEDLINE | ID: mdl-36645099

ABSTRACT

BACKGROUND: Ameloblastoma may present a significant treatment challenge in the locally advanced, recurrent and metastatic setting. Comprehensive genomic profiling (CGP) can identify targetable genomic alterations to aid in treatment. METHODS: Ameloblastoma samples were sequenced using hybrid-capture based sequencing. A systematic literature review was performed to examine outcomes in studies employing targeted treatment in ameloblastoma. RESULTS: We reviewed 14 cases of Ameloblastoma using CGP. There were six patients with activating BRAF mutations, five with PIK3CA, five with SMO, four with FGFR2, one with EGFR, and one with ROS1. All cases were MSI stable and the median TMB was 2.5 mutations/Mb. A separate literature review of clinical outcomes in ameloblastoma showed a predominance of at least partial response to targeted treatment (7/12 cases). CONCLUSION: CGP is helpful in identifying specific driver mutations in patients with complex ameloblastoma. Targeted treatment has been employed with success in achieving treatment response.


Subject(s)
Ameloblastoma , Precision Medicine , Humans , Ameloblastoma/genetics , Ameloblastoma/therapy , Protein-Tyrosine Kinases , Proto-Oncogene Proteins , Mutation , Genomics
5.
Arch Oral Biol ; 140: 105454, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35597128

ABSTRACT

OBJECTIVE: This article aims to systematically and comprehensively discuss molecular biology-related progress and targeted therapeutic strategies for ameloblastoma, which are expected to be helpful for the diagnosis and treatment of ameloblastoma. DESIGN: A comprehensive review of scientific literature relevant to ameloblastoma, including the latest classification, global epidemiology, molecular biology advances, and targeted therapy. RESULTS: Among the 156 articles cited, a total of 20 non-coding RNAs, 13 genes, 27 proteins, and 8 pathways were involved, which play a variety of roles in ameloblastoma. These roles include participation in the biological behaviours of ameloblastoma migration, differentiation, and apoptosis; detection of ameloblastoma proliferative properties; detection of ameloblastoma angiogenesis; and identification of ameloblastoma carcinogenesis. CONCLUSIONS: At present, some progress has been made in molecular biology and targeted therapy for ameloblastoma involving BRAF and SMO genes. The related non-coding RNAs, genes, proteins, and pathways involved in this review provide new ideas and directions for the occurrence and development of ameloblastoma and have the potential to become new gene therapy targets.


Subject(s)
Ameloblastoma , Ameloblastoma/genetics , Ameloblastoma/therapy , Humans , Molecular Biology , Mutation , Proto-Oncogene Proteins B-raf/genetics
6.
J Stomatol Oral Maxillofac Surg ; 123(5): e433-e438, 2022 10.
Article in English | MEDLINE | ID: mdl-35017129

ABSTRACT

INTRODUCTION: This meta-analysis provides reliable data on the prevalence of unicystic ameloblastomas (UA's) among solid/multicystic ameloblastomas (SMA's), as well the ratio of their presence in the maxilla and mandible and in the tooth-bearing area versus the posterior regions of the mandible, including the third molar region and ascending ramus. MATERIAL AND METHODS: A systematic review and meta-analysis was performed according to PRISMA guideline using the strategy ((unicystic ameloblastoma) OR (((ameloblastoma) OR (solid ameloblastoma)) OR (multicystic ameloblastoma))) NOT ((((systematic review) OR (literature review)) OR (case report)) OR (Immunohistochemical)). DISCUSSION: The study included 3856 SMA's and 1537 UA's, which amounted to 28.5% UA's. Of the 380 cases of UA from twelve articles that mentioned the involved jaws, 355 were in the mandible and 25 in the maxilla. The preponderance for the mandible is much higher than reports from previous studies of smaller series. Only five articles mentioned the location within the mandible. The vast majority was in the posterior area. CONCLUSION: The consequences for treatment were discussed, with an emphasis on the approach to unicystic lesions in the posterior part of the mandible for which a protocol is suggested.


Subject(s)
Ameloblastoma , Ameloblastoma/diagnosis , Ameloblastoma/epidemiology , Ameloblastoma/therapy , Head , Humans , Jaw/pathology , Mandible/pathology
7.
Sci Rep ; 11(1): 24088, 2021 12 16.
Article in English | MEDLINE | ID: mdl-34916549

ABSTRACT

Ameloblastoma is a benign, epithelial cancer of the jawbone, which causes bone resorption and disfigurement to patients affected. The interaction of ameloblastoma with its tumour stroma drives invasion and progression. We used stiff collagen matrices to engineer active bone forming stroma, to probe the interaction of ameloblastoma with its native tumour bone microenvironment. This bone-stroma was assessed by nano-CT, transmission electron microscopy (TEM), Raman spectroscopy and gene analysis. Furthermore, we investigated gene correlation between bone forming 3D bone stroma and ameloblastoma introduced 3D bone stroma. Ameloblastoma cells increased expression of MMP-2 and -9 and RANK temporally in 3D compared to 2D. Our 3D biomimetic model formed bone nodules of an average surface area of 0.1 mm2 and average height of 92.37 [Formula: see text] 7.96 µm over 21 days. We demonstrate a woven bone phenotype with distinct mineral and matrix components and increased expression of bone formation genes in our engineered bone. Introducing ameloblastoma to the bone stroma, completely inhibited bone formation, in a spatially specific manner. Multivariate gene analysis showed that ameloblastoma cells downregulate bone formation genes such as RUNX2. Through the development of a comprehensive bone stroma, we show that an ameloblastoma tumour mass prevents osteoblasts from forming new bone nodules and severely restricted the growth of existing bone nodules. We have identified potential pathways for this inhibition. More critically, we present novel findings on the interaction of stromal osteoblasts with ameloblastoma.


Subject(s)
Ameloblastoma/physiopathology , Ameloblastoma/therapy , Jaw Neoplasms/physiopathology , Jaw Neoplasms/therapy , Osteogenesis , Stromal Cells , Tissue Engineering/methods , Ameloblastoma/complications , Ameloblastoma/genetics , Animals , Bone Resorption/etiology , Bone Resorption/therapy , Core Binding Factor Alpha 1 Subunit/genetics , Core Binding Factor Alpha 1 Subunit/metabolism , Gene Expression , Humans , Jaw Neoplasms/complications , Jaw Neoplasms/genetics , Matrix Metalloproteinase 2/genetics , Matrix Metalloproteinase 2/metabolism , Neoplasm Invasiveness , Osteoblasts/physiology , RANK Ligand/genetics , RANK Ligand/metabolism , Rats , Tumor Cells, Cultured , Tumor Microenvironment
8.
BMJ Case Rep ; 14(12)2021 Dec 14.
Article in English | MEDLINE | ID: mdl-34906959

ABSTRACT

Ameloblastic carcinoma is a rare malignant odontogenic neoplasm that exhibits diverse clinical and radiological presentations. In fact there are several differential diagnoses during histopathological evaluation too. Lack of adequate reports could not establish the predominant demographic, clinical and radiological presentations. For the same reasons, the role of adjuvant radiotherapy and chemotherapy is also unsubstantiated yet. This case discusses the innocuous clinical and radiological presentation of ameloblastic carcinoma in a 55-year-old man where the diagnostic confirmation was achieved through histopathological evaluation. The differential diagnoses, treatment and follow-up details of this case are discussed in light of the previous published case reports and systematic reviews of case reports in an attempt to increase the sensitisation among dentists towards ameloblastic carcinoma.


Subject(s)
Ameloblastoma , Carcinoma , Mandibular Neoplasms , Odontogenic Tumors , Ameloblastoma/diagnostic imaging , Ameloblastoma/therapy , Diagnosis, Differential , Humans , Male , Mandibular Neoplasms/diagnostic imaging , Mandibular Neoplasms/therapy , Middle Aged , Odontogenic Tumors/diagnosis
9.
Med. oral patol. oral cir. bucal (Internet) ; 26(2): e181-e186, Mar. 2021. tab
Article in English | IBECS | ID: ibc-224438

ABSTRACT

Background: The ameloblastoma management is still challenging to the high recurrence rates and significantmorbidity associated with radical treatment. The purpose of this 10-year retrospective study was to analyze theinfluence of ameloblastoma type and treatment strategy on the long-term outcomes and recurrence rates.Material and Methods: The retrospective analyses of 64 histologically-confirmed ameloblastoma cases was per-formed. The possible risk factors for recurrence and the development of complications were estimated statistically.Results: The treatment strategy applied for this group of patients was the following: thirty-four patients (53.1%)were treated conservatively with enucleation or extended bone curettage. Radical treatment (bone resection) wasapplied in 30 (46.9%) cases. The follow-up period ranged from 2 to 10 years (mean value 4.28 ± 3,26). General re-currence rate consisted 32.8%. This study did not find significant correlations between clinical or histopathologi-cal features of the ameloblastoma and the recurrence rate. The only factor that significantly influence recurrencerate was the treatment strategy (41% in conservative treatment vs 15% in radical treatment, p<0.05). Postoperativecomplications were observed in 42 patients (65.6%) and included face asymmetry and disfigurement (17.2%), tem-porary paresthesia of the inferior alveolar nerve (IAN) - 23.4%, permanent paresthesia of IAN - 20.3%, paresisof a marginal branch of the facial nerve - 6.3%, infection 12.5%, and swelling - 20.3%. The complication rates,esthetic and functional deficiency were significantly higher in radically treated patients (p<0.05)Conclusions: Our study confirms that higher recurrence rate is associated with conservative treatment for am-eloblastoma, while radical treatment leads to an increased number of postoperative complications that affect thepatient's quality of life.(AU)


Subject(s)
Humans , Ameloblastoma/therapy , Odontogenic Tumor, Squamous/therapy , Oral Health , Retrospective Studies , Oral Medicine , Pathology, Oral , Recurrence
10.
Odovtos (En línea) ; 22(3)dic. 2020.
Article in English | LILACS, SaludCR | ID: biblio-1386501

ABSTRACT

Abstract Objectives: Odontogenic keratocyst (OKC) and ameloblastoma are slowly growing and locally invasive tumors with high recurrence rate. The aim of this study was to investigate the clinicopathologic features of recurrent ameloblastoma and OKC cases, and evaluate outcomes of our treatments in terms of recurrence. Material and Methods: A total of 23 patients with confirmed recurrent ameloblastoma or OKC and treated in our clinic within eleven years period were reviewed retrospectively. Results: Eleven recurrent OKC cases and twelve recurrent ameloblastoma cases were included. Most recurrences occurred within five years after the initial treatment (69.6%). Enucleation had the highest recurrence rate among the first treatments (18/23). All recurrences were located in the mandible, with one exception (22/23). All recurrent OKCs were multilocular. Different histopathologic subtypes of ameloblastoma were seen in our study, follicular ameloblastoma was the most common (8/12). The mean diameter of the lesions was 4.3 cm (ranging from 2 cm to 7 cm). Statically significant relation was found between location and diameter of lesion and year of recurrence onset (p=0.004; p=0.026). We performed radical treatments in these cases (ten patients underwent marginal resections, and thirteen patients underwent segmental resection), and no recurrence was observed during the follow-up period. Conclusion: Previous inadequate surgical procedures were the most important cause of recurrence. Marginal or segmental resection with safety margins is the best method to treat recurrences of OKC or ameloblastoma cases.


Resumen Objetivo: Los keratoquistes odontogénicos (KQO) y ameloblastomas son tumores invasivos de lento crecimiento local con una alta tasa de recurrencia. El propósito de este estudio fue investigar las características clínico patológicas de los casos de ameloblastoma y KQO recurrentes y evaluar los resultados de tratamientos en término de recurrencia. Materiales y Métodos: Un total de 23 pacientes con casos confirmados de ameloblastomas o KQO recurrentes tratados en nuestra clínica en un período de once años fueron incluidos. Resultados: Once casos de KQO recurrentes y doce ameloblastomas recurrentes fueron incluidos. La mayoría de las recurrencias ocurrieron en los primeros 5 años posteriores al tratamiento inicial (69.6%). La enucleación mostró la tasa de recurrencia más alta entre los tratamientos iniciales (18/23). Todas las recurrencias se presentaron en la mandíbula excepto por un caso (22/23). Todos los KQO fueron multiloculares. Distintos subtipos histológicos del ameloblastoma fueron detectados en el estudio y el ameloblastoma folicular fue el más común (8/12). El diámetro promedio de las lesiones fue de 4.3cm en un rango de 2cm a 7cm. Una relación estadísticamente significativa se encontró entre la ubicación y el diámetro de la lesión y el tiempo de aparición de la recurrencia (p=0.004; p=0.026). Se realizaron tratamientos radicales en los siguientes casos, diez pacientes tuvieron resecciones marginales y trece pacientes resección segmental; no se observaron recurrencias en el período de seguimiento. Conclusión: Procedimientos previos inadecuados fueron la causa más relevante de recurrencia. Resección marginal o segmental con márgenes de seguridad son el mejor método para tratar casos de ameloblastoma y KQO recurrentes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Ameloblastoma/therapy , Odontogenic Cysts/therapy
11.
J Cancer Res Ther ; 15(3): 455-462, 2019.
Article in English | MEDLINE | ID: mdl-31169204

ABSTRACT

Metastasizing ameloblastoma (MA) is a very rare odontogenic tumor with 2% of incidence rate. It exhibits benign histopathological features and malignant intrinsic quality in the form of metastasis which makes it a little more than a pathological curiosity. Various molecular aspects related with malignant behavior have been discussed. Because of this, it provides a diagnostic challenge for clinicians and surgeons. It is an elusive lesion which should be more researched and studied so that definitive diagnostic features can be put forward. The objective of this paper is to review the molecular aspect involved in the pathogenesis of MA which will aid in differentiating non-MA from MA and thus helping in providing proper treatment at an early stage.


Subject(s)
Ameloblastoma/etiology , Ameloblastoma/metabolism , Ameloblastoma/diagnosis , Ameloblastoma/therapy , Biomarkers, Tumor , Disease Management , Disease Susceptibility , Epithelial-Mesenchymal Transition , Humans , Neoplasm Metastasis , Neoplasm Staging , Tumor Microenvironment
12.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 48-53, maio/ago. 2019. ilus
Article in Portuguese | LILACS, BBO - Dentistry | ID: biblio-1006569

ABSTRACT

O ameloblastoma é um tumor odontogênico benigno raro que afeta a região mandibular. Possui um crescimento localizado, também pode ser infiltrativo e persistente, assintomático, com estímulo desencadeador desconhecido. Sua prevalência ocorre com maior frequência em pacientes entre a quarta e quinta década de vida. Além de ser um relato de caso clínico, o presente estudo visa esclarecer as características clínicas, radiográficas, histopatológicas, condutas e opções durante o tratamento e o prognóstico para os diversos tipos de ameloblastomas, sendo realizada a radiografia panorâmica, a tomografia computadorizada e exame histopatológico, obtendo o diagnóstico da variante unicística que possui as características como uma cavidade monocítica bem definida e radiograficamente apresenta radiolucências expansivas uniloculares com margens bem definidas. O tratamento inicial proposto foi a marsupialização, remoção à marsupialização na qual uma janela cirúrgica comunicando com a cavidade bucal, suturada junto à mucosa adjacente, é aberta para o esvaziamento progressivo do conteúdo interno da lesão, acarretando em sua descompressão, consequente diminuição. Após a reavaliação do caso foi observada a necessidade de remover toda a lesão, realizando a ressecção parcial da mandíbula com um melhor prognóstico(AU)


Ameloblastoma is a rare benign odontogenic tumor that affects the mandibular region, has a localized growth, may also be infiltrative and persistent, asymptomatic, with unknown triggering stimulus. Its prevalence occurs more frequently in patients between the fourth and fifth decade of life. In addition to being a clinical case report, the present study aims to clarify the clinical, radiographic, histopathological, behavioral and options characteristics during the treatment and the prognosis for the various types of ameloblastomas. Panoramic radiography, computed tomography and histopathological examination obtaining the diagnosis of the unicystic variant that has the characteristics as a well defined monocytic cav ity and radiographically presents expansive unilocular radiolucencies with well defined margins. The initial proposed treatment was the marsupialization removal to marsupialization in which a surgical window communicates with the oral cavity, sutured adjacent to the adjacent mucosa, is opened for progressive emptying of the internal contents of the lesion, leading to its decompression and consequent decrease. After the reassessment of the case, it was observed the need to remove the entire lesion, performing partial resection of the mandible with a better prognosis(AU)


Subject(s)
Humans , Male , Adult , Ameloblastoma , Ameloblastoma/therapy , Ameloblastoma/diagnostic imaging , Surgery, Oral , Mouth Neoplasms , Ameloblastoma/pathology
13.
Swiss Dent J ; 129(3): 193-203, 2019 Mar 11.
Article in German | MEDLINE | ID: mdl-30932396

ABSTRACT

The dentigerous cyst is the second most frequent odontogenic cyst after the radicular one. Typically, dentigerous cysts are asymptomatic and are commonly diagnosed incidentally. Due to the slow, expansive growth dentigerous cysts have the potential for dislocation of adjacent structures (neighbouring teeth, canalis retromolaris), root resorptions and in an extreme case could cause jaw fractures. A histological examination represents a sine qua non, because other more alarming pathologies (odontogenic keratocyst, unicystic ameloblastoma, myxoma, primordial odontogenic tumour etc.) can exhibit clinically and radiologically a similar appearance. This brief overview aims to illustrate, by two clinical cases, the examination, the diagnosis and decision-making for either a cystostomy or a cystectomy. The surgical procedure of both techniques is presented in a step-by-step manner.


Subject(s)
Ameloblastoma , Dentigerous Cyst , Odontogenic Tumors , Ameloblastoma/therapy , Dentigerous Cyst/therapy , Humans , Odontogenic Tumors/therapy
14.
J Oral Maxillofac Surg ; 77(8): 1643-1649, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30902604

ABSTRACT

Ameloblastomas typically occur in adults and are considered a rarity in the pediatric patient population. We report on the treatment outcome of a pediatric patient who presented with a unicystic ameloblastoma in the mandible. A 15-year-old boy presented with a large, expansile lesion in the ramus-angle region of the mandible. Incisional biopsy findings confirmed the lesion was a type II unicystic ameloblastoma. Treatment consisted of unroofing of the bone overlying the lesion followed by enucleation with peripheral ostectomy. A 10-mL disposable Luer-lock syringe was cut and modified to fit into the window of the lesion to facilitate irrigation with saline solution. The disposable syringe was held in position with 0.18-mm stainless steel wire for 3 months. Modification of the conservative treatment using the syringe allowed for complete regeneration of bone in the large cavity without the need for bone graft or resection of the lesion. At the 3-year follow-up, there was no sign of recurrence.


Subject(s)
Ameloblastoma , Conservative Treatment , Mandibular Neoplasms , Adolescent , Adult , Ameloblastoma/therapy , Humans , Male , Mandibular Neoplasms/therapy , Neoplasm Recurrence, Local
15.
Article in English | MEDLINE | ID: mdl-30448231

ABSTRACT

OBJECTIVES: Odontogenic tumors (ODTs) are a heterogeneous group of lesions derived from elements of tooth-forming tissues. No detailed data on the incidence of odontogenic tumors in the United Kingdom have been published. The aim of this study was to retrospectively describe the range and incidence of odontogenic tumors from 1992 to 2016 in a single specialist unit and to compare this population with others. STUDY DESIGN: By using the Oral and Maxillofacial Pathology database, Sheffield (UK), we included both local and referred consultation cases. A proportion of diagnoses were reclassified in accordance with the 2017 World Health Organization classification. RESULTS: In total, 559 odontogenic tumors were diagnosed. Overall, the most common lesions were ameloblastoma (196 [33.8%]), odontoma (148 [25.5%]), and odontogenic myxoma (37 [6.3%]), but this varied between local and referral case populations, with odontomas being most common in the local population (43%). The sites affected and the gender and age of patients were similar to other Western populations. Malignant ODTs comprised 33 cases (5.7%), of which 9 (27.3%) were ameloblastic carcinoma. The majority of the malignant ODTs comprised referral cases. CONCLUSIONS: Here, we present the first detailed data on ODTs within a UK population, and the pattern of incidence from the local population is similar to other Western populations. The exceptional rarity of malignant ODTs emphasizes the need for specialist centers for their treatment to gain diagnostic experience.


Subject(s)
Ameloblastoma , Odontogenic Tumors , Odontoma , Ameloblastoma/diagnosis , Ameloblastoma/epidemiology , Ameloblastoma/therapy , Humans , Odontogenic Tumors/diagnosis , Odontogenic Tumors/epidemiology , Odontogenic Tumors/therapy , Odontoma/diagnosis , Odontoma/epidemiology , Odontoma/therapy , Pathology, Oral , Retrospective Studies , United Kingdom/epidemiology
16.
Oral Dis ; 25(7): 1683-1696, 2019 Oct.
Article in English | MEDLINE | ID: mdl-30548549

ABSTRACT

OBJECTIVES: The aim of the present study was to assess the outcomes of radical and conservative treatment approaches of solid/multicystic and unicystic ameloblastoma in terms of recurrence rates. MATERIAL AND METHODS: A systematic review and meta-analysis was conducted based on the PRISMA statement. Search was performed using PubMed, Embase, SCOPUS, and Web of Science for articles published from January 1969 until March 2018. Quality assessment of the selected articles was conducted using the Quality Appraisal of Case Series Studies Checklist. The meta-analysis was performed using the MedCalc program. RESULTS: The search strategy yielded 6,984 articles; 20 studies met the eligibility criteria and were included in the meta-analysis. The pooled recurrence rate of solid/multicystic ameloblastomas following radical treatment was 8%, while conservative treatment caused recurrences in 41%. For unicystic ameloblastomas, these values were 3% and 21%, respectively. The risk of recurrences in both types of ameloblastomas following radical treatment was lower than following conservative treatment. CONCLUSIONS: The present study showed statistically significant differences in recurrence favoring radical treatment for both unicystic and solid/multicystic ameloblastoma. The solid/multicystic type showed more recurrences than the unicystic type. Unfortunately, since only retrospective studies were available, the evidence is less strong as wished for.


Subject(s)
Ameloblastoma/therapy , Conservative Treatment , Jaw Neoplasms/therapy , Neoplasm Recurrence, Local , Ameloblastoma/pathology , Checklist , Humans , Jaw Neoplasms/pathology , Netherlands/epidemiology , Retrospective Studies , Treatment Outcome
17.
Ear Nose Throat J ; 97(7): E26-E32, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30036443

ABSTRACT

Ameloblastoma is a histologically benign but locally aggressive tumor of the jaws. We conducted a retrospective cohort study to review the clinical, radiologic, and pathologic features of patients with ameloblastoma of the mandible and maxilla and to report the outcomes of treatment. Our study population was made up of a series of 30 consecutively presenting patients-15 men and 15 women, aged 19 to 81 years (median: 61.5)-who had undergone their primary treatment of ameloblastoma of the mandible or maxilla at Memorial Sloan Kettering Cancer Center from January 1987 through December 2012. In addition to demographic data, we compiled information on clinical characteristics, imaging findings, the type of surgery, surgical margins, adjuvant treatments, histologic patterns, length of follow-up, time to recurrence, treatment of recurrence, and factors that had an influence on recurrence. All but 2 patients with negative margins were cured. Favorable outcomes were associated with the administration of adjuvant postoperative radiotherapy for patients with positive margins and a repeat resection for patients with recurrences. Complete excision with negative margins, however, remains the gold standard for curative treatment.


Subject(s)
Ameloblastoma/therapy , Antineoplastic Agents/administration & dosage , Mandibular Neoplasms/therapy , Maxillary Neoplasms/therapy , Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Female , Humans , Male , Middle Aged , Postoperative Period , Retrospective Studies , Treatment Outcome , Young Adult
18.
Oral Dis ; 24(1-2): 63-66, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29480593

ABSTRACT

Ameloblastoma are the most common odontogenic tumor. As they usually do not form metastasis, they are considered as benign tumors with a locally invasive growth pattern and destruction of the jaws and the surrounding tissue (Oral Diseases, 23, 2017, 199). This article focuses on clinical, radiological, and therapeutic findings, which may influence diagnosis and treatment of ameloblastoma in the future.


Subject(s)
Ameloblastoma/genetics , Ameloblastoma/therapy , Jaw Neoplasms/genetics , Jaw Neoplasms/therapy , Molecular Targeted Therapy , Ameloblastoma/diagnostic imaging , Ameloblastoma/pathology , Humans , Jaw Neoplasms/diagnostic imaging , Jaw Neoplasms/pathology
19.
J Oral Pathol Med ; 47(4): 417-424, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29453876

ABSTRACT

BACKGROUND: Fibroblast growth factor 2 (FGF2) and FGF receptor 1 (FGFR1) have been investigated in different human neoplasms and were shown to play important roles in the pathogenesis of these diseases; however, very few are known regarding their prognostic importance in the context of ameloblastoma. Therefore, the aim of this study was to investigate whether the expression of FGF2 and FGFR1 is associated with ameloblastoma clinical behavior. METHODS: Fifty-eight cases of ameloblastoma arranged in tissue microarray were submitted to immunohistochemistry against FGF2 and FGFR1. Clinicopathological parameters regarding sex, age, tumor size, duration and location, treatment, recurrences, radiographic features, cortical disruptions, and follow-up data were obtained from patients' medical records and correlated with the molecules expression. Univariate and multivariate Cox regression analyses were used to investigate the prognostic potential of the biomarkers. RESULTS: Forty-four cases (75.9%) exhibited cytoplasmic positivity for FGF2 in central and peripheral epithelial cells, 46 of 58 (79.3%) showed FGFR1 cytoplasmic positivity predominantly in the columnar peripheral cells, and 43 cases (74.1%) were positive for both. Expression of FGF2 and FGF2 + FGFR1 was associated with tumor recurrences (P = .05). However, univariate and multivariate analyses did not demonstrate a significant influence of FGF2, FGFR1, or FGF2 + FGFR1 in the 5-year disease-free survival (DFS) rate (P = .27, P = .33, and P = .25, respectively). CONCLUSION: Cytoplasmic expression of FGF2 and FGF2 + FGFR1 is associated with ameloblastoma recurrence, but FGF2 and FGFR1 are not determinants of a lower DFS.


Subject(s)
Ameloblastoma/metabolism , Fibroblast Growth Factor 2/biosynthesis , Jaw Neoplasms/metabolism , Receptor, Fibroblast Growth Factor, Type 1/biosynthesis , Adult , Ameloblastoma/therapy , Disease-Free Survival , Female , Humans , Jaw Neoplasms/therapy , Male , Prognosis , Retrospective Studies
20.
Med. oral patol. oral cir. bucal (Internet) ; 23(1): e54-e58, ene. 2018. tab
Article in English | IBECS | ID: ibc-170304

ABSTRACT

Background: Ameloblastoma is a neoplasm classified as a benign epithelial odontogenic tumor of the jaws, grow slowly and are locally invasive. The aim of the present study was to investigate the incidence, treatment, and complication of patients with ameloblastoma in East-Indonesia during six years retrospective study. Material and Methods: This retrospective study included 84 patients who were diagnosed with ameloblastoma from 2011 to 2016. There were 56 patients with treatment data available. Data from each patient, including gender, age, histologic type, the size of the tumor, radiologic form, tumor location, type of treatment, and complication were reviewed and analyzed retrospectively. Results: Fourteen patients were diagnosed with unicystic ameloblastoma (25%), thirty two patients with multicystic follicular ameloblastoma (57%) and ten patients with an unspecified multicystic ameloblastoma (18%). A total of about 35 patients were treated conservatively (62.5%) and 21 patients were treated radically (37.5%). Swelling was present as a pre-operative complication in all 56 cases (100%). There were no complaints concerning speech. Conclusions: The majority findings of the histologic type were multicystic ameloblastoma and their location were in the mandible. Most ameloblastoma were treated conservatively and reconstructions were made with only titanium plates and not bone graft (AU)


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Subject(s)
Humans , Male , Female , Ameloblastoma/epidemiology , Ameloblastoma/therapy , Odontogenic Cyst, Calcifying/epidemiology , Jaw Neoplasms/epidemiology , Indonesia/epidemiology , Ameloblastoma/complications , Ameloblastoma/pathology , Retrospective Studies , Surveys and Questionnaires
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