Is conservative surgery a better choice for the solid/multicystic ameloblastoma than radical surgery regarding recurrence? A systematic review.

PURPOSE: Determine if conservative surgery of primary solid/multicystic ameloblastoma (SMA) is capable of decreasing the recurrence rate as effectively as radical surgery. METHODS: We searched in MEDLINE, Web of Science, Scopus and Cochrane Library for original studies reporting on the conservative or radical treatment of primary SMA and the related recurrence rate. All selected data were independently assessed. Meta-analysis was performed and the Relative Risk (RR) of recurrence with a confidence interval of 95% was the effect measure. P value for the summary effect of < 0.05 was considered statistically significant. RESULTS: The 2647 records retrieved were reduced to 7 studies to be qualitatively assessed and 4 studies were included in the meta-analysis. RR of 1.88 [0.59, 5.95] of the pooled values pointed that recurrence rate after the conservative surgery is neither comparable nor lower than the radical surgery (P = 0.28). CONCLUSIONS: Conservative surgery does not reduce the recurrence rate as efficiently as radical surgery for primary SMA. However, there is not enough evidence to support this statement.

Ameloblastoma: un estudio retrospectivo de 48 casos / Ameloblastoma: a retrospective study of 48 cases

El ameloblastoma es un tumor odontogénico benigno, localmente invasivo y recidivante, que constituye aproximadamente el 11% de los tumores odontogénicos. Estos tumores ocurren más frecuentemente en la mandíbula. El cuadro clínico se caracteriza generalmente por presentar deformaciones faciales, crecimiento lento y asintomático. El tratamiento depende del tipo, la localización y el tamaño del tumor, así como de la edad del paciente. El objetivo del presente trabajo es realizar un estudio retrospectivo de los casos diagnosticados de ameloblastomas en los datos existentes de los archivos del Departamento de Patología Oral de la Pontifícia Universidade Católica de Minas Gerais, Brasil. Se analizaron los archivos de pacientes en el periodo de enero de 1978 a marzo de 2012, con un diagnóstico definitivo de ameloblastoma. Método. Fueron analizadas las informaciones con respecto a sexo, raza, edad del paciente, presencia de síntomas, aspecto radiográfico del tumor, diagnóstico histopatológico y ubicación anatómica. Resultados. Dentro de los 48 pacientes con ameloblastoma se observó mayor incidencia en la mandíbula en la zona del cuerpo y ángulo (45,8%), que afecta por igual a hombres y mujeres, con un promedio de edad de 36 años y en su gran mayoría se mostraron asintomáticos (81,2%). El tipo más frecuente fue el multiquístico (66,7%), seguido por el uniquístico (31,2%) y el periférico (2,1%). La mayoría de lesiones fueron observadas en la raza blanca (56,3%) y radiográficamente se mostró más frecuente la imagen multilocular (60,4%). Conclusión. Los datos de los ameloblastomas reportados en este estudio fueron similares a los de otras series publicadas en la literatura médica (AU)

Ameloblastoma is a benign, locally invasive and recurrent, odontogenic tumor, which accounts for about 11% of odontogenic tumors. These tumors occur more frequently in the mandible. The clinical picture presented is generally characterized by slow growing and asymptomatic facial deformities. Treatment depends on the type, location and size of the tumor, as well as the age of the patient. The aim of this paper is to present a retrospective study of diagnosed cases of ameloblastoma in existing data files of the Department of Oral Pathology Catholic University of Minas Gerais, Brazil. Data was collected from the files of patients with a definitive diagnosis of ameloblastoma during the period January 1978 to February 2012. Method: An analysis was made of the data, including sex, race, patient age, symptoms, radiographic appearance of the tumor, the histopathological diagnosis and anatomic location. Results: Of the 48 patients with ameloblastoma there was an increased incidence in the jaw and the angle (45.8%). It affected both men and women, with a mean age of 36 years, and the large majority were asymptomatic (81.2%). The most frequent histological type was multicystic (66.7%), followed by unicystic (31.2%), and peripheral (2.1%). Most lesions were observed in white people (56.3%) and radiographically, it was more often a multilocular image (60.4%). Conclusion: The data reported in this study of ameloblastomas were similar to other series reported in the medical literature (AU)

Recurrent ameloblastoma following osseous reconstruction--a review of twenty years.

BACKGROUND: The adequate therapy of ameloblastoma may require a compromise between the least destructive treatment possible of a benign tumour and a sufficiently radical method to prevent recurrences. Frequently recurrences appear after 10 years or longer, therefore regular follow-up visits even after more than 5 years are recommended. The primary reconstruction of bones and/or soft tissues, which is likely to be performed especially for benign processes is threatened by recurrences. METHODS: A retrospective analysis of our patient group during the past 20 years has shown that a differentiated pretherapeutic securing of the histology as well as a radical surgical policy are the most important criteria, influencing the likelihood of recurrences. Three representative case histories are described below. RESULTS: The rate of cumulative relapses with regard to various observation time amounted to 17% after 5 years and 19% after 10 years, respectively. CONCLUSION: Ameloblastomas carry a certain risk of developing local recurrences depending on histology and the type of surgical treatment. Long-term follow-up should be arranged.

[Preventive removal of displaced teeth]. / Müssen verlagerte Zähne prophylaktisch entfernt werden, ja oder nein?

Using the data acquired from our catamnestic survey, we were able to establish a broad catalogue of complications involved with impacted and displaced teeth. Given these complications, it is not medically responsible to leave impacted and displaced teeth in the jaw, even if they are asymptomatic. The risks increase considerably with age. Late operative removal of such teeth can be a dangerous intervention due to local complications such as abscesses, cysts, osteomyelitis, tumors, systemic diseases, and age-related changes in the cardiovascular system.