American Journal of Orthodontics and Dentofacial Orthopedics
Clinician's cornerOrthodontic occlusal reconstruction after conservative treatment of unicystic ameloblastoma in an adolescent patient: 10-year follow-up
Section snippets
Diagnosis and etiology
A girl, age 14 years 10 months, consulted the university hospital with a chief complaint of swelling in the mandibular angle and pain on biting. On the panoramic radiograph, the unicystic radiolucent area with the impacted second molar was observed on the right side of mandible (Figs 1, A and 2, A).
Under general anesthesia, a mucoperiosteal flap was exfoliated along the mandibular right first molar, and a small bone defect appeared at the distal region of the first molar. After aspiration, the
Treatment progress
Three years after the surgery, orthodontic treatment was initiated to improve the patient's genetic and iatrogenic malocclusion (Fig 4, A and B). She was diagnosed as having an Angle Class II malocclusion, with a skeletal Class II jaw-base relationship, severe crowding, and a total open bite from the long-term use of the occlusal splint. Her occlusal contacts were only on the right first molars and the left molars. The mandibular second molar on the affected side was partially erupted with
Discussion
The patient was still in adolescence when the symptoms appeared, and the radiographic examinations indicated the unicystic radiolucent area. The biologic behavior of a unicystic ameloblastoma is considered less invasive, and it responds more favorably to conservative treatment than does a multicystic ameloblastoma.5, 6, 7, 8, 9, 10 Therefore, conservative therapy with the marsupialization technique was performed in this patient.
Unicystic ameloblastoma is most generally encountered in the
Conclusions
Orthodontic occlusal reconstruction was useful in a young patient after conservative treatment of a unicystic ameloblastoma.
Acknowledgments
We thank Professor Naozumi Ishimaru of the Tokushima University Graduate School for his helpful comments about the pathologic findings.
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Cited by (6)
Treatment of an extensive unicystic ameloblastoma in a 7-year-old child: The best approach?
2015, British Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Several treatments have been suggested, and success has been associated with recurrence rates,3–6 but the approach should not be based solely on these.5,6 In children resection causes important functional and aesthetic damage as a result of alterations to craniofacial development.3–6 We present a case of extensive unicystic ameloblastoma of the mandible, and discuss the best approach to treatment.
Conservative management (marsupialization) of unicystic ameloblastoma: literature review and a case report
2017, Maxillofacial Plastic and Reconstructive SurgeryConservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature
2017, Journal of Maxillofacial and Oral SurgeryA Retrospective Cohort Study of the Cumulative Survival Rate of Obturator Prostheses for Marsupialization
2019, Journal of Prosthodontics
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.