Effectiveness of a new decisional algorithm in managing mandibular ameloblastomas: A 10-years experience

Sammartino, G.; Zarrelli, C.; Urciuolo, V.; di Lauro, A.E.; di Lauro, F.; Santarelli, A.; Giannone, N.; Lo Muzio, L.

doi:10.1016/j.bjoms.2006.08.023

« Previous Next »British Journal of Oral and Maxillofacial Surgery
Volume 45, Issue 4 , Pages 306-310, June 2007

Effectiveness of a new decisional algorithm in managing mandibular ameloblastomas: A 10-years experience

G. Sammartino
- Department of Odontostomatological and Maxillofacial Sciences, “Federico II”, University of Naples, Naples, Italy
C. Zarrelli
- Department of Odontostomatological and Maxillofacial Sciences, “Federico II”, University of Naples, Naples, Italy
V. Urciuolo
- Department of Odontostomatological and Maxillofacial Sciences, “Federico II”, University of Naples, Naples, Italy
A.E. di Lauro
- Department of Odontostomatological and Maxillofacial Sciences, “Federico II”, University of Naples, Naples, Italy
F. di Lauro
- Department of Odontostomatological and Maxillofacial Sciences, “Federico II”, University of Naples, Naples, Italy
A. Santarelli
- Department of Surgical Sciences, University of Foggia, Via Carelli 28, 71100 Foggia, Italy
N. Giannone
- Department of Surgical Sciences, University of Foggia, Via Carelli 28, 71100 Foggia, Italy
L. Lo Muzio
- Department of Surgical Sciences, University of Foggia, Via Carelli 28, 71100 Foggia, Italy
- Corresponding author. Tel.: +39 0881 685809; fax: +39 0881 685809.

Accepted 21 August 2006. published online 25 October 2006.

Abstract

We present a new treatment algorithm aimed to assist surgeons to develop a rational diagnostic protocol and establish effective conservative surgical management in patients with mandibular ameloblastoma.

Fifteen consecutive cases treated by conservative management were reviewed. Data collected included age, sex, symptoms and signs at diagnosis, anatomical distribution of the lesions, numbers and types of operations, number of recurrences, and duration of follow-up post-operatively.

Curettage was the first operation for all patients and they were closely followed-up post-operatively. During the follow-up period (4–10 years), small recurrences were diagnosed early in 7 patients who were treated by radical surgery including marginal or “box” resection. No further recurrences were observed after the second operation.

When detected early, recurrences are small and surrounded by a large amount of uninvolved normal bone so it is possible to manage them with a radical resection, so lowering the risk of further recurrence and avoiding severe cosmetic and functional problems.

Keywords: Ameloblastoma, Conservative surgery, Odontogenic tumours, Algorithm