Objective: To analyse the quality of life of patients receiving repair of bone defect with folded fibula flap after removal of mandibular ameloblastoma. Methods: The case data of 39 patients with ameloblastoma admitted to the First Affiliated Hospital of Zhengzhou University from August 2013 to April 2016 were retrospectively analysed, including 21 males and 18 females, from 18 to 58 years old. 3D printing and digital technology were used in flap preparation before surgery in all patients. The folded fibular flaps were used to repair mandibular defects and the implants were placed between 6-9 months after surgery. The short form-36 health survey questionnaire (SF-36) and the university of Washington quality of life questionnaire (UW-QOL) were applied to evaluate the quality of life of patients before surgery and at 6 months and 24 months after surgery. The higher the score, the better the condition. SPSS 20.0 was adopted for statistical analysis. Results: The SF-36 survey showed that the mean score of body role before surgery (72.4±11.7) was significantly higher than that at 6 months after surgery (39.6±11.1, t=23.580, P<0.05) or that at 24 months after surgery (59.8±6.4, t=8.358, P<0.001). Compared with the preoperative mean scores of Physical Pain (73.0±11.0), General Health (73.4±10.4) and Health Changes (79.2±3.9) before surgery, the mean scores Physical Pain (53.1±7.7), General Health (53.5±7.5) and Health Changes (63.9±11.7) at 6 months after surgery were decreased significantly respectively (t=13.068, 13.756 and 10.880, respectively, all P<0.05), but the mean scores Physical Pain (78.8±14.0), General Health (80.9±12.6) and Health Changes (84.4±4.6) at 24 months after surgery were increased significantly respectively (t=-2.904, -4.027 and -7.586, respectively, all P<0.05), with significant differences in the mean scores of Physical Pain, General Health and Health Changes between 6 and 24 months after surgery (t=-14.241, -16.490, -14.294, respectively, all P<0.001). The UW-QOL survey showed that the mean scores of chewing, language and taste functions decreased at 6 months after surgery (53.1±6.7, 53.0±7.7 and 62.2±9.9, respectively), but improved at 24 months after surgery (67.9±3.9, 63.9±2.9 and 68.4±11.1, respectively), with statistically significant difference (t=-16.765, -11.675 and 2.498, respectively, all P<0.001). Conclusion: The application of folded fibula flaps to repair bone defects after sugery of mandibular ameloblastoma can better meet the needs of language and chewing functions and improve the quality of life of patients.
Adolescent ; Adult ; Ameloblastoma/surgery* ; Bone Transplantation ; Female ; Fibula/surgery* ; Free Tissue Flaps ; Humans ; Male ; Mandible/surgery* ; Mandibular Neoplasms/surgery* ; Middle Aged ; Quality of Life ; Reconstructive Surgical Procedures ; Retrospective Studies ; Young Adult

Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.
Ameloblastoma ; Ameloblasts ; Biopsy ; Busan ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Fibula ; Free Tissue Flaps ; Head ; Humans ; Male ; Mandibular Osteotomy ; Middle Aged ; Neck ; Neck Dissection ; Pathology, Oral ; Radiotherapy ; Recurrence ; Surgery, Oral

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Ameloblastoma ; Archives ; Biopsy ; Dentigerous Cyst ; Dentistry ; Diagnosis ; Fibroma, Ossifying ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Jaw Neoplasms ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral

Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.
Ameloblastoma* ; Curettage ; Decompression ; Follow-Up Studies ; Humans ; Methods ; Prognosis ; Recurrence ; Surgery, Oral ; Transplants

Ameloblastoma is a benign odontogenic tumor with an aggressive biological behavior, and the surgical treatment frequently results in failure for the postoperative recurrence. The aim of this article was to investigate whether the proliferative ability and prognosis of ameloblastoma could be evaluated by the radiographic boundary. The ameloblastoma cases treated by the conservative therapy in our hospital between 1981 and 2001 were divided into three groups based on the nature of the radiographic borders of the lesions. The biologic behavior was evaluated by Ki-67 antibody immunohistochemically. Comparisons of prognosis and Ki-67 expression were carried out by statistic methods. There were 24 cases of well-defined edge with sclerosis (group I), 41 cases of well-defined edge without sclerosis (group II) and 32 cases of ill-defined edge (group III). The recurrent rates were 29.2% in group I, 43.9% in group II and 62.5% in group III (P<0.05). The cells in group III expressed the highest Ki-67 level (P<0.05). The radiographic boundary could be used as one of indicators in evaluating the proliferative ability of ameloblastoma and the patient's prognosis, which was consistent with Ki-67 expression.
Adult ; Ameloblastoma ; diagnostic imaging ; pathology ; surgery ; Cell Proliferation ; Chi-Square Distribution ; Female ; Humans ; Ki-67 Antigen ; analysis ; Male ; Mandibular Neoplasms ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Observer Variation ; Prognosis ; Radiography, Panoramic ; Retrospective Studies ; Young Adult

INTRODUCTION: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. MATERIALS AND METHODS: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation , this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. RESULTS: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. CONCLUSION: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.
Ameloblastoma ; Follow-Up Studies ; Humans ; Jaw ; Male ; Recurrence ; Root Resorption ; Surgery, Oral ; Tooth, Impacted

INTRODUCTION: Ameloblastoma is a benign but locally invasive tumor with a high recurrence rate. The aim of this study was to make an easier diagnosis and treatment planning of ameloblastoma. MATERIALS AND METHODS: From January 1993 to October 2009, 139 cases from 123 patients, who had been diagnosed with ameloblastoma through radiologic and biopsy in the department of oral and maxillofacial surgery of Kyunpook National University, were selected as the subjects in this study. According to the medical charts, 9 factors (age, gender, location, chief complaints, duration, radiographic findings, size and recurrence) concerned in deciding the treatment method and the relevance between each factor and the treatment methods were examined.(Conservative treatments were marsupialization, enucleation, curettage and lateral decortication. Radical treatments included block excision, resection and hemisection) RESULTS: In the patients under the age of 20, 77.14% had conservative treatments, whereas 22.86% underwent radical treatments. In the patients over the age of 20, 44.23% were treated conservatively treatments, and 55.77% underwent radical treatments. For unilocular types, 28.57% had conservative treatments, whereas 71.43% had radical treatments. For the multilocular types, 66.67% underwent conservative treatments, and 33.33% had radical treatments. For the primary cases, 58.68% were treated conservatively and 41.32% had radical treatments. For the recurrent cases, 16.67% and 83.33% underwent conservative and radical treatments, respectively. CONCLUSION: There was statistical significance in the factors affecting the treatment methods, such as age, radiographic findings and recurrence.
Ameloblastoma ; Biopsy ; Curettage ; Humans ; Recurrence ; Surgery, Oral

ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery of Chosun University Dental Hospital from January 2000 to December 2008.RESULTS: The patients comprised 12 males (46.1%) and 14 females (53.9%), and their ages ranged from 10 to 69 years (average, 37.3 years). All cases presented a mandibular location, and in particular, 13 cases (50%) demonstrated an occurrence in the mandibular body. Clinically, 8 cases (30.8%) presented no symptoms, and the most prevalent chief complaint was swelling in 13 cases (50%). Radiographically, a unilocular type appeared in 14 cases (53.8%), and a multilocular type was observed in 10 cases (38.5%). Histopathologically, there were 8 follicular types (30.8%) and 7 plexiform types (26.9%). Conservative treatment was performed in 5 cases (19.2%), and radical treatment was performed in 21 cases (80.8%). The follow-up period ranged from 1 to 10 years. The total recurrence rate was 15.4%, and the mean duration of recurrence was 6.7 years. Three of the 5 cases (60%) that received conservative treatment demonstrated a recurrence, as compared to 1 of the 21 cases (4.8%) that underwent radical treatment.CONCLUSION: The radical treatment was more effective than the conservative treatment for recurrence prevention. We should consider a continuous follow-up check after operation.]]>
Ameloblastoma ; Female ; Follow-Up Studies ; Humans ; Male ; Mandible ; Odontogenic Tumors ; Recurrence ; Retrospective Studies ; Surgery, Oral

OBJECTIVETo exploit computer-aided design and computer-aided manufactured (CAD/CAM) techniques and application in the reconstruction of mandible large-scale defect with vascularized fibular bone graft.

METHODSBefore actually performing surgery, three-dimensional(3D) computed tomography(CT) was performed in 7 patients with mandibular large-scale defects, and 3D CT images were acquired by processing CT data. Then the CT data were transformed into a readable format and transferred to produce facsimile models by means of using rapid prototyping(RP) techniques. When individual mandibular models and enantiomorphous models were produced, evaluation and surgical simulation was performed in model, which included measuring range of mandible lesions, prefabrication of mandibular reconstructive titanium palate, precise position of titanium screws, shaping the free vascularized fibula by mandibular, etc. According to the simulations, the mandible reconstructions were finished in operation.

RESULTCAD/CAM techniques and application can distinctly display the mandibular lesions and ambient relationships, which is very useful for clinical assessment and surgical planning. Particular advantages were the unlimited trials with the imaging method, and the feeling of reality with the model method. The actual operative time was shortened, and surgery results were satisfactory with few complications.

CONCLUSIONCAD/CAM techniques are very helpful for simulation of mandible large-scale defect with complicated anatomical and reconstructive problems. By preoperative simulation of procedures, surgeons can improve or refine treatment planning using this method and improve postoperative results.

Adult ; Ameloblastoma ; surgery ; Computer-Aided Design ; Female ; Fibula ; blood supply ; transplantation ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Mandible ; surgery ; Mandibular Neoplasms ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Reproducibility of Results

INTRODUCTIONA case of spontaneous bone regeneration after mandible resection is reported.

CASE REPORTA 6-year-old boy suffered from ameloblastoma in his right mandible. Six months after haemimandibulectomy, a bone regeneration forming a new form of mandible is seen.

HISTOPATHOLOGYLamellar mature bone was observed. Resection of the large portion of the mandible as the choice of treatment as the tumor was grown extensively. Spontaneous bone regeneration after a mandible resection.

CONCLUSIONUnexpected spontaneous bone regeneration may be explained by the fact that periosteum, as the source of osteogenic cells, might be responsible for this process.

Ameloblastoma ; surgery ; Bone Regeneration ; physiology ; Child ; Humans ; Male ; Mandible ; surgery ; Mandibular Neoplasms ; surgery