Prosthetic Implant-supported Rehabilitation after Mandibular Ameloblastoma Resection: An 8-year Follow-up Case Report |Chapter 2 | Medical Science: Recent Advances and Applications Vol. 9

 

Introduction: Ameloblastomas are benign but locally invasive odontogenic tumours, most frequently located in the mandible. The gold standard treatment is the surgical resection with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. Dental implants are the main option for prosthetic rehabilitation. An individualised treatment plan is necessary, which requires multidisciplinary teams: maxillofacial surgeons, implantologists and prosthodontists. Case presentation: This case report describes the prosthetic rehabilitation of a 42-year-old man after mandibular ameloblastoma resection. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis by Computer-Aided Design-Computer-Aided Manufacturing. During an 8-year and 5-month follow-up, some clinical complications were observed: peri-implant disease and explantation of one implant due to a lack of osseointegration. A strict maintenance program was performed to avoid these problems.

 

Discussion and Conclusion: An immediate reconstruction of the postoperative defect is essential to avoid aesthetic problems and functional sequelae. The functional reconstruction of large mandibular segments with microvascularized flaps and dental implants is considered the best option. Nonetheless, it is vitally important to monitor the patient closely and to follow a maintenance program to minimise peri-implant disease.

 

Author(s) Details

Moreno-Soriano, C
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain.

 

Estrugo-Devesa, A
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Institut d’Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L’Hospitalet de Llobregat, Barcelona, Spain.

 

Castañeda-Vega, P
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain.

 

Jané-Salas, E
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Institut d’Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L’Hospitalet de Llobregat, Barcelona, Spain.

 

Antonio Marí Roig
Maxillofacial Surgery Department, Bellvitge University Hospital, Catalonia, Spain and Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute), IDIBELL, Barcelona, Spain.

 

López-López, J
Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Institut d’Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), Dentistry Hospital University of Barcelona – University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v9/6001

Ameloblastoma: A Report of Two Cases | Chapter 2 | Medicine and Medical Research: New Perspectives Vol. 7

 

Ameloblastoma is a slow-growing locally aggressive, benign odontogenic epithelium with a greater tendency for recurrence and involves aggressive bone loss and teeth. It is believed to be derived from cell rests of the enamel organ, either remnants of the dental lamina or Hertwig's sheath, the epithelial rest of Malassez. An Unicystic Ameloblastoma (UA) represents an ameloblastoma variant, that's a cyst. They are often related to an unerupted third molar, with a peak incidence within the third and fourth decade of life.

 

The most common site of preference is the mandibular molar and ramus area than the anterior and premolar region. The article presents two case series of unicystic ameloblastoma of a 25-year-old female who had a localized swelling in the left side of the mandible which resembled a keratocystic odontogenic tumor clinically and radiographically. Based on histopathological examination the final diagnosis was unicystic ameloblastoma with the mural pattern. The second case report presented a 32-year-old female with a diffuse swelling in the left lower jaw which histopathologically revealed ameloblastoma with the plexiform variant. An incisional biopsy was done to get a definitive diagnosis for both cases. A postoperative panoramic radiograph was taken and was found to be satisfactory in both cases. The case series presented certain unique features of female predilection and a multilocular variant with mural and plexiform pattern unicystic ameloblastoma. Both patients were surgically managed more conservatively with enucleation and cauterization as cystic types are found to be less aggressive compared to solid variants of ameloblastoma. They were on a regular follow period postoperatively. It can be concluded that unicystic ameloblastoma with a mural growth pattern has a tendency for recurrence if inadequately managed surgically. Proper management avoids the propensity of recurrence rate.

 

Author (s) Details

Gayathri Devi M.
Department of Oral Medicine & Radiology, The Tamil Nadu Dr. M.G.R Medical University, India.

 

Bakyalakshmi K.
Department of Oral Medicine & Radiology, The Tamil Nadu Dr. M.G.R Medical University, India.

 

Cap Regu P.
Department of Oral Medicine & Radiology, The Tamil Nadu Dr. M.G.R Medical University, India.

 

Vijayakumar P
Department of Oral Medicine & Radiology, The Tamil Nadu Dr. M.G.R Medical University, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v7/1971