Physiological bone regeneration from Maxillary Ameloblastoma with conservative intervention. Follow up for 8 years.

Abstract

Ameloblastoma is a tumor of odontogenic origin and highly aggressive. Four clinical variants of ameloblastomas are known: solid or multicystic, unicystic, peripheral or extra- osseous and desmoplastic. Among the treatment alternatives, a treatment that ensures a high percentage of successful prognosis for the patient is preferred, being the most indicated, radical resection, or in bulk. Conservative treatment is less used due to its recurrence rate. A clinical case of a 13-year-old male patient is presented to the Rosales National Hospital, in the Maxillofacial Surgery service of El Salvador with an inflammation in the posterior mandibular region on the left side of the face. Intraoral examination revealed mild extrusion and mobility grade 2 of parts 37 and 36. Clinical, radiographic and histopathological analyzes confirmed the diagnosis of Ameloblastoma. It was treated conservatively by curettage, peripheral osteotomy and marsupialization. A good aesthetic and functional result was obtained, applying the conservative technique, with an adequate healing and physiological bone regeneration, without recourse to bone grafting materials.  After an 8-year follow-up no evidence was found of tumor recurrence. The decision regarding the type of treatment to be applied, depends on the clinical variables, tumor extension and adequate postoperative monitoring and care of the patient.