Conservative Management of Unicystic Ameloblastoma- A Case Report

Abstract

Ameloblastoma is the most common benign odontogenic tumor of the jaws that constitutes about 1% of all cysts and tumors of the jaws^1,2. It is generally a painless, slow growing, locally aggressive tumor causing expansion of the cortical bone, perforation of the lingual or the buccal cortical plate and infiltration to the soft tissues. It has peak incidence in third and fourth decade of life but can be found in any age group with equal gender predilection (1:1)^1,5. The relative frequency of mandible to maxilla is reported to be varying from 80% -20% to 99–1%. In the mandible majority of Ameloblastoma are found in the molar ramus region^1,3. In a conventional radiograph, Ameloblastoma can present as either unilocular or multilocular corticated radiolucency. The bony septae results in a honey comb, soap bubble or tennis racket appearance. In some places, cortical plates are spared and expanded where as in other region they are destroyed; root resorption is a common finding⁶. Buccal and lingual cortical plate expansion is more common in Ameloblastoma than in other tumour⁷. Conventional radiograph is sufficient for small mandibular lesions but maxillary lesions and extensive lesions require CBCT, CT and MRI to establish the extent of the lesion⁷. The challenge in managing Ameloblastoma is by attaining complete excision and reconstruction of the defect when the tumor is large. Ameloblastoma is treated by enucleation, curettage or surgical excision depending on size and type of the lesion and conservative therapy also.

This report gives a comprehensive knowledge regarding the conservative therapy using a  Iodoform and paraffin paste which has been a boon in treatment of odontogenic tumor.