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Okechi UC, Akpeh JO, Chukwuneke FN, Saheeb BD, Okwuosa CU, Obi DI, Ogbozor BE. Ameloblastoma of the jaws in children: an evaluation of cases seen in a tertiary hospital in South-Eastern Nigeria. Ghana Med J 2021; 54:36-41. [PMID: 32863411 PMCID: PMC7445702 DOI: 10.4314/gmj.v54i1.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Ameloblastoma is one of the most common benign odontogenic tumours in Nigeria. It is considered uncommon in children. Materials and methods This is a retrospective study of pediatric patients with histopathological diagnosis of ameloblastoma seen over seven years at the Oral and Maxillofacial Surgery Department of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Relevant information was retrieved from patients' records and data obtained were analysed using SPSS version 23, the chi-square test was used to compare qualitative variables, a p-value of <0.05 was considered as significant. Results One hundred and thirty-six cases of ameloblastoma in all age groups were seen within the period. Thirty of the cases met the requirement. The mean age of the patients was 14.4 STD 2.03 (range from 10–17) years. Fourteen (46.7%) patients were male while 16 (53.3%) were female giving a ratio of 1:1.1. The duration of the lesion ranged from 3 months to 72 months (mean 15.07 months). Histologically, the follicular type (n=20, 66.7%) constitute the majority, while the clinical types were solid-multicystic (n=18, 60%) and unicystic (n=12, 40%). Enucleation was the treatment of choice in most (n=18, (60%)) of the patients. Conclusion Ameloblastoma is relatively uncommon in children, especially those less than ten years of age. The solid-multicystic variety was the predominant type in the children studied. Most patients presented long after the onset of the tumour and enucleation with mechanical curettage produced satisfactory results in these patients. Funding None declared
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Affiliation(s)
- Uchenna C Okechi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria, Ituku- Ozalla, Enugu, Nigeria
| | - James O Akpeh
- Department of Otorhinolaryngology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku- Ozalla, Enugu, Nigeria
| | - Felix N Chukwuneke
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria, Ituku- Ozalla, Enugu, Nigeria
| | - Birch D Saheeb
- Department of Oral and Maxillofacial Surgery, University of Benin/University of Benin Teaching Hospital Benin-City, Nigeria
| | - Chukwubuzor U Okwuosa
- Department of Oral and Maxillofacial Pathology, University of Nigeria Teaching Hospital, Ituku- Ozalla, Enugu, Nigeria
| | - Donald I Obi
- Department of Oral and Maxillofacial Surgery, University of Nigeria Teaching Hospital, Ituku- Ozalla, Enugu, Nigeria
| | - Bernard E Ogbozor
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria, Ituku- Ozalla, Enugu, Nigeria
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Bilodeau EA, Hunter KD. Odontogenic and Developmental Oral Lesions in Pediatric Patients. Head Neck Pathol 2021; 15:71-84. [PMID: 33723756 PMCID: PMC8010029 DOI: 10.1007/s12105-020-01284-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Abstract
This article reviews odontogenic and developmental oral lesions encountered in the gnathic region of pediatric patients. The process of odontogenesis is discussed as it is essential to understanding the pathogenesis of odontogenic tumors. The clinical presentation, microscopic features, and prognosis are addressed for odontogenic lesions in the neonate (dental lamina cysts/gingival cysts of the newborn, congenital (granular cell) epulis of the newborn, melanotic neuroectodermal tumor, choristoma/heterotopia, cysts of foregut origin), lesions associated with unerupted/erupting teeth (hyperplastic dental follicle, eruption cyst, dentigerous cyst, odontogenic keratocyst/keratocystic odonogenic tumor, buccal bifurcation cyst/inflammatory collateral cyst) and pediatric odontogenic hamartomas and tumors (odontoma, ameloblastic fibroma, ameloblastoma, adenomatoid odontogenic tumor, primordial odontogenic tumor). Pediatric odontogenic and developmental oral lesions range from common to rare, but familiarity with these entities is essential due to the varying management implications of these diagnoses.
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Affiliation(s)
- Elizabeth A Bilodeau
- School of Dental Medicine, University of Pittsburgh, G-135 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261 USA
| | - Keith D Hunter
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Kalwagadda S, Kumar B, Nair SC, Shah AK, Shroff SS. Management of Ameloblastoma with Free Tissue Flap in Comparison with Other Reconstructive Options Available. J Maxillofac Oral Surg 2020; 19:283-288. [PMID: 32346241 DOI: 10.1007/s12663-019-01203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 02/13/2019] [Indexed: 11/25/2022] Open
Abstract
Aim To review the management and reconstruction of ameloblastoma of mandible in different age groups over a period of 11 years. Methodology This retrospective study includes 51 cases operated in the Maxillofacial Unit, Bhagwan Mahaveer Jain Hospital, Bangalore, from the year 2007 to 2017. The data of these patients were collected to record demographic data such as age, gender with site of tumour and type of reconstruction after resection, follow-up period and incidence of complications. This study evaluated the outcome in terms of aesthetics, function and choice of reconstruction in different age groups. Results Most patients were of 21-40 age group. 37 (72.5%) were found to be unicystic ameloblastoma. 41 (80.3%) patients underwent reconstruction following the resection. There was a change in trend seen over a period of time with free grafts and reconstruction plate being historical, except in special situations like old age and unfit patients. According to one-way ANOVA and Tukey's post hoc analysis, free flaps were known to take a longer duration (mean = 503 min) compared to other modes of reconstruction. However, free grafts and free flaps were demonstrated to have a good facial contour and speech with most cases dentally rehabilitated with implants. Among the complications, 1 (16%) case with reconstruction plate showed screw loosening, 2 (28%) cases with free grafts showed graft exposure, and 1 (3.5%) case with free flap had venous congestion, making free flaps the most reliable option. Conclusion Free fibula is the gold standard of mandible reconstruction, but depending on age, medical condition, economic status and size of the defect other modes of reconstruction can be chosen with the acceptance of suboptimal results.
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Affiliation(s)
- Sowjanya Kalwagadda
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Balasubramanya Kumar
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sanjiv C Nair
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Anjan Kumar Shah
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
| | - Sunil S Shroff
- Department of Oral and Maxillofacial Surgery, Bhagwan Mahaveer Jain Hospital, 17, Millers Road, Kaverappa Layout, Vasanthnagar, Bengaluru, Karnataka 560052 India
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Yang R, Tang Y, Zhang X, Liu Z, Gokavarapu S, Lin C, Ren Z, Zhou Y, Cao W, Ji T. Recurrence factors in pediatric ameloblastoma: Clinical features and a new classification system. Head Neck 2019; 41:3491-3498. [PMID: 31322781 DOI: 10.1002/hed.25867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 01/27/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ameloblastomas of jaw in the pediatric population are a rare clinical entity and have not been well addressed in the literatures. The present retrospective study analyzed the risk factors associated with recurrence of pediatric ameloblastomas. METHODS Cases of primary pediatric ameloblastomas seen in a tertiary hospital between 2005 and 2015 were analyzed to identify the clinical factors associated with recurrence. RESULTS There were a total of 104 cases of primary pediatric ameloblastomas. The overall mean maximum tumor diameter was 4.11 ± 1.339 cm. The receiver operating characteristic curve and the Youden Index showed an optimal cutoff point of 4.95 cm to accurately predict recurrence. Bone cortex/soft tissue invasion were associated with tumor recurrence (P < .001). CONCLUSIONS The maximum tumor diameter, root resorption, and bone cortex/soft tissue invasion were risk factors for recurrence of pediatric ameloblastomas. The new classification system may serve as a predictor of recurrence in pediatric ameloblastomas.
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Affiliation(s)
- Rong Yang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Tang
- Department of Stomatology, Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheqi Liu
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sandhya Gokavarapu
- Discipline of Oral and Maxillofacial Surgery, University Dental Cluster, National University Health System (NUHS), Singapore
| | - Chengzhong Lin
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenhu Ren
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongmei Zhou
- Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Cao
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Fahradyan A, Odono L, Hammoudeh JA, Howell LK. Ameloblastic Carcinoma In Situ: Review of Literature and a Case Presentation in a Pediatric Patient. Cleft Palate Craniofac J 2018; 56:94-100. [PMID: 29715060 DOI: 10.1177/1055665618774021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Ameloblastic carcinomas are rare malignant lesions with 3 mandibular pediatric cases reported in the literature. We present a case of ameloblastic carcinoma in situ in a 15-year-old male with a right mandibular cystic lesion on computed tomography. The incisional biopsy revealed plexiform ameloblastoma. Due to the infiltrating and aggressive nature of the tumor, the patient underwent hemimandibulectomy and immediate reconstruction with a vascularized osteocutaneous fibula free flap. The final pathology was read as ameloblastic carcinoma in situ. Given the rarity of this disease in the pediatric population, this case report may be a valuable addition to the current literature.
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Affiliation(s)
- Artur Fahradyan
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Lauren Odono
- 2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA
| | - Jeffrey A Hammoudeh
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lori Kathryn Howell
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
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Incidental ameloblastoma diagnosed after treatment for childhood tumor. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Meshram M, Sagarka L, Dhuvad J, Anchlia S, Vyas S, Shah H. Conservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature. J Maxillofac Oral Surg 2016; 16:333-341. [PMID: 28717292 DOI: 10.1007/s12663-016-0987-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 12/03/2016] [Indexed: 12/13/2022] Open
Abstract
AIMS The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines. MATERIALS AND METHODS A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010-2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added. RESULTS Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases. CONCLUSION Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.
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Affiliation(s)
- Mitsu Meshram
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
| | - Lalit Sagarka
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
| | - Jigar Dhuvad
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
| | - Sonal Anchlia
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
| | - Siddharth Vyas
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
| | - Harsh Shah
- 117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad, 16 India
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Focal Benign Disorders of the Pediatric Mandible With Radiologic-Histopathologic Correlation: Mandibular Development and Lucent Lesions. AJR Am J Roentgenol 2016; 208:180-192. [PMID: 27762604 DOI: 10.2214/ajr.16.16587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Lucent lesions of the pediatric mandible may present variably. Cysts, neoplasms, and developmental and inflammatory conditions have a host of possible causes. There is also substantial overlap in the imaging appearance of cysts and that of benign but locally aggressive tumors that need to undergo resection. CONCLUSION The purpose of this article is to present common and uncommon lucent lesions of the mandible in children, with an emphasis on benign abnormalities. Discussions of imaging and histopathologic features are provided.
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