Ameloblastoma Management: “Horses for Courses” Protocol

  • Suresh MenonEmail author
  • Veerendra Kumar
  • S. Archana
  • Priyangana Nath
  • Satyapriya Shivakotee
  • Mahbubul Hoda
Original Article



The purpose of the article is to review 45 cases of ameloblastoma treated in a tertiary care centre depending on the extent of the pathology, in terms of recurrence and morbidity of the patients.

Materials and method

This was a retrospective study of patients who underwent treatment for ameloblastoma between 2009 and 2018 at Vydehi Institute of Dental Sciences, Bangalore. During the first phase of 4 years, the focus of the treatment was on avoiding any recurrence, and therefore, resection followed by reconstruction with reconstruction plates was the only modality used in ten patients. However, from 2014, it was decided to treat each patient based on the extent of the lesion and decide on either conservative management in the form of enucleation followed by peripheral ostectomy and chemical cauterisation or resection with safe margins and reconstruction with reconstruction plates.


The study sample consisted of 45 patients, and the ages ranged from 12 to 65 years with an average of 36. There were 30 males and 15 females. In the first phase of treatment protocol adopted, ten patients underwent resection. In the later period, 18 patients were treated by conservative methods and 16 patients were treated by radical management. There were only three recurrences over a period of 3-year follow-up in the group treated conservatively.


Considering the benign nature of the tumour and the morbidity after resection, patients, most of whom are in the younger age group, can still be subjected to conservative treatment provided they are followed up for a long period thus assuring them of a better quality of life.


Enucleation Carnoy’s solution Recurrence Ameloblastoma Resection 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Eckardt AM, Kokemuller H, Flemming P, Schultze A (2009) Recurrent ameloblastoma following osseous reconstruction—a review of twenty years. J Craniomaxillofac Surg 37:36–41CrossRefGoogle Scholar
  2. 2.
    Fregnani ER, da Cruz Perez DE, de Almeida OP, Kowalski LP, Soares FA, de Abreu AF (2010) Clinicopathological study and treatment outcomes of 121 cases of ameloblastomas. Int J Oral Maxillofac Surg 39:145–149CrossRefGoogle Scholar
  3. 3.
    Shi S, Liu Y, Shan Y, Fu T, Zhao S (2014) Enucleation combined with peripheral ostectomy: its role in the management of large cystic ameloblastomas of the mandible. J Cranio-Maxillo-Facial Surg 42:1659–1663CrossRefGoogle Scholar
  4. 4.
    Pogrel MA, Montes DM (2009) Is there a role for enucleation in the management of ameloblastoma? Int J Oral Maxillofac Surg 38:807–812CrossRefGoogle Scholar
  5. 5.
    Tingchun W, Zhe C, Fengchen T, Quanziang T, Citing Y (1984) Ameloblastoma of the mandible treated by resection, preservation of the inferior alveolar nerve, and bone grafting. J Oral Maxillofac Surg 42:93–96CrossRefGoogle Scholar
  6. 6.
    Gardner DG (1984) A pathologist’s approach to the treatment of ameloblastoma. J Oral Maxillofac Surg 42:161–166CrossRefGoogle Scholar
  7. 7.
    Ueno S, Mushimoto K, Shirasu R (1989) Prognostic evaluation of ameloblastoma based on histologic and radiographic typing. J Oral Maxillofac Surg 47:11–15CrossRefGoogle Scholar
  8. 8.
    Nakamura N, Higuchi Y, Mitsuyasu T, Sandra F, Ohishi M (2002) Comparison of long-term results between different approaches to ameloblastoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:13–20CrossRefGoogle Scholar
  9. 9.
    Bataineh AB (2000) Effect of preservation of the inferior and posterior borders on recurrence of ameloblastomas of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:155–163CrossRefGoogle Scholar
  10. 10.
    Huffman GG, Thatcher JW (1974) Ameloblastoma—the conservative surgical approach to treatment: report of four cases. J Oral Surg 32:850Google Scholar
  11. 11.
    Haqa J, Siddiquib S, McGurkc M (2016) Argument for the conservative management of mandibular ameloblastomas. Br J Oral Maxillofac Surg 54:1001–1005CrossRefGoogle Scholar
  12. 12.
    de Paulo LFB, Oliveira MTF, Rodrigues ÁR, Zanetta-Barbosa D (2015) Short communication treatment of an extensive unicystic ameloblastoma in a 7-year-old child: the best approach? Br J Oral Maxillofac Surg 53:292–294CrossRefGoogle Scholar
  13. 13.
    Chapelle KA, Stoelinga PJ, de Wilde PC, Brouns JJ, Voorsmit RA (2004) Rational approach to diagnosis and treatment of ameloblastomas and odontogenic keratocysts. Br J Oral Maxillofac Surg 42:381–390CrossRefGoogle Scholar
  14. 14.
    Robinson L, Martinez MG (1977) Unicystic ameloblastoma: a prognostically distinct ent ity. Cancer 40:2278CrossRefGoogle Scholar
  15. 15.
    Lee PK, Samman N, Ng IO (2004) Unicystic ameloblastoma—use of Carnoy’s solution after enucleation. Int J Oral Maxillofac Surg 33:263–267CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryVydehi Institute of Dental SciencesBangaloreIndia

Personalised recommendations