Ameloblastoma secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Secondary Prevention
Recurrence is common, although the recurrence rates for block resection followed by bone graft are lower than those of enucleation and curettage.[18] Follicular variants appear to recur more than plexiform variants.[2] Unicystic tumors recur less frequently than "non-unicystic" tumors.[2] Persistent follow-up examination is essential for managing ameloblastoma.[19] Follow up should occur at regular intervals for at least 10 years.[20] Follow up is important, because 50% of all recurrences occur within 5 years postoperatively.[2] Recurrence within a bone graft (following resection of the original tumor) does occur, but is less common.[21] Seeding to the bone graft is suspected as a cause of recurrence.[19] The recurrences in these cases seem to stem from the soft tissues, especially the adjacent periosteum.[22] Recurrence has been reported to occur as many as 36 years after treatment.[23] 0 Rates of recurrence may be as high as 15% to 25% after radical treatment and 75% to 90% after conservative treatment Recurrence rates of ameloblastoma are reportedly as high as 15-25% after radical treatment[13–15] and 75-90% after conservative treatment.[13–17] Therefore, wide resection of the jaw in accordance with the treatment of malignant tumors is usually recommended for ameloblastomas. Recent advancements in understanding the biological behaviors of ameloblastoma have led to more rational surgical approaches.
To reduce the likelihood of recurrence within grafted bone, meticulous surgery[21] with attention to the adjacent soft tissues is required.[2