Plexiform unicystic ameloblastoma: a case report and data analysis in the Indian population

Relapses after using Carnoy's solution in treating aggressive benign odontogenic lesions

BACKGROUND

Chemical curettage has become popular in the definitive treatment of benign aggressive odontogenic lesions. Therefore, this study aims to verify the relapse rate and associated factors after the enucleation protocol, peripheral ostectomy and Carnoy's solution.

METHODS

This is a retrospective sectional study with 30 patients, selected by non-probabilistic convenience sampling, submitted to the protocol from 2008 to 2018. The study was composed by the data collection phase of the medical records and clinical and radiographic analysis of the patients in order to verify the presence of relapses. Descriptive and statistical analyzes were performed using the Stata/IC version 14.0 program (StataCorp, College Station, TX, USA). The Mann-Whitney Test, Fisher's Exact Test and the χ2 Test, as well as the Kaplan Meier method and the Log-rank Test were used to verify the possible prognostic factors for relapses, adopting P<0.05.

RESULTS

The sample consisted of 22 patients with odontogenic keratocysts (73.3%), 3 odontogenic myxomas (10%) and 5 ameloblastomas (16.7%). Relapses affected 7 patients (23.3%), all in odontogenic keratocysts, and the relapse time was between 12-34 months. There was no statistical difference between the evaluated factors and relapse development. Patients who remained with teeth adjacent to the lesion after treatment had an earlier relapse time, a cumulative risk of more than 80% for relapse after 29 months postoperatively, and a 5.5 times greater chance of developing relapses than patients who had their teeth extracted.

CONCLUSIONS

The protocol is advantageous when compared to isolated treatments and can be used as an alternative to resection.

Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature

BACKGROUND AND OVERVIEW

Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings.

CASE DESCRIPTION

In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.