From Volume 46, Issue 9, October 2019 | Pages 862-864
This case involves a 46-year-old female who was referred to the Bristol Dental Hospital Oral and Maxillofacial Surgery department with a non-healing socket. Investigations were carried out and biopsy confirmed diagnosis of granular cell ameloblastoma. She was subsequently treated with a segmental resection and a bone graft to reconstruct the defect of her mandible.
The healing of an extraction socket is generally an uncomplicated process; however, it is not an uncommon finding for delayed healing to take place. Clinicians are faced with this post-operative complication in both primary and secondary care settings. In the majority of cases of delayed healing from extraction sockets, it is local factors which dominate, such as clot disintegration, secondary infection or foreign bodies within the socket.1 However, other lesions which may complicate healing can be overlooked and underestimated owing to their rare occurrence. Failure of the alveolus to heal post exodontia in the absence of any medical or dental pathology is a feature which should raise the index of suspicion for other differential diagnoses to be considered, including a possible intra-oral neoplastic tumour.2
Odontogenic tumours encompass a group of lesions of variable clinical behaviour and histopathology.3 Of all swellings within the oral cavity, 9% are odontogenic tumours and, within this group, ameloblastoma accounts for 1% of them.3 Ameloblastoma is a slow-growing odontogenic tumour of the jaw often presenting in the second decade of life.4 There are different histopathological variants of ameloblastoma, of which plexiform and follicular subtypes are more common.5 A rare subtype of ameloblastoma which has been reported as being more aggressive is the granular cell subtype, and this accounts for less than 5% of cases.6 If left untreated, it can cause severe facial abnormalities and consequently have significant impact on patients' lives.
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