Article: Volume 47 Number 6 Page 510 - June 2020

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  Dent Update 2020; 47: 510-514

Oral and Maxillofacial Surgery:  Is Less More? A Conservative Multidisciplinary Approach to Ameloblastoma

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Abstract: This case report outlines a novel conservative surgical approach to the management of a unicystic ameloblastoma with the use of marsupialisation, enucleation, cryotherapy and orthodontic extrusion to enable successful treatment without neurological damage or deformity. It has been increasingly recognized that conservative treatment of unicystic ameloblastomas, instead of wide local excision, can reduce morbidity whilst maintaining an acceptably low recurrence rate. Several case series have also demonstrated orthodontic extrusion of impacted third molars in moving the apex of the roots away from the inferior alveolar nerve. This is possibly the first case report of the combination of these two procedures in an adult with a large unicystic ameloblastoma.

Clinical relevance: This is not an infrequently seen neoplasia: this paper therefore has the opportunity to inform management of this condition amongst clinicians.

Author notes: Hussein Mohamedbhai, MRCS, BM, BDS, MMedSc, Oral and Maxillofacial Surgery ST1, Debipriya Dasgupta, MRCS, MBBS, BDS, BSc, Oral and Maxillofacial Surgery ST3, Oral and Maxillofacial Surgery Department, Whipps Cross Hospital, London E11 1NR, Charlotte Hubbett, BSc, MBBS, FY1 in Emergency Medicine at Newham University Hospital and Nayeem Ali, FRCS, FDS, MBBS, BDS, Consultant Oral and Maxillofacial Surgeon, Oral and Maxillofacial Surgery Department, Whipps Cross Hospital, London E11 1NR, UK.

Objective: To inform the management and improved outcome in certain cases of unicystic ameloblastoma associated with an unfavourably positioned third molar tooth.

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