Comparison of long-term results between different approaches to ameloblastoma

Objective. The long-term results of different surgical approaches to ameloblastoma were compared to develop a more rational surgical approach to this tumor. Study design. Seventy-eight primary ameloblastomas, including 27 unicystic, 21 multicystic, and 30 solid-type tumors, were examined in this study. The methods of treatment consisted of radical surgery (ie, resection-both segmental and marginal) and conservative treatments (ie, marsupialization alone, marsupialization followed by enucleation with sufficient bone curettage if necessary, and enucleation with bone curettage). The effect of marsupialization on recurrence data after a follow-up period of at least 5 years was evaluated with respect to clinical type and histologic pattern. Results. Marsupialization was performed in 31 cystic ameloblastomas before surgery, and the effective rate of marsupialization was 74.2%. Recurrence was observed in 7.1% (3/42) after radical surgery and in 33.3% (12/36) in conservative treatments. Relatively higher tendencies of recurrence were observed in the multicystic type and follicular and/or plexiform pattern tumors. Conclusions. Conservative treatments including marsupialization and enucleation followed by sufficient bone curettage were thought to be useful, reducing the need for jaw resection. This result extends the indications for conservative treatment of ameloblastoma.