Summary Of Ameloblastoma
- Ameloblastoma is a rare benign but aggressive tumor of jaw bone and soft gingival tissue.
- Due to its aggressive nature, it can cause destruction of the jaw bone.
- Almost 1 to 3 percent of all jaw tumors are ameloblastoma.
- It can develop in upper jaw or lower jaw, but the more preferential site of involvement is near the molars that are yet to erupt.
- This growth arises from the cells that normally transform to develop into enamel. In fact it can be said that it is a neoplasm of enamel.
- Ameloblastoma usually develops in people between ages of 30 and 40. It can cause distortion and disfigurement of the face if the growth enlarges in size.
- Diagnosis is easily made with the help of CT, MRI, and biopsy of the tumor.
- Treatment modality includes complete surgical excision of the tumor. However, recurrence of the tumor is possible.
Types Of Ameloblastoma
- There are three variants of ameloblastoma.
- They are solid or multicystic ameloblastoma, unicystic ameloblastoma, and peripheral ameloblastoma.
- The first two mostly develop in the jaw bones. The last peripheral ameloblastoma develops in the gingival tissue of the lower jaw near the area of premolar or canine tooth.
- Multicystic is common and occurs in the middle aged individuals.
- Unicystic variety is seen in young individuals between 20 and 30 years. The growth has affinity to develop in the lower jaw. It is less aggressive than multicystic ameloblastoma.
- Peripheral ameloblastoma develops in the gingival and mucus lining of the buccal cavity. People affected are more than 40 years of age. This form of ameloblastoma is less aggressive than both other variants.
What Is The Cause Of Ameloblastoma?
- The origin of ameloblastoma is from ameloblasts. They are the cells that form the tooth enamel, the hard outer layer of the tooth.
- Its occurrence is more prevalent in people having impacted teeth.
- The exact cause is not very well understood, but trauma to the jaw, infection of tooth and gum, or lack of vital nutrients is suspected to be the underlying triggers.
- People suffering from Gorlin-Goltz syndrome are vulnerable to develop this condition.
- The disease is seen in adults with an average age between 30 to 40 years.
- The timorous growth is more prevalent in men as compared to women. But the size of tumor is usually larger in females.
- It can occur in any person, but ameloblastoma is often seen in African Americans.
Signs And Symptoms Of Ameloblastoma
Following are the signs and symptoms of ameloblastoma;
- The growth can occur in lower jaw or upper jaw. But it is seen more in lower jaw in the third molar area.
- The tumor is painless.
- Ameloblastoma is aggressive tumor and can destroy the lining of jaw when it grows and spreads to the sinuses and socket of the eye.
- Person with this tumor has loose teeth with presence of soft gums and mouth sores.
- Patient has facial deformation due to the progressive and destructive tendency of the growth, although the tumor is non cancerous. Deformity is caused due to growth of the tumor.
- Because of the tumor, patient is not able to fix his dentures or bridges.
- The condition is painful if it spreads to the nasal sinuses or at the base of nose.
Diagnosis And Treatment Of Ameloblastoma
- Diagnosis of the tumor is possible with the help of radiographic imaging techniques such as CT scan and MRI of the jaw.
- Biopsy of the tissue from the affected site is a confirmatory test for ameloblastoma.
The modality of treatment depends on several factors such as the size of tumor, its location in the jaw area, variety of ameloblastoma and involvement of nearby area such as nasal sinus.
- Surgical excision of the tumor is the treatment of choice. Although the tumor is non malignant, it is quiet aggressive and therefore may destroy the jaw bone slowly if it is not treated.
- Once the tumor is surgically removed, patient may need reconstruction of the face to reduce disfigurement.
- Even after its surgical removal, ameloblastoma has tendency to reoccur. In such situation repeat surgery may be needed.