Ameloblastoma

The ameloblastoma (from Old English amel " melting " and Ancient Greek βλάστη ( blastä ) "seed" ) ( obsolete: Adamantinoma ) is a locally invasive tumor which by the enamel- forming cells, the ameloblasts derived.

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Pathology

The outgoing from the teeth ( odontogenic ) tumors are derived from the embryonic tooth germ. This consists of mesodermal and ectodermal components ( see cotyledon ). The ameloblastoma is a frequent tendency to relapse and is usually benign, that is, it does not form metastases. Rarely is the malignant ( malignant) ameloblastoma, this can result from a preexisting benign ameloblastoma or arise de novo. We distinguish between the tubular ( follicular ) type and reticular ( plexiform ) type.

Clinic

The ameloblastoma is usually an incidental finding, which appears as a painless Kieferauftreibung. About 30% of ameloblastomas go out of follicular cysts. In later stages may resorption by the position of the teeth and cause by displacement and pressure on nerve sensory disturbances. It is found in the lower jaw ( preferred locations: the mandibular angle and ascending ramus ) six times more likely than in the maxilla ( canine ). Are mostly affected younger patients ( age 30 - 40 ), the distribution of men and women is high about the same.

Diagnosis

A diagnosis is only possible by histological examination of the cyst -like bellows. Radiographic evidence may be the fact that neoplastic events are more prone to Zahnresorptionen. However Zahnresorptionen may occur rarely in normal odontogenic cysts.

Imaging methods

Radiographically, a one - ( like soap bubbles ) or multi-chamber ( honeycomb- like) shows by bone osteolysis resolutions sharply defined with whitening resolution of the cortex.

Differential Diagnosis

  • Radicular cyst at the root tip, it is clear from Mallassez'schen epithelial
  • Follicular cyst on the lower jaw, rare transition in ameloblastoma
  • Keratocystic odontogenic tumor (formerly keratocyst )
  • Odontogenic Plattenepitheltumor
  • Calcifying epithelial odontogenic tumor ( Pindborg tumor)
  • Ameloblastic fibroma
  • Ameloblastic fibro-
  • Ameloblastic fibrodentinoma
  • Odontoameloblastoma
  • Giant cell granuloma
  • Osteosarcoma

Therapy

The treatment of choice is resection safe in healthy individuals with a safety margin of 5 mm and the subsequent primary bone reconstruction. Prognostic postoperatively to expect the previous situation, due to the tendency for recurrence but are (semi-) recommended annual inspections over a period of 5 to 10 years.

Swell

Note: The term ameloblastoma is an etymological bastard.

Germ layer
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