A STUDY ON THE PROGNOSIS AFTER ENUCLEAT10N IN THE UNICYSTIC AMELOBLASTOMA

Jeong, Young Soo; Lee, Eui Wung

Abstract

Since the apparent development of ameloblastoma in the wall of a dentigerous cyst was first described by Cahn in 1933. many colleagues have reported the ameloblastoma originated odontogenic cyst. In 1970. Vickers and Gorlin published specific histologic criterria of the ameloblastoma originated odontogenic cyst, and in 1977, robinson and Martinez referred to this variant as unicystic ameloblastoma in which the tesponse to encleation or curettage was found to be fanorable with low recurrence rate. This lesion was divided into 3 Groups (luminal, plexiform, connective tissue invasion type) according to the histopathologic feature by Ackeymann etc. in 1988, and they recommended radical treatment In connective tlssue Invasion type. Conservative enucleation and currettge have been reported the choice treatment compared with conventional ameloblastoma. which has represented low recurrent rate, but the study on the prognosis after enucletion according to the histologic subtypes of the unlcystic ameloblastoma has been rare. This study is to invested the recurrence and clinical features of 22 ameloblastomas which have been experienced by enucleation as trearment method from January 1990 to October 1997 in Dental College Hospital of Yonsei University. The results obtained are as follows. 1. The most common patients complains were painless or painful swelling of jaw(19 cases, 86.4%). dysthesia (2 cases, 9.1%), pus discharge (1 case, 4.5%) were next In order. 2. The most frequent age was 2nd decade which was 12 cases(54.5%), and next frequent age was 3rd decade which was 8 cases (36.5%). The average age was 20.5 years old, and sex ratio was 1.4:1 (male female). 3. All 22 cases were developed in the mandible, and body area occupied 15cases (68.2%), ramus area was 6 Cases(27.2%) and symphysis area was 1 case (4.5%). 4. Radiographically, unilocular type was 81.8%, and the cases related with impacted tooth were ular type and 3 cases (75%) In multllocular type. 5. According to histologic subtype by Ackermann's classification, luminal type and were 4case(18.2%) respeclively, connective tissue type was 12 cases (63.6%). 6. Average follow-up period was 3.4 years, and the recurrence was 1 case(4.5%) of total 22 cases, which was connective tissue Invasion type (7.14%) histologically. Based on the above results, when patient's function, esthetics, and paychologic factor are considered,the enucleation was adequarte primary treatment modality In any histologic type of the unlcystic ameloblastoma