J Korean Assoc Oral Maxillofac Surg.  2017 Apr;43(2):115-119. 10.5125/jkaoms.2017.43.2.115.

Aggressive unicystic ameloblastoma affecting the posterior mandible: late diagnosis during orthodontic treatment

• Pereira de Castro Lopes SL
• Flores IL
• de Oliveira Gamba T
• Ferreira-Santos RI
• Leonelli de Moraes ME
• Alvarez Cabello A
• Nascimento Moutinho P

• KMID: 2377015
• DOI: http://doi.org/10.5125/jkaoms.2017.43.2.115

Abstract

Maxillofacial images must be examined to find pathologies not identified during clinical examination. Unicystic ameloblastoma (UA) extending to the mandibular body and ramus was neglected on initial panoramic radiographic examination. After orthodontic therapy, a huge lesion was observed clinically and through imaging exams. After the conservative surgery, no recurrence was observed during five years of follow-up. This case emphasized the need for careful evaluation of patient images focusing on the oral diagnosis before any dental treatment planning, including orthodontic therapy.

Keyword

Oral diagnosis; Dentistry; Diagnostic imaging; Ameloblastoma

MeSH Terms

Ameloblastoma*
Delayed Diagnosis*
Dentistry
Diagnosis, Oral
Diagnostic Imaging
Follow-Up Studies
Humans
Mandible*
Pathology
Recurrence

Figure

• 

  Fig. 1 First panoramic radiograph acquired for orthodontic planning showed a unilocular radiolucent image associated with the mandibular right third molar.

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  Fig. 2 Panoramic radiograph after the orthodontic treatment showing a well-defined extensive unilocular lesion with the involvement of the mandibular third molar.

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  Fig. 3 Axial and coronal computed tomography scans highlighting lesion expansion. Note the lingual and buccal cortical plate expansion and thinning.

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  Fig. 4 Panoramic radiograph showing the decompressed lesion area with a radiopaque filling, suggesting bone neoformation.

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  Fig. 5 Panoramic radiographs revealed the right posterior mandible after complete lesion curettage (A) and bone neoformation (B).

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  Fig. 6 Panoramic reconstruction and parasagittal slices showing a complete bone neoformation and the dental implants osseointegration.

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