Odontogenic tumours in children and adolescents: a study of 78 Nigerian cases.

BACKGROUND: There is paucity of literature on odontogenic tumours in children and adolescents. Available records are difficult to compare due to differences in study criteria. To contribute to the records, a 20-year study of odontogenic tumours on the basis of the WHO classification (Kramer et al., 1992) in Nigerian African children and adolescents < or =18 years of age was undertaken. MATERIAL: A retrospective survey of oral/jaw tumours and allied lesions in children and adolescents < or =18 years of age seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria between 1979 and 1998. Data collected were histopathologic type, age, clinical features, radiologic appearance, treatment and record of recurrence. METHOD: Odontogenic tumours selected using the WHO classification were used for further study. Data were collected from case notes, radiographs, histopathologic reports and follow-up records. Information retrieved was used to complete a questionnaire and subjected to analysis. RESULTS: Two hundred and fifty-two (252) subjects < or =18 years were recorded, from which 78 (31%) had odontogenic tumours. Among seven types of odontogenic tumours seen, ameloblastoma (54%), odontogenic myxoma (19%) and adenomatoid odontogenic tumour (9%) were predominant. All patients seen were from 6 to 18 years with more than half (53%) between 15 and 18 years of age. A patient with multiple, bilateral odontomas of the maxilla and mandible resembling Herrmann's syndrome was recorded. Seventy-three patients were treated using enucleation (37%), dentoalveolar resection with preservation of lower border (15%) and segmental resection (48%). Five patients absconded after tumour diagnosis. No tumour recurrence was recorded in 65 treated cases followed-up for between 2 months and 10 years. CONCLUSION: This report shows that while ameloblastoma was the predominant odontogenic tumour, its frequency in Nigerian African children was lower than in the adult population. A case resembling Herrmann's syndrome is also presented.     

Odontogenic tumors: a review of 319 cases in a Nigerian teaching hospital

OBJECTIVE: This study sought to determine the relative frequency of odontogenic tumors in a Nigerian population and to compare these data with previous reports. STUDY DESIGN: Records of patients seen at the Lagos University Teaching Hospital between January 1980 and December 2003, with histologic diagnosis of odontogenic tumors (based on World Health Organisation classification, 1992), were analyzed. RESULTS: Odontogenic tumors constituted 9.6% of all the biopsies of oral and jaw lesions seen within the period under study. Three hundred and eight (96.6%) were intraosseous, and 11 (3.4%) were peripheral (peripheral odontogenic fibroma=7; peripheral myxoma=3; peripheral ameloblastoma=1). The mean age of patients was 29.9+/-15.6 years (range, 4-85 years). Among these cases, 96.6% of the tumors were benign and 3.4% were malignant. Ameloblastoma with predilection for the mandible was the most frequent odontogenic tumor (63%), followed by adenomatoid odontogenic tumor (AOT) (7.5%), myxoma (6.5%), calcifying epithelial odontogenic cyst (5.3%), and odontogenic fibroma (5.3%). More cases of malignant odontogenic tumors were seen than cases of calcifying epithelial odontogenic tumor and odontomas. The mean ages of patients with AOT, ameloblastic fibroma, and odontoma were significantly lower than those with ameloblastoma ( P<.05). No significant difference was found between the mean ages of patients with benign odontogenic tumors and those with malignant odontogenic tumors ( P=.058). CONCLUSIONS: Odontogenic tumors, especially ameloblastoma, are not considered rare among Nigerians, whereas odontoma, regarded as the most frequent odontogenic tumor in North and South America, is rare.     

Ameloblastoma in children and adolescents

This study first reviewed the data of 37 patients aged 18 years and younger with ameloblastoma over a 16-year period and then reviewed the literature on this subject from 1970 to 2009. Of 37 patients with ameloblastoma, 23 were male and 14 were female, a ratio of 1.6:1. The mean age was 14.8 years. All lesions were in the mandible. Clinical typing included 28 solid type and 9 unicystic type. Ten cases were recurrent (27.0%). A series of literature review disclosed 233 well-documented cases of ameloblastoma in children and adolescents. The ages ranged from 4 to 20 years with a mean age of 14.5 years. The distribution among males and females were almost identical: 53.6% (125/233) males and 46.4% (108/233) females (1.16:1). The mandible was affected in 225 (96.6%), the maxilla in 8 (3.4%). Histologically, solid type (63.1%) predominated over unicystic type (36.9%). Of 226, 123 (54.4%) patients were treated with radical resection, 103 (45.6%) underwent conservative method. Owing to a high recurrent rate of ameloblastoma, solid type of tumors should be approached with radical surgical treatment, while conservative measure can be applied selectively to unicystic type. Long-term follow-up is important because recurrence may appear years after tumor removal.     

Odontogenic tumors in an Iranian population: a 30-year evaluation

Oral and maxillofacial pathology has paramount importance in connecting basic science and clinical features; progress in this field will improve diagnosis and treatment. Although the prevalence of odontogenic tumors varies in different geographic sites, there are no reports in English on the relative frequency of odontogenic tumors in Iran. In the present 30-year retrospective study, the case records of all patients referred to the Mashhad Faculty of Dentistry during the period 1978-2008 were evaluated. Subsequently, all lesions diagnosed as odontogenic tumors were subjected to microscopic reevaluation. Data regarding sex, gender, location, and histopathology were gathered. Among 8,766 patients, only 165 odontogenic tumors (1.9%) were found, with a mean age of 26.3 years (range 6-81 years). One hundred and fifty-eight tumors were central with high frequency in the posterior region of both jaws especially in the mandible and seven were peripheral tumors, including five in the posterior mandible and two in anterior maxilla. Malignant transformation was seen in three cases as malignant ameloblastoma (1.8%). The most common tumor was ameloblastoma, followed by odontoma, odontogenic myxoma, and adenomatoid odontogenic tumor. Nevertheless, odontogenic tumors occurred more in females in the third decade with affinity for the posterior mandible in this study.     

Orofacial tumours in suburban Nigerian children and adolescents

We report the type and distribution of orofacial tumours in south-western Nigerian children and adolescents. The 512 records of patients with oral and maxillofacial tumours in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, from 1991 to 2001, were searched and the 146 records (28%) of patients aged 19 years and less were reviewed. Their mean age was 10 years (female:male ratio 1:1.4). Of the 146 tumours 74 (51%) were malignant and 72 (49%) were benign. Of the latter 31 were from soft tissue and 41 were from the jaw (20 odontogenic and 21 non-odontogenic). The most common benign soft tissue and jaw tumours were gingival epulis and ameloblastoma respectively. Of the malignant tumours 67 were lymphomas, 5 sarcomas and 2 carcinomas.     

Recurrent ameloblastoma of the maxillo-facial region. Clinical features and treatment

21 recurrent cases of ameloblastoma in the maxillofacial region in Nigerian subjects are described. These had a typical age, sex and site distribution and characteristic clinical features. Extension of the disease into the cranial vault was seen in one individual but no metastasis was detected at presentation and follow-up review. The effective surgical treatment was en bloc excision with preservation of the lower border of the mandible or radical resection often including adherent soft tissues and skin. Follow-up data were recorded and all the patients were free from the disease for 6 months to 6 years.     

A review of 318 odontogenic tumors in Kaduna, Nigeria.

PURPOSE: To analyze 318 odontogenic tumors seen at a tertiary oral care center in Kaduna, Nigeria for comparison with findings in previous Nigerian and world records. MATERIALS AND METHODS: A retrospective survey of odontogenic tumors based on the classification of Kramer et al was undertaken at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, from all histopathologically proven cases of tumors and tumor-like lesions of the oral and perioral structures. Data were retrieved from case notes, radiographs, histopathology results, and follow-up records. Information collected were used to complete a questionnaire and subjected to analysis. RESULTS: There were 990 tumor and tumor-like lesions of the oral and perioral structures, of which 318 were odontogenic tumors (32%). Twelve histopathologic types of odontogenic tumors were found with more benign (n=314; 99%) than malignant (n=4; 1%). Ameloblastoma made up 233 (73%) of the tumors, followed by odontogenic myxoma (n=38; 12%), ameloblastic fibroma (n=9; 3%), and the adenomatoid odontogenic tumor (2%). Three cases of calcifying odontogenic cyst were co-existent with ameloblastoma (2) and ameloblastic fibro-odontoma (1). Among 275 surgically treated odontogenic tumors, enucleation was performed in 64 cases (23%), dentoalveolar segment resection with preservation of lower border of the mandible (n=33; 12%), segmental resection (n=168; 61%), and composite resection (n=9; 3%); 1 case was deemed inoperable. At least 8 cases of ameloblastoma (13%) recurred out of 60 followed up. CONCLUSION: Ameloblastoma is a fairly common tumor of Nigerian Africans accounting for 73% of odontogenic tumors and 24% of all tumors and tumor-like lesions of the oral and perioral structures. Various forms of resection are practiced to eradicate the tumor in view of the late presentation in our environment. Patients in Nigeria do not often return for follow-up reviews. A minimum of 5 years of follow-up reviews are necessary after treatment of ameloblastoma.     

促结缔组织增生性成釉细胞瘤的X线分析

目的 总结促结缔组织增生性成釉细胞瘤的X线特点。方法 对病理确诊的15例促结缔组织增生性成釉细胞瘤的X线表现进行回顾性分析,并与一般型成釉细胞瘤对比观察。结果 促结缔组织增生性成釉细胞瘤主要位于前牙区和（或）前磨牙区（13／15）。X线有3种表现：①单房改变（7／13）,病变范围小且有密度不均小片状或条索状影像;②多房性皂泡状改变（2／13）,肿瘤内有较多致密条纹样直线或不规则状骨隔;③混合性改变（4／13）,病变区内可见似丛增生团块,边缘带伴有单囊状改变。该瘤组织学上以大量增生的纤维结组织间质中散在不规则、压缩状上皮岛或条索为特点。结论 促结缔组织增生性成釉细胞瘤为成釉细胞瘤的一种新的类型,具有特征性X线和组织学表现,X线方面应与骨化性纤维瘤和牙源性粘液瘤等鉴别。     

Clinical features and management of oral and maxillofacial tumors in children.

OBJECTIVE: To clarify the characteristics of oral and maxillofacial tumors in children, we carried out a clinical study of such tumors and reviewed the relevant procedures for treatment. Study design. Medical records of 105 patients less than 15 years of age who were treated for oral and maxillofacial tumors during the 20 years between 1976 and 1997 were retrieved and analyzed. RESULTS: Of the 105 cases, 102 (97.1%) involved tumors that were benign; only 3 patients (2.9%) had tumors that were malignant. With regard to benign soft tissue tumor, the most common type was hemangioma (25/69; 36.2%), the second most common type was papilloma (19/69; 27.5%), and the most common site was the tongue. With regard to bone tumor, the most common type was odontoma (14/33; 42.4%), the second most common type was ameloblastoma (11/33; 33.3%), and the most common site was the mandible. Most of the odontogenic tumors (25/28; 89.3%) developed in patients more than 6 years of age; these tumors may develop after dental crown formation. In each case of benign soft tissue tumor, resection was performed; 4 of these tumors (2 hemangiomas, 1 lymphangioma, and 1 papilloma) recurred, but after re-resection recurrence has not been found for more than 4 years. In the cases of benign jawbone tumor, resection and enucleation were the procedures principally performed; 3 ameloblastomas recurred after enucleation, but after relatively wide resection for these recurrent tumors there has been no recurrence for more than 17 years. With regard to the ameloblastomas, enucleation with preservation of the periosteum was effective and bone regeneration occurred rapidly. CONCLUSIONS: Most oral and maxillofacial tumors in children are benign. In any case of such benign tumor, including ameloblastoma, minimal surgical treatment should be the procedure of first choice.     

Ameloblastoma in children.

PURPOSE: The purpose of this report was 1) to report the experience of the University of Maryland, Department of Oral and Maxillofacial Surgery (OMS Department) in the treatment of ameloblastoma in children and 2) to review the world literature on the treatment of ameloblastoma in children from 1970 to 2001. METHODS AND MATERIALS: This study first reviews the experience of the OMS Department of the University of Maryland with ameloblastomas in children and then reviews the literature on this subject. The first part of the study was undertaken by a retrospective chart review of all patients with a diagnosis of ameloblastoma in the OMS Department between May 1991 and December 1999. The literature on ameloblastoma in Western societies and Africa was separately reviewed from 1970 through 2001. Reports earlier than 1970 were not reviewed, as the histologic diagnosis of ameloblastoma was not well defined before that period. RESULTS: In the Maryland series, 11 patients under the age of 20 years with ameloblastoma were treated. Eight patients were seen primarily, and 3 presented with recurrent lesions. The average age was 15.5 years; 5 of 11 patients were black, and 9 of 11 tumors were unicystic ameloblastomas. The literature review showed 85 children in the Western reports and 77 reported from Africa. The average ages were 14.3 and 14.7 years, respectively, but unicystic ameloblastomas accounted for 76.5% of the Western and only 19.5% of the African children, with an increased frequency of occurrence in the mandibular symphisis in African (44.2%) versus Western (5.8%) patients. Analysis of recurrence after enucleation of unicystic ameloblastomas in 20 children followed at least 5 years or until recurrence showed a recurrence of 40%. CONCLUSIONS: Ameloblastomas in children differ from adults, with a higher percentage of unicystic tumors. African children appear to resemble the adult pattern. Although enucleation has been claimed to give acceptable recurrence rates in unicystic ameloblastoma, there are no large series with long follow-up in children. The histologic pattern that exhibits mural invasion in unicystic ameloblastoma suggests that more aggressive surgery is necessary.     

Oral tumors in children: a review

The objective of this study was to present an analysis of the incidence and diagnosis of 172 oral tumors in Jordanian children and adolescents. During the period of evaluation, 1605 patients with oral cavity tumors were seen. Of which 172 (11%) were in children under 18 years, who were treated after histopathological confirmation of the diagnosis during the 18 years 1980-1998. Diagnosis, incidence and age at presentation were the main outcome measures, and the results showed that 156 patients (91%) had benign tumors and 16 patients (9%) were malignant. The most common benign tumor was haemangioma 24 (14%), and the most common malignant tumor was sarcoma 15 (8.5%). The most common odontogenic tumor was odontoma 35 (20%), and non-odontogenic tumor, ossifying fibroma 4 (2%). The most common site of soft tissue tumors was the lip 25 (14.5%), and of bony tumors the mandible 43 (25%). About 40% of the tumors developed in patients between the ages of 6 and 12 years. Most of the hemangiomas and lymphangiomas developed in patients less than 6 years old, and most of the ameloblastomas in those over 12 years of age. These data are important to assess geographical differences in the incidence of lesions and to all clinicians to make realistic judgments in counseling patients before biopsy about the probability of diagnosis. Most of these lesions were probably developmental malformations rather than neoplasms.     

Ameloblastoma: Biological profile of 3677 cases

Available literature on ameloblastoma of the jaw was reviewed, including publications from 1960 to 1993, and compared to the latest larger review, published by Small and Waldron in 1955.The average age of patients with ameloblastoma is 36 years. In developing countries ameloblastomas occur in younger patients. Men and women are equally affected. Women are 4 years younger than men when ameloblastomas first occur, and the tumours appear to be larger in females. Dominant clinical symptoms such as painless swelling and slow growth are non-characteristic. The ratio of ameloblastoma of the mandible to maxilla is 5 to 1. Ameloblastomas of the mandible occur 12 years earlier than those of the maxilla. Ameloblastomas occur most frequently in the molar region of the mandible. In Blacks, ameloblastomas occur more frequently in the anterior region of the jaws. Radiologically, 50% of ameloblastomas appear as multilocular radiolucent lesions with sharp delineation. Histologically, one-third are plexiform, one-third follicular; other variants such as acanthomatous ameloblastoma occur in older patients. Two percent of ameloblastomas are peripheral tumours. Unicystic ameloblastomas occurring in younger patients have been found in 6%.Detailed data on 345 patients with ameloblastoma were evaluated for clarification of therapeutic approaches. Chemotherapy and radiation seem to be contraindicated. Ameloblastomas of the maxilla should be treated as radically as possible, ameloblastomas of the mandible should also be treated radically. However, ameloblastomas which radiologically appear as unilocular lesions may be treated conservatively (enucleation, curettage), whenever all areas of the cystic lumen are controllable intraoperatively. Unicystic ameloblastomas occurring in patients 15 years younger than those with multisystic ameloblastoma may be treated conservatively except in cases with invasion of epithelium into the cyst wall. Different recurrence rates have been found for histological variants of the ameloblastoma. Follicular ameloblastomas appear to recur more often than the plexiform type. Unicystic ameloblastomas reveal lower recurrence rates than “non-unicystic” ameloblastomas. The peripheral type of ameloblastoma may be excised, since conservative therapy results in low recurrence rates. Postoperative follow-up is most important in the therapy of ameloblastoma, because more than 50% of all recurrences occur within 5 years postoperatively.     

The pattern and occurrence of ameloblastoma in adolescents treated at a university teaching hospital,in Kenya: A 13-year study

Ameloblastoma presenting in the adolescent age group is rare with few studies documenting their occurrence.AimThe aim of this study was to carry out an analysis of the pattern and occurrence of ameloblastoma in those less than 20 years of age.Materials and methodPatients from the University of Nairobi Dental teaching Hospital treated for ameloblastoma were included in the study over a 13-year period. The study highlights the demographic, clinic-radiographic and histologic features of benign locally aggressive lesions.ResultsA total of 127 patients were recorded of which, 27 (21.3%) were below the age of 20 years; no case was reported below the age of 10 years. 18.5% were below the age of 14 years and 81.5% were 15–19 years old. The gender predilection was ～1:1. All of the tumours occurred in the mandible, with radiographic features of a multilocular radiolucencies (85.2%); and a fewer unilocular lesions (14.8%). The management is in a staged-wise approach: resection and/or disarticulation with temporary reconstruction using mandibular stainless steel or titanium plates and delayed bone grafting.ConclusionThe occurrence of ameloblastoma can mimic an odontogenic cyst, clinicians therefore need to be vigilant when examining adolescents so that conservative treatment is started early in order to reduce the subsequent morbidity.     

单囊型成釉细胞瘤的临床病理特点及其与复发的关系

目的：探讨单囊型成釉细胞瘤的临床病理变化及其与患者预后的关系。方法：回顾分析33例单囊型成釉细胞瘤的临床和X线特点以及相关随访资料，并对照观察该型肿瘤的组织结构、生长方式以及肿瘤性上皮衬里的形态特征。结果：本组10－29岁为高发年龄，91％发生于下颌骨，累及上颌骨者仅3例；根据组织学特点，本组肿瘤被分为单纯囊型（I型，8例）、伴囊腔内瘤结节增殖（Ⅱ型10例）和伴囊内肿瘤浸润（Ⅲ型，15例），3种亚型，29例随访患者中有6例术后复发，手术与复发间隔4－11年不等。结论：综合分析随访和临床病理资料，提示肿瘤复发可能与其发生部位、术前临床诊断以及组织不分型有关。     

Ameloblastoma: analysis of 207 cases in a Nigerian teaching hospital.

OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature.     

复发性成釉细胞瘤的临床、影像、病理学分析

目的对复发性成釉细胞瘤（RAB）的临床、影像、病理学进行综合分析,为其诊断和治疗提供依据。方法对南京大学口腔医院1996年1月-2008年3月收治的具有完整病例资料的23例RAB患者的临床资料进行总结,并进行影像学和病理学分型。结果23例RAB患者中,有20例复发1次,3例复发2次,共复发26次。23例患者中,19例首次手术治疗采用刮治术,4例首次手术治疗采用根治术;复发后4例患者采用刮治术,19例患者采用根治术。26例次RAB的影像学分型：12例次为多房型,6例次为单房型,8例次为外周型;病理分型：21例次为滤泡型,5例次为丛状型。刮治术后复发者以多房型最多（11例次）,根治术后复发者以外周型最多（8例次）。结论刮治术后成釉细胞瘤复发率明显高于根治术后;滤泡型成釉细胞瘤浸润性较强,易于复发。     

Odontogenic tumours in children and adolescents: a collaborative study of 431 cases

This study describes the oral and maxillofacial pathological characteristics of a series of odontogenic tumours in children and adolescents from three Brazilian reference centres. The records were reviewed for all odontogenic tumours in patients up to 18 years old based on criteria proposed by the World Health Organization (WHO) in 2005. Data concerning sex, age, skin colour and tumour location were collected and plotted. Four hundred and thirty one odontogenic tumours in children and adolescents were found, accounting for 37.5% of the total number of odontogenic tumours diagnosed. Benign tumours were predominant (99.8% of the cases), and odontoma was the most frequent type (41.4%), followed by keratocystic odontogenic tumours (25.5%) and ameloblastoma (14.6%). Odontogenic tumours were rarely detected in early childhood, and their prevalence increased with age. An almost equal distribution was observed with respect to sex and the site of the lesions. This study is the largest reported retrospective analysis describing odontogenic tumours in children and adolescents to date. The authors detected some variation in the relative frequency of odontogenic tumours compared with similar reports. Additional studies should be conducted based on the new WHO classification and predetermined age parameters to enable comparative analysis among different worldwide populations.     

Desmoplastic and non-desmoplastic ameloblastoma: a comparative clinicopathological analysis

OBJECTIVES: The aim of this study was to review a large series of ameloblastomas, accessioned during a period of 35 years in a single Oral Pathology Diagnostic Center, for the incidence of desmoplastic ameloblastoma (DA) and in order to analyze the clinical features of this unusual variant.
MATERIALS AND METHODS: All cases diagnosed as ameloblastoma were reviewed and 14 were rediagnosed as DA. These cases were analyzed in terms of gender, patient age, location, clinical diagnosis, radiographic features and recurrence following treatment. Data from DA and non-desmoplastic ameloblastoma (NDA) were compared.
RESULTS: The incidence of DA in this series was 8.8%. The mean age of NDA and DA were 39.1 and 38.8 years respectively, and a higher female prevalence was observed in the latter. The mandible was the most affected bone in both groups of tumors, but with a different regional distribution. Most NDA arose in the angle and ramus of the mandible, but the premolar/molar region was the preferential location for DA. The most common radiographic feature in DA was the osteolytic type, either monolocular or multilocular. Most of these cases were clinically diagnosed as ameloblastoma. According to follow-up data available, 21.4% of DA and 10.1% of NDA recurred.
CONCLUSIONS: The results of this study do not support the hypothesis that DA should be a separate clinicopathological entity. It seems most likely that DA is another his-tologic variant of ameloblastoma.     

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.