Fourteen-Year Survey on the Management of Ameloblastoma in a London Hospital - What Works Best?

Abstract

Introduction: Ameloblastomas are the second most common odontogenic tumour, derived of epithelial origin. Although benign, they can be locally aggressive, with a rare potential for malignant transformation and metastasis. High recurrence rates often necessitate complete surgical resection, compromising both function and aesthetics, while conservative approaches aim to preserve these. This study evaluates the outcomes of various management strategies for ameloblastomas over a 14-year period to determine the most effective treatment modality. Method(s): A retrospective analysis was conducted on all benign jaw cystic lesions treated at an inner-city London District General Hospital. Of 117 cases, 11 patients were diagnosed with ameloblastoma, and their management pathways were reviewed. Surgical treatments, including enucleation and decompression (with or without stenting), were evaluated based on tumour size reduction, location, and histological characteristics. Result(s): Enucleation achieved a mean size reduction of 77%, providing the largest percentage reduction in size and significantly exceeding decompression with stenting, which averaged a 23% reduction. Stenting was considerably less effective for ameloblastoma cases when compared against the results of a similar study investigating the management of odontogenic keratocysts. Not all ameloblastomas treated with enucleation needed a second procedure. All those treated with stents on average were larger pre-operatively (54 mm compared to 30 mm average). Recurrent cases following stenting required more extensive interventions, including mandibular resection and reconstruction. Conclusion(s): The ideal treatment method aims to minimise recurrence, preserve function and maintain aesthetic integrity. Surgical planning must account for tumour size, location, and patient comorbidities to achieve the best outcomes.Copyright © 2025