An incidental finding of a large unicystic ameloblastoma in the maxilla: a case report

Abstract

An ameloblastoma is a benign epithelial odontogenic tumour with 80% occurring in the mandible. Despite being benign, it can be locally aggressive and if left undetected, it can have lethal consequences. This case report discusses an incidental finding and management of a maxillary unicystic ameloblastoma (UA) in a paediatric orthodontic patient. An 11-year-old male patient was referred to the Orthodontic Department at Whipps Cross Hospital by his dentist for delayed eruption of the UR1. The patient complained of a new right sided facial swelling. Initial clinical and radiographic examination revealed dilacerated UR1, transposed UR23, ectopic UR5, retained URE and extensive radiolucency in the right maxilla. An urgent CBCT scan showed a large well defined corticated radiolucency associated with the ectopic UR5, displacing the URE4321 and elevating the maxillary sinus up to the orbital floor. The differential diagnoses included: dentigerous cyst, odontogenic keratocyst or ameloblastoma. The patient underwent extraction of URE5 and enucleation of the lesion with placement of Bio-Gide membrane and Mucograft under general anaesthetic. The cyst specimen was later confirmed to be a UA. Regular clinical and radiographic reviews have been conducted, demonstrating good bony infill and soft tissue healing six months post-operatively. Orthodontic treatment was delayed until resolution occurred. Conservative management of UAs may offer a better quality of life by reducing morbidity in young patients whilst also maintaining an acceptable low rate of recurrence. This case has shown the importance of proper examinations for new patients as detecting abnormalities early can lead to more successful treatment outcomes.Copyright © 2025