Odontogenic tumour classification:

  • Odontogenic epithelium iwthout odontogenic ectomenchyme

Ameloblastoma is a benign but locally aggressive odontogenic tumour It is the most common clinically significant odontogenic tumour characterized by its slow growth and potential for extensive bone destruction

Etiology and Pathophysiology

Contributory factors :

Prevalence

Histological Features

  • Islands of epithelial cells with reverse polarization of columnar cells

Unicystic:

  • A central cystic cavity
  • Lined with odontogenic epithelium
  • Supporting stroma is composed of spindle cells and may contain inflammtory cells
  • Central areas of the islands resemble the stellate reticulum

Radiographically:

  • appear as well-defined radiolucencies
  • May be uniloccular or multilocular (soap bubble or honeycombed appreance)
  • Frequently associated with the jawbone and surrounding teeth
  • Often associated with root resorption of adjacent teeth

Clinical Features

  • causes bone resorption (bucco-lingual cortical expansion is common )

Location

  • Most commonly seen in the posterior mandible, often seen in the 4th decade of life

Appearance

Differential Diagnoses

  • Dentigerous cyst
  • Squamous odontogenic tumour
  • Ameloblastic carcinoma

Relevant Clinical Investigations

  • OPG
  • Biopsy
  • Pulp vitality testing of adjacent teeth

Patient Management

  • Treated surgically with wide resection margins
  • unicystic ameloblastoma (luminal type) may be treated more conservatively with enucleation and curettage