Abstract
Background: Two-stage surgical protocol for multicystic mandibular provided satisfactory clinical outcomes. The fenestration procedure reduced the range of tumor and curettage in the second stage sustains the shape of mandibular. With or without bone grafting, osteogenesis and bone reconstruction occurred in mandibular bone defect, which provided adequate bone for implant restoration. Aim/Hypothesis: To provide a reference for evaluating the long-term outcomes of spontaneous osteogenesis and implant restoration after staging surgical treatment for multicystic mandibular ameloblastoma. Materials and Methods: A 17-year-old male was diagnosed as multicystic mandibular ameloblastoma and received a two-stage surgical protocol. Radiographic analysis was taken before and after every stage of the treatment. In the first stage, the ameloblastoma was treated by fenestration and decompression technique. Obvious reduction of the lesion extent was observed 9 months later and the curettage of the cyst was presented in the second stage of surgery without bone substitudes grafting. Osteogenesis was discovered in the 6-month and 9-month follow-up of the second stage surgery. Two 4.5x11.0 mm Ankylos implants were placed 14 months after the second stage surgery. The implants were embedded and the healing abutments were attached to the implants 4 months later. Restoration was accomplished 5 months afterwards. The patient was recalled for clinical examination 2 and 4 years post-restoration. Results: Spontaneous osteogenesis was observed 9 months and 14 months after two-stage surgical treatment. Bone-to-implant contact was displayed according to the post-surgical cone-beam CT scan. Normal functioning of the implant restoration was observed in the 2-year and 4-year follow-up. Neither recurrence of the tumor or implant complications was discovered in this case. Conclusions and Clinical Implications: Implant restoration without bone substitudes grafting after staging surgical treatment for ameloblastoma would receive long-term stable outcome in this case. Keywords: Ameloblastoma, staging surgical treatment, implantation, no-grafting
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