Abstract
BackgroundIn this study, we present a case of unicystic ameloblastoma (UA) treated by marsupialization followed by surgical enucleation as a conservative approach. UA is a rare, benign, less aggressive, and less invasive variant of ameloblastoma that is observed quite often in younger patients. Radical approaches have effects on the physical and psychological development of a growing young patient; therefore, conservative approaches are widely used for UA management in children.Case presentationThis report described a case of an 11-year-old girl with UA of the mandibular molar–ramus area, which also involved impaction of the second and third molars. The lesion was marsupialized, and 31 months after marsupialization, surgical enucleation was performed with extraction of the impacted third molar. The second molar, which was preserved, spontaneously and completely erupted. No recurrence was observed during a 49-month follow-up.ConclusionsConservative treatments for UA in young patients have more advantages. Our results provide evidence that marsupialization is effective in regressing the lesion size to ease complete removal, preserving mandibular growth, maintaining involved second molar, and promoting the eruption of the tooth.
Highlights
In this study, we present a case of unicystic ameloblastoma (UA) treated by marsupialization followed by surgical enucleation as a conservative approach
Our results provide evidence that marsupialization is effective in regressing the lesion size to ease complete removal, preserving mandibular growth, maintaining involved second molar, and promoting the eruption of the tooth
Conservative treatments comprise enucleation, enucleation followed by application of Carnoy’s solution, or marsupialization followed by enucleation [1, 2, 9, 16, 20]
Summary
The treatment of UA has been controversial and can be radical or conservative [1, 2, 9, 15, 17,18,19]. According to a systematic review by Lau and Samman, when marsupialization was performed with or without further treatment, the recurrence rate (18%) was lower than that of enucleation alone (30.5%) [9]. Sano et al reported the spontaneous eruption of an involved second molar in UA of the mandible after marsupialization followed by enucleation and believed that spontaneous eruption and favorable occlusion were obtained for four reasons [7]. The impacted second molar naturally erupted after reducing the tumor volume from marsupialization. Spontaneous eruption occurred after marsupialization without the extraction of the involved second molar This tooth functions well without the need for a root canal
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