Does Preservation of the Inferior Alveolar Nerve in the Close Margin of the Mandibular Ameloblastoma Increase the Risk of Recurrence?

Abstract

Preservation of the inferior alveolar nerve (IAN) during mandibular resection improves the patient's quality of life. This study aimed to assess the risk of recurrence in patients with or without IAN preservation following mandibular resection for the treatment of ameloblastoma. In this retrospective cohort study, patients with biopsy-proven, intraosseous, multicystic ameloblastoma in the mandible, without IAN involvement, were included. The minimum follow-up period was 36months. In preserved group, the IAN was saved in the close margin, and the IAN was resected in the sacrificed group. The mandibular nerve management (preservation or sacrifice of the IAN) was a primary predictive variable. The primary outcome variable was time to recurrence of the jaw lesion. Age, sex, tumor size, and ameloblastoma histological subtype were covariates. A time-to-event analysis (Cox regression analysis) was performed to determine the risk of recurrence with or without preservation of the IAN. Thirty-seven patients in the preserved group and 38 in the sacrificed group were included in this study. The median follow-up period was 43months. The mean tumor size was 3.88±0.89cm in the preserved group, and the mean tumor size was 3.74±0.56cm in the sacrificed group. There was no significant difference in the mean tumor size between the 2 groups. The time-to-event analysis, based on the Cox regression analysis of covariates, did not approve the study's null hypothesis (an increased recurrence with IAN preservation; hazard ratio: 0.77 [0.20-2.93]; P=.71). Based on the present results, preservation or sacrifice of the IAN in the close margin of mandibular ameloblastoma was not associated with an increased recurrence of lesions.