Ossification of Non-vascularized Free-Fibula Graft for Mandibular Reconstruction after Resection of Ameloblastoma: Review of Literature and Presentation of 2 cases

Georgina David Dhalwale

doi:10.31579/2768-2757/020

Abstract

Introduction: Ameloblastoma is a benign neoplasm of odontogenic epithelial origin occurring more commonly in the mandibular posterior region and rarely in the maxilla. About 50-60% of ameloblastomas occur in the mandibular ramus area, while only 10% is seen in mandibular anterior region. Ameloblastomas are slow growing, locally invasive, rarely malignant tumours affecting the jaw. Mostly commonly seen in the 4th-6th decade of life affecting males more commonly than females. The resection of the mandibular segment without adequate reconstruction leads to functional as well as esthetic loss. Case Report: Here we describe two case reports of ameloblastoma with segmental resection and reconstruction using fibula graft. Discussion & Review of Literature: Avascular fibula graft with its high bone density, ease of access to harvest, and tendency to show less resorption helps to achieve satisfactory esthetic contour and function in reconstruction of segmental defects of mandible Conclusion: This article describes two case reports of ameloblastoma with segmental resection and reconstruction using fibula graft along with review of literature.

Highlights

Ameloblastoma is a benign neoplasm of odontogenic epithelial origin occurring more commonly in the mandibular posterior region and rarely in the maxilla
Ameloblastoma is a neoplasm of odontogenic epithelium of enamel organ ‐type tissue that has not undergone differentiation to the point of hard tissue formation [11, 18, 25]
According to World Health Organization (WHO) 1992, ameloblastoma is defined as, “a benign but locally invasive polymorphic neoplasm consisting of proliferating odontogenic epithelium, which usually has a follicular or plexiform pattern, lying in a fibrous stroma” [4, 5, 6, 8]

Summary

Introduction

Ameloblastoma is a benign neoplasm of odontogenic epithelial origin occurring more commonly in the mandibular posterior region and rarely in the maxilla. Ameloblastomas are slow growing, locally invasive, rarely malignant tumours affecting the jaw. Case Report: Here we describe two case reports of ameloblastoma with segmental resection and reconstruction using fibula graft. According to WHO 1992, ameloblastoma is defined as, “a benign but locally invasive polymorphic neoplasm consisting of proliferating odontogenic epithelium, which usually has a follicular or plexiform pattern, lying in a fibrous stroma” [4, 5, 6, 8]. Surgical management is the measure of treatment of ameloblastomas. Chana et al proposed a 1 to 2 cm normal margin, and the large defect left after resection guarantees reconstruction preferably with the free fibula graft [1]

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