Materiały źródłowe

• #1 Ameloblastoma: Management and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6289562/

  Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. […] Resection with wide margins and reconstruction in the same sitting is currently accepted as the treatment of choice in most cases. Idea of conservative surgery is no longer entertained since it is associated with higher recurrence rate. […] Segmental mandibulectomy with removal of 1-2 cm disease-free bone with immediate reconstruction is considered as an ideal treatment for ameloblastoma. This gives good cosmetic results and also addresses speech and eating problems. […] The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study, we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

• #2 Ameloblastoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ameloblastoma/diagnosis-treatment/drc-20449426

  Ameloblastoma treatment may depend on your tumor’s size and location, and the type and appearance of the cells involved. Treatment may include: […] Surgery to remove the tumor. Ameloblastoma treatment usually includes surgery to remove the tumor. Ameloblastoma often grows into the nearby jawbone, so surgeons may need to remove the affected part of the jawbone. An aggressive approach to surgery reduces the risk that ameloblastoma will come back. […] Radiation therapy. Radiation therapy using high-powered energy beams might be needed after surgery or if surgery isn’t an option. […] Due to the risk of recurrence after treatment, lifelong, regular follow-up appointments are important.

• #3 Ameloblastoma | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17438

  Mural and solid ameloblastomas are treated with complete surgical excision with normal bone margins at a minimum of five to fifteen mm, though ten mm margins are most common. Reported recurrence rates are up to 70%, with incomplete resection being the most common reason for the high recurrence rate. Enucleation and curettage, cryotherapy and marsupialization have all been used to treat ameloblastomas; however, these modalities are not curative and are not standard of care now. […] Ameloblastic carcinoma treatment is generally via surgical resection with 2 to 3 cm margins. Concurrent chemoradiotherapy is an option after resection for positive margins or perineural invasion. In malignant ameloblastoma, surgical resection with 1 to 2 cm margins is usually the treatment modality of choice, and no chemotherapy or radiotherapy is generally required.

• #4 Ameloblastoma: Management and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6289562/

  Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. […] Resection with wide margins and reconstruction in the same sitting is currently accepted as the treatment of choice in most cases. Idea of conservative surgery is no longer entertained since it is associated with higher recurrence rate. […] Segmental mandibulectomy with removal of 1-2 cm disease-free bone with immediate reconstruction is considered as an ideal treatment for ameloblastoma. This gives good cosmetic results and also addresses speech and eating problems. […] The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study, we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

• #5 Ameloblastoma: Management and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6289562/

  Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. […] Resection with wide margins and reconstruction in the same sitting is currently accepted as the treatment of choice in most cases. Idea of conservative surgery is no longer entertained since it is associated with higher recurrence rate. […] Segmental mandibulectomy with removal of 1-2 cm disease-free bone with immediate reconstruction is considered as an ideal treatment for ameloblastoma. This gives good cosmetic results and also addresses speech and eating problems. […] The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study, we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

• #6 Ameloblastoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22143-ameloblastoma

  Surgery is the most effective treatment. […] Early treatment and careful monitoring after treatment can prevent an ameloblastoma from damaging your jaw. […] Surgery that removes the tumor and some nearby tissue (enough to ensure no abnormal cells remain) is the best treatment for ameloblastoma. […] Most people with ameloblastomas need radical surgery. Your provider will remove the tumor and a large amount of bone and tissue to reduce the chance of your tumor growing back. […] If you’re not a candidate for surgery, your provider may recommend radiation therapy to get rid of the tumor. Or you may need radiation therapy after surgery to destroy any remaining tumor cells. […] Afterward, you may need additional treatments to get back to feeling like yourself again. […] Seeking treatment for an ameloblastoma can prevent these worst-case scenarios from happening. […] Ask your provider about the type of surgery they recommend based on your tumor type and health. They’re your best resource for explaining the best treatments available to get rid of the tumor while sparing as much healthy tissue in your jaw as possible.

• #7 Ameloblastoma: Management and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6289562/

  Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. […] Resection with wide margins and reconstruction in the same sitting is currently accepted as the treatment of choice in most cases. Idea of conservative surgery is no longer entertained since it is associated with higher recurrence rate. […] Segmental mandibulectomy with removal of 1-2 cm disease-free bone with immediate reconstruction is considered as an ideal treatment for ameloblastoma. This gives good cosmetic results and also addresses speech and eating problems. […] The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study, we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

• #8 Pathology Outlines – Ameloblastoma

  https://www.pathologyoutlines.com/topic/mandiblemaxillaameloblastoma.html

  Ameloblastoma, conventional type: […] – Mandible: usually treated with a segmental resection (marginal if small), which includes at least 1 cm bone margins and at least 1 adjacent uninvolved anatomic barrier […] – Maxilla: resected en bloc via various midface approaches, at least 1 cm margins and at least 1 adjacent uninvolved anatomic barrier […] – Curettage associated with high recurrence rate (60 – 80%) […] – Nonsurgical therapy: although BRAF inhibitors have been used, no advantage over traditional surgical treatment for a previously untreated, intraosseous gnathic ameloblastoma has been documented […] […] […] Ameloblastoma, unicystic type: enucleation or resection […] […] […] Ameloblastoma, extraosseous / peripheral type: conservative excision […] […]

• #9 The Effect of Conservative vs. Radical Treatment of Ameloblastoma on Recurrence Rate and Quality of Life: An Umbrella Review

  https://www.mdpi.com/2077-0383/13/17/5339

  In Hendra et al. 2019, the pooled recurrence rate of solid/multicystic ameloblastomas following radical treatment was 8%, while conservative treatment caused recurrences in 41%. For unicystic ameloblastomas, these values were 3% and 21%, respectively. […] Similarly, Almeida et al. showed that the relative risk of recurrence was 3.15-fold greater when conservative treatment was performed on primary multicystic ameloblastoma in comparison to radical treatment. […] The primary finding of this umbrella review is that radical treatments for ameloblastoma are associated with significantly lower recurrence rates compared to conservative treatments. This suggests that radical approaches may offer better long-term disease control. […] For clinicians, this review underscores the importance of weighing the benefits of lower recurrence rates against the risks of adverse outcomes, including esthetic and functional impairments.

• #10 SciELO Brazil – Management techniques of ameloblastoma: a literature review Management techniques of ameloblastoma: a literature review

  https://www.scielo.br/j/rgo/a/7Yfszb339syBSBBv896TdkS/

  Ameloblastoma is a benign neoplasm essentially composed of epithelial tissue that has an invasive and infiltrative behavior at local level with a high recurrence rate. […] This way, this study is a literature review of works published between 2006 and 2014 conducted to find the existing protocols for the treatment of ameloblastomas. […] When proper diagnosis is carried out, it is crucial to establish a good treatment plan based on clinical and imaging examinations. […] There are several reports of various treatment methods for ameloblastomas, ranging from the most conservative to the most radical. Example are: curettage; cryotherapy; removal associated with cryotherapy; marsupialization; electrocauterization; sclerotherapy; and radiotherapy. […] One of the most reported techniques is complete surgical removal of the lesion, including the extension of a security margin with at least 1- to 2-cm thickness to reduce the risk of recurrence.

• #11 SciELO Brazil – Management techniques of ameloblastoma: a literature review Management techniques of ameloblastoma: a literature review

  https://www.scielo.br/j/rgo/a/7Yfszb339syBSBBv896TdkS/

  The disadvantages of radical methods are chewing problems, dysfunction of mandibular movements, and noticeable mutilation including facial deformity. […] Therefore, the present study was conducted in order to bring together the information of the literature about treatment options for ameloblastomas. […] An efficient clinical and imaging assessment is very important to determine the best treatment, given that unilocular cases are less aggressive. […] These cases have less chance of recurrence, thus allowing dental surgeons to perform a less invasive surgery. […] Often, surgeons choose the combination of conventional surgery and ancillary methods, such as the application of Carnoy’s solution, cryotherapy, or diathermy, in order to reduce the risk of lesion recurrence. […] A fundamental step to choose the best treatment for ameloblastomas is the identification of the type of lesion, namely: peripheral; unicystic; multicystic; and even solid and desmoplastic.

• #12 SciELO Brazil – Management techniques of ameloblastoma: a literature review Management techniques of ameloblastoma: a literature review

  https://www.scielo.br/j/rgo/a/7Yfszb339syBSBBv896TdkS/

  According to several authors, smaller and unicystic lesions can be treated with enucleation and curettage, which can also be associated with other ancillary procedures, such as peripheral osteotomy, application of Carnoy’s solution, and cryotherapy. […] Even with the purpose of avoiding recurrences of the lesion, it is possible to combine procedures such as cryotherapy or radiotherapy with the main intervention. […] After an extensive review of the literature on treatments of ameloblastomas, we concluded that: (a) the best treatment for ameloblastoma is still its total resection, given that recurrence rates are low when this technique is used; (b) even though total resection of the lesion is the most appropriate treatment, it can lead to irreversible sequelae; (c) conservative treatments, such as decompression and marsupialization, have been proposed in the literature to avoid sequelae, followed by radical surgical treatment.

• #13 SciELO Brazil – Management techniques of ameloblastoma: a literature review Management techniques of ameloblastoma: a literature review

  https://www.scielo.br/j/rgo/a/7Yfszb339syBSBBv896TdkS/

  According to several authors, smaller and unicystic lesions can be treated with enucleation and curettage, which can also be associated with other ancillary procedures, such as peripheral osteotomy, application of Carnoy’s solution, and cryotherapy. […] Even with the purpose of avoiding recurrences of the lesion, it is possible to combine procedures such as cryotherapy or radiotherapy with the main intervention. […] After an extensive review of the literature on treatments of ameloblastomas, we concluded that: (a) the best treatment for ameloblastoma is still its total resection, given that recurrence rates are low when this technique is used; (b) even though total resection of the lesion is the most appropriate treatment, it can lead to irreversible sequelae; (c) conservative treatments, such as decompression and marsupialization, have been proposed in the literature to avoid sequelae, followed by radical surgical treatment.

• #14 Treatment of recurrent mandibular ameloblastoma

  https://www.spandidos-publications.com/10.3892/etm.2013.1165?text=fulltext

  Local treatment has an increased risk of recurrence, therefore it may be complemented with further application of Carnoy’s solution, cryotherapy or diathermy in order to reduce the recurrence rate. […] The purpose of this study was to analyze the therapeutic results obtained from a series of patients with mandibular ameloblastomas and to specifically focus attention on evaluating the surgical management of recurrent ameloblastoma. […] When detecting tumor recurrence, the ideal treatment method is bone resection with a safety margin of at least 1 cm beyond the radiographically visible margins. […] This may be performed by either marginal or segmental mandibulectomy depending on the location and extent of recurrence. […] Immediate reconstruction of the bone defect with free grafts or flaps, placement of dental implants and rehabilitation with implant-supported prostheses in a second stage can improve jaw function and facial harmony of the patient.

• #15 SciELO Brazil – Management techniques of ameloblastoma: a literature review Management techniques of ameloblastoma: a literature review

  https://www.scielo.br/j/rgo/a/7Yfszb339syBSBBv896TdkS/

  The management protocol proposed in 2010 recommends that unicystic ameloblastomas should initially be approached with marsupialization, followed by a careful radiological assessment to determine whether the lesion is decreasing. […] The authors propose that these resections should have a bone margin of at least 1.5 cm between the lesion and healthy tissue. […] The authors suggest that the treatment of solid/multicystic ameloblastomas should firstly consider the assessment of anatomical barriers, such as cortical bone, periosteum, muscles, and mucous membranes that might have been affected. […] In order to reduce the extent of the surgery performed to remove the lesion, and decrease the risk of recurrence, some techniques can be associated with the final resolutive procedure. […] Marsupialization is an example of a technique that has been used in some extensive ameloblastomas.

• #16 Conservative management (marsupialization) of unicystic ameloblastoma: literature review and a case report | Maxillofacial Plastic and Reconstructive Surgery | Full Text

  https://jkamprs.springeropen.com/articles/10.1186/s40902-017-0134-0

  The treatment of UA has been controversial and can be radical or conservative. […] Conversely, conservative treatments comprise enucleation, enucleation followed by application of Carnoys solution, or marsupialization followed by enucleation. […] UAs biologic behavior is considered to be less invasive, and it responds more favorably to conservative treatment than a multicystic ameloblastoma. […] Therefore, conservative therapy was performed in our patient. We used marsupialization as an initial treatment of UA to minimize the tumors volume, and after they regressed in size, they were enucleated. […] The aim of marsupialization is to reduce the size of the tumor so that a less extensive surgery is required. […] The benefits of decompression are maintenance of pulp vitality, preservation of the inferior alveolar nerve or maxillary sinus, preservation of the mandibular contour and growth, prevention of fracture of the jaw, and low risk for recurrence.

• #17 Management of large multicystic ameloblastoma of mandible- Resection and reconstruction with recon plate – JOOO

  https://www.joooo.org/html-article/18950

  Ameloblastoma is a common benign, locally aggressive odontogenic neoplasm that usually occurs in the vicinity of the mandibular molars or ramus. […] Although surgery is the mainstay of treatment, the extent of resection is controversial. The challenge in managing ameloblastoma is in achieving complete excision such that chances of recurrence is minimal and reconstruction of the defect when the tumour is large. […] Enucleation/curettage versus resection with broad margins has been the two treatment options for ameloblastomas that have generated controversy. With cautious enucleation, solid ameloblastomas have a high recurrence rate (6090%). […] The solid or multicystic-type ameloblastoma has so been given the preference for a segmental excision with a 1 to 2-cm margin. […] The main goals of mandibular reconstruction are to restore function and produce a satisfactory cosmetic result.

• #18 Treatment of recurrent mandibular ameloblastoma

  https://www.spandidos-publications.com/10.3892/etm.2013.1165?text=fulltext

  Ameloblastoma is a locally invasive benign odontogenic tumor with a high rate of recurrence in the long term. […] The therapeutic challenge is to achieve a complete lesion excision with the least possible morbidity. […] A number of different treatment strategies have been previously reported including local techniques (curettage, enucleation or marsupialization) or radical treatments (marginal or en-bloc segmental resection with safety margins and reconstruction of bone defect). […] Solid/multicystic ameloblastomas have been identified as the most aggressive subtype, with a high recurrence rate following local excision. […] By contrast, unicystic ameloblastomas are described to have a lower rate of recurrence and enucleation, with curettage potentially being sufficient for their management.

• #19

  https://journals.lww.com/jodd/fulltext/2022/16020/management_of_paediatric_ameloblastoma.12.aspx

  Ameloblastoma is a benign odontogenic tumour of epithelial origin that is slowly growing, locally aggressive, has a high recurrence rate but is uncommon in children. […] Treatment of ameloblastoma in children is complicated by three factors: (1) physiologic factors such as the continued facial growth, different bone physiology and the presence of unerupted teeth; (2) difficulty in the initial diagnosis and (3) predominance of the unicystic type of ameloblastoma. […] To present the outcome and advantage of a conservative treatment approach in the management of unicystic ameloblastoma in a paediatric patient. […] Enucleation with peripheral ostectomy seems a viable option in paediatric patients considering the amount of post-operative morbidity associated with aggressive management which can always be taken up a later stage if warranted.

• #20

  https://journals.lww.com/jodd/fulltext/2022/16020/management_of_paediatric_ameloblastoma.12.aspx

  Treatment planning for ameloblastoma in a child must take into consideration the age of the patient, type and size of the lesion and reconstruction of the defect thereafter. […] This modified enucleation approach could perhaps be considered a treatment option in the management of large UCAs in paediatric patients, particularly in cases without cortical or periosteal breakthroughs. […] Published reports now recommend a relatively conservative treatment like enucleation with peripheral ostectomy in the first instance, reserving a more aggressive therapy for any recurrence considering the growth potential and capacity for bone regeneration in children. […] Although the dictum for treatment of ameloblastoma is to treat it aggressively. In paediatric patients, considering the age and growth potential, the conservative treatment seems a viable option with good results.

• #21 Curettage combined with decompression for the treatment of ameloblastoma in children: report of two cases | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-04126-8

  Ameloblastoma (AM) is the most common benign odontogenic tumor, which is more often detected in the mandible than maxilla, especially the mandibular body and mandibular angle. […] Compared with the mainstream osteotomy and reconstructive surgery for adult ameloblastoma, there is more room for discussion in the treatment of pediatric ameloblastoma. […] We report two patients with ameloblastoma under 10 years old who are treated with curettage and fenestration, which is a beneficial method for children with ameloblastoma. […] Based on the principles of minimally invasive and functional preservation, we believe that curettage combined with decompression can be the first choice for treating AM in children, especially for mandibular lesions. […] Our previous retrospective study showed that the effective rate of fenestration decompression combined with secondary curettage(FDSC) in the treatment of multicystic ameloblastoma was 71.19%, and the effective rate in the treatment of unicystic ameloblastoma was 93.02%.

• #22 Curettage combined with decompression for the treatment of ameloblastoma in children: report of two cases | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-04126-8

  Given the high recurrence rate of curettage and the impact of osteotomy on growth, development, and psychology of children, we aim to use curettage combined with decompression in recent years to treat patients with classic AM who meet the indications, and satisfactory results have been achieved. […] The superiority of this approach was particularly evident in the treatment responses of the two patients aged under 10. […] We believe that decompression combined with curettage could be the first choice for treating AM in children, especially for mandibular lesions.

• #23

  https://journals.lww.com/jodd/fulltext/2022/16020/management_of_paediatric_ameloblastoma.12.aspx

  Treatment planning for ameloblastoma in a child must take into consideration the age of the patient, type and size of the lesion and reconstruction of the defect thereafter. […] This modified enucleation approach could perhaps be considered a treatment option in the management of large UCAs in paediatric patients, particularly in cases without cortical or periosteal breakthroughs. […] Published reports now recommend a relatively conservative treatment like enucleation with peripheral ostectomy in the first instance, reserving a more aggressive therapy for any recurrence considering the growth potential and capacity for bone regeneration in children. […] Although the dictum for treatment of ameloblastoma is to treat it aggressively. In paediatric patients, considering the age and growth potential, the conservative treatment seems a viable option with good results.

• #24 Management of Recurrence of Ameloblastoma and Odontogenic Keratocyst: A Cross-Sectional Study

  http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S2215-34112020000300174

  Management of Recurrence of Ameloblastoma and Odontogenic Keratocyst: A Cross-Sectional Study […] The aim of this study was to investigate the clinicopathologic features of recurrent ameloblastoma and OKC cases, and evaluate outcomes of our treatments in terms of recurrence. […] We performed radical treatments in these cases (ten patients underwent marginal resections, and thirteen patients underwent segmental resection), and no recurrence was observed during the follow-up period. […] Marginal or segmental resection with safety margins is the best method to treat recurrences of OKC or ameloblastoma cases. […] Treatment modalities in the literature include decompression, marsupialization, curettage, enucleation, and more invasive methods, such as radical enucleation and resection. […] Ameloblastomas can be treated by conservative and radical approaches.

• #25 Management of Recurrence of Ameloblastoma and Odontogenic Keratocyst: A Cross-Sectional Study

  http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S2215-34112020000300174

  Conservative treatments involve enucleation with adjunctive procedures such as chemical cauterization or peripheral ostectomy with a 1-1.5-cm margin. […] Radical approaches is indicated for recurrent cases and larger ameloblastomas involving the inferior alveolar canal or lower. […] The radical approach comprises segmental or marginal resection involving healthy bone 1.5-2 cm beyond the radiological margin. […] For recurrent OKCs or ameloblastomas, marginal or segmental resection with safety margins is the most suitable method for maintaining disease-free survival.

• #26 Treatment of recurrent mandibular ameloblastoma

  https://www.spandidos-publications.com/10.3892/etm.2013.1165?text=fulltext

  Local treatment has an increased risk of recurrence, therefore it may be complemented with further application of Carnoy’s solution, cryotherapy or diathermy in order to reduce the recurrence rate. […] The purpose of this study was to analyze the therapeutic results obtained from a series of patients with mandibular ameloblastomas and to specifically focus attention on evaluating the surgical management of recurrent ameloblastoma. […] When detecting tumor recurrence, the ideal treatment method is bone resection with a safety margin of at least 1 cm beyond the radiographically visible margins. […] This may be performed by either marginal or segmental mandibulectomy depending on the location and extent of recurrence. […] Immediate reconstruction of the bone defect with free grafts or flaps, placement of dental implants and rehabilitation with implant-supported prostheses in a second stage can improve jaw function and facial harmony of the patient.

• #27 Treatment of recurrent mandibular ameloblastoma

  https://www.spandidos-publications.com/10.3892/etm.2013.1165?text=fulltext

  Local treatment has an increased risk of recurrence, therefore it may be complemented with further application of Carnoy’s solution, cryotherapy or diathermy in order to reduce the recurrence rate. […] The purpose of this study was to analyze the therapeutic results obtained from a series of patients with mandibular ameloblastomas and to specifically focus attention on evaluating the surgical management of recurrent ameloblastoma. […] When detecting tumor recurrence, the ideal treatment method is bone resection with a safety margin of at least 1 cm beyond the radiographically visible margins. […] This may be performed by either marginal or segmental mandibulectomy depending on the location and extent of recurrence. […] Immediate reconstruction of the bone defect with free grafts or flaps, placement of dental implants and rehabilitation with implant-supported prostheses in a second stage can improve jaw function and facial harmony of the patient.

• #28 Ameloblastoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22143-ameloblastoma

  Surgery is the most effective treatment. […] Early treatment and careful monitoring after treatment can prevent an ameloblastoma from damaging your jaw. […] Surgery that removes the tumor and some nearby tissue (enough to ensure no abnormal cells remain) is the best treatment for ameloblastoma. […] Most people with ameloblastomas need radical surgery. Your provider will remove the tumor and a large amount of bone and tissue to reduce the chance of your tumor growing back. […] If you’re not a candidate for surgery, your provider may recommend radiation therapy to get rid of the tumor. Or you may need radiation therapy after surgery to destroy any remaining tumor cells. […] Afterward, you may need additional treatments to get back to feeling like yourself again. […] Seeking treatment for an ameloblastoma can prevent these worst-case scenarios from happening. […] Ask your provider about the type of surgery they recommend based on your tumor type and health. They’re your best resource for explaining the best treatments available to get rid of the tumor while sparing as much healthy tissue in your jaw as possible.

• #29 Ameloblastoma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ameloblastoma?content_id=CON-20155798

  Ameloblastoma treatment may depend on your tumor’s size and location, and the type and appearance of the cells involved. Treatment may include: […] Surgery to remove the tumor. Ameloblastoma treatment usually includes surgery to remove the tumor. Ameloblastoma often grows into the nearby jawbone, so surgeons may need to remove the affected part of the jawbone. An aggressive approach to surgery reduces the risk that ameloblastoma will come back. […] Surgery to repair the jaw. If surgery involves removing part of your jawbone, surgeons can repair and reconstruct the jaw. This can help improve how your jaw looks and works afterward. The surgery can also help you to be able to eat and speak. […] Radiation therapy. Radiation therapy using high-powered energy beams might be needed after surgery or if surgery isn’t an option. […] Due to the risk of recurrence after treatment, lifelong, regular follow-up appointments are important.

• #30 Ameloblastoma: Management and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6289562/

  Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. Management of ameloblastoma poses a challenge for all involved in the field of head and neck surgery because successful treatment requires not only adequate resection but also a functional and aesthetically acceptable reconstruction of the residual defect. […] Resection with wide margins and reconstruction in the same sitting is currently accepted as the treatment of choice in most cases. Idea of conservative surgery is no longer entertained since it is associated with higher recurrence rate. […] Segmental mandibulectomy with removal of 1-2 cm disease-free bone with immediate reconstruction is considered as an ideal treatment for ameloblastoma. This gives good cosmetic results and also addresses speech and eating problems. […] The management of ameloblastoma still poses a big challenge in spite of being the most common odontogenic tumor. In our study, we have found that segmental mandibulectomy with disease-free margin of around 1 cm and immediate reconstruction with free tissue transfer have shown good results.

• #31

  https://journals.lww.com/jcraniofacialsurgery/fulltext/2018/05000/treatment_of_mandibular_ameloblastoma_involving.107.aspx

  Recurrence of ameloblastoma is directly related to the surgical approach. […] Resection with 1 to 2 cm. margin has been shown to result in lower recurrence rates but can be associated with greater morbidity, poor cosmetic, and functional outcomes. […] The TMJ can be restored using iliac crest grafts, costochondral grafts, DO, microvascular-free bone flaps, metallic condylar head attached to a reconstruction plate, and alloplastic TMJ prosthesis. […] The use of mirroring technology in the planning software used in the patients presented in this report facilitated a predictable restoration of good mandibular contour. […] The authors have used alloplastic custom fitted devices coupled with autogenous-free iliac bone grafts. […] The early results in these 3 patients demonstrate excellent and quick return to good facial form and function. […] In those patients, a total joint replacement with a custom prosthesis can provide a reliable alternative for the reconstruction. […] The use of concomitant nonvascularized bone graft facilitated optimum future dental restoration with less morbidity than a fibula-free flap or costochondral graft.

• #32

  https://journals.lww.com/jcraniofacialsurgery/fulltext/2018/05000/treatment_of_mandibular_ameloblastoma_involving.107.aspx

  Recurrence of ameloblastoma is directly related to the surgical approach. […] Resection with 1 to 2 cm. margin has been shown to result in lower recurrence rates but can be associated with greater morbidity, poor cosmetic, and functional outcomes. […] The TMJ can be restored using iliac crest grafts, costochondral grafts, DO, microvascular-free bone flaps, metallic condylar head attached to a reconstruction plate, and alloplastic TMJ prosthesis. […] The use of mirroring technology in the planning software used in the patients presented in this report facilitated a predictable restoration of good mandibular contour. […] The authors have used alloplastic custom fitted devices coupled with autogenous-free iliac bone grafts. […] The early results in these 3 patients demonstrate excellent and quick return to good facial form and function. […] In those patients, a total joint replacement with a custom prosthesis can provide a reliable alternative for the reconstruction. […] The use of concomitant nonvascularized bone graft facilitated optimum future dental restoration with less morbidity than a fibula-free flap or costochondral graft.

• #33 The Use of Virtual Surgical Planning for Management of Ameloblastoma: A Case Report

  https://clinmedjournals.org/articles/iaoms/research-reports-in-oral-and-maxillofacial-surgery-rroms-6-062.php?jid=iaoms

  Ameloblastoma is a rare progressively growing epithelial odontogenic neoplasm. Although benign, it can expand and invade surrounding structures, and to reoccur if not adequately removed. Current treatment is wide local excision with reconstruction. […] Current treatment recommendation is wide local excision beyond radiographical margins with immediate reconstruction. […] With the advent of virtual surgical planning, we now have a multitude of reconstructive options in our arsenal. […] A potential disadvantage of using a custom prosthesis is the cost and lead time to receiving the components. […] Custom implants appear to provide stable and improved long-term outcomes over stock and autologous implants. […] This case study showed the steps and thought processes in a reconstruction of a hemi-mandibular defect post ameloblastoma resection with custom prosthesis and TMJ replacement. This is a viable option with today’s technology in virtual surgical planning with good functional and aesthetic outcome.

• #34 Oral Rehabilitation of Patients with Ameloblastoma of the Mandible. Clinical Results in Three Patients with Different Bone Reconstruction Techniques

  https://opendentistryjournal.com/VOLUME/12/PAGE/1107/FULLTEXT/

  Ameloblastoma is a locally aggressive neoplasm. In order to reduce the risk of recurrence, wide resection has been recommended. Immediate reconstruction with an iliac crest transplant is a favorable flap option. There is no need for volume-enhancing treatment prior to implant therapy. In addition, there is the added benefit of reduced rehabilitation time.

• #35 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  Most authors consider ameloblastoma to be radioresistant. Whereas in 1982 Reynolds wrote a major article on the effect of irradiation on ameloblastoma in which he discussed the basic principles of radiation therapy and concluded that radiotherapy has a place in locally advanced tumors or cases of surgery is refused. […] Different forms of radiation therapy have been used successfully for non-surgical management of ameloblastomas especially in patients medically unstable for surgery. These include helical tomotherapy, image-guided radiation therapy, intensity-modulated radiation therapy, and proton beam therapy. […] Our patient benefited from exclusive radiotherapy using the VMAT technique, at a dose of 60 Gy in 2 Gy per fraction. […] The treatment of choice of primary and recurrent ameloblastoma is radical or non-radical surgery. Surgical treatment implies total removal of the lesion, generally with a safety margin of one-two centimeters, and is more indicated for a more aggressive lesion, such as in cases of multicystic ameloblastoma or even in unicystic cases with infiltrating characteristics.

• #36 Ameloblastoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ameloblastoma/diagnosis-treatment/drc-20449426

  Ameloblastoma treatment may depend on your tumor’s size and location, and the type and appearance of the cells involved. Treatment may include: […] Surgery to remove the tumor. Ameloblastoma treatment usually includes surgery to remove the tumor. Ameloblastoma often grows into the nearby jawbone, so surgeons may need to remove the affected part of the jawbone. An aggressive approach to surgery reduces the risk that ameloblastoma will come back. […] Radiation therapy. Radiation therapy using high-powered energy beams might be needed after surgery or if surgery isn’t an option. […] Due to the risk of recurrence after treatment, lifelong, regular follow-up appointments are important.

• #37 Ameloblastoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22143-ameloblastoma

  Surgery is the most effective treatment. […] Early treatment and careful monitoring after treatment can prevent an ameloblastoma from damaging your jaw. […] Surgery that removes the tumor and some nearby tissue (enough to ensure no abnormal cells remain) is the best treatment for ameloblastoma. […] Most people with ameloblastomas need radical surgery. Your provider will remove the tumor and a large amount of bone and tissue to reduce the chance of your tumor growing back. […] If you’re not a candidate for surgery, your provider may recommend radiation therapy to get rid of the tumor. Or you may need radiation therapy after surgery to destroy any remaining tumor cells. […] Afterward, you may need additional treatments to get back to feeling like yourself again. […] Seeking treatment for an ameloblastoma can prevent these worst-case scenarios from happening. […] Ask your provider about the type of surgery they recommend based on your tumor type and health. They’re your best resource for explaining the best treatments available to get rid of the tumor while sparing as much healthy tissue in your jaw as possible.

• #38 Ameloblastoma | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17438

  Mural and solid ameloblastomas are treated with complete surgical excision with normal bone margins at a minimum of five to fifteen mm, though ten mm margins are most common. Reported recurrence rates are up to 70%, with incomplete resection being the most common reason for the high recurrence rate. Enucleation and curettage, cryotherapy and marsupialization have all been used to treat ameloblastomas; however, these modalities are not curative and are not standard of care now. […] Ameloblastic carcinoma treatment is generally via surgical resection with 2 to 3 cm margins. Concurrent chemoradiotherapy is an option after resection for positive margins or perineural invasion. In malignant ameloblastoma, surgical resection with 1 to 2 cm margins is usually the treatment modality of choice, and no chemotherapy or radiotherapy is generally required.

• #39 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  Most authors consider ameloblastoma to be radioresistant. Whereas in 1982 Reynolds wrote a major article on the effect of irradiation on ameloblastoma in which he discussed the basic principles of radiation therapy and concluded that radiotherapy has a place in locally advanced tumors or cases of surgery is refused. […] Different forms of radiation therapy have been used successfully for non-surgical management of ameloblastomas especially in patients medically unstable for surgery. These include helical tomotherapy, image-guided radiation therapy, intensity-modulated radiation therapy, and proton beam therapy. […] Our patient benefited from exclusive radiotherapy using the VMAT technique, at a dose of 60 Gy in 2 Gy per fraction. […] The treatment of choice of primary and recurrent ameloblastoma is radical or non-radical surgery. Surgical treatment implies total removal of the lesion, generally with a safety margin of one-two centimeters, and is more indicated for a more aggressive lesion, such as in cases of multicystic ameloblastoma or even in unicystic cases with infiltrating characteristics.

• #40 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  The choice of surgical approach is difficult and influenced by the risk of recurrence. However, the therapeutic decision must take into account several factors including the patient’s age, the anatomical location of the tumor, its extension, the radiological appearance, and the need for regular follow-up of the patient. […] The risk of recurrence is greatest in the first three years but can occur much later, 15 to 30 years later. Adequate periodic clinical and radiologic follow-up for at least ten years is highly essential. […] Radiotherapy finds its place in locally advanced forms or the event of a refusal of surgery. Radiotherapy with modulation of intensity is a real advance that allows delivering an adequate dose to the tumor while sparing the organs at risk.

• #41

  https://link.springer.com/article/10.1007/s00405-016-3899-3

  The purpose of this study is to report our institutional experience using radiotherapy in the treatment of ameloblastoma and ameloblastic carcinoma. […] Radiotherapy complications were scored using the Common Terminology Criteria for Adverse Events, version 4.0. Local control was achieved in 4 of the 6 patients. […] For patients with local recurrence or inadequate margins after surgery, adjuvant radiotherapy provides the potential for disease control. In the setting of metastatic disease, targeted therapies may provide an additional opportunity for salvage.

• #42 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  Most authors consider ameloblastoma to be radioresistant. Whereas in 1982 Reynolds wrote a major article on the effect of irradiation on ameloblastoma in which he discussed the basic principles of radiation therapy and concluded that radiotherapy has a place in locally advanced tumors or cases of surgery is refused. […] Different forms of radiation therapy have been used successfully for non-surgical management of ameloblastomas especially in patients medically unstable for surgery. These include helical tomotherapy, image-guided radiation therapy, intensity-modulated radiation therapy, and proton beam therapy. […] Our patient benefited from exclusive radiotherapy using the VMAT technique, at a dose of 60 Gy in 2 Gy per fraction. […] The treatment of choice of primary and recurrent ameloblastoma is radical or non-radical surgery. Surgical treatment implies total removal of the lesion, generally with a safety margin of one-two centimeters, and is more indicated for a more aggressive lesion, such as in cases of multicystic ameloblastoma or even in unicystic cases with infiltrating characteristics.

• #43 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  Ameloblastoma is a benign odontogenic tumor. It is locally invasive and unlimited growth capacity, with a propensity for recurrence if not entirely excised. The therapeutic challenge in this type of tumors is to have an adequate resection with a wide margin of normal tissue but also a functional and aesthetically acceptable reconstruction of the residual defect. The role of radiotherapy is currently demonstrated in inoperable cases. […] The patient benefited from exclusive radiotherapy at a dose of 60 Gy. […] The patient received exclusive external radiotherapy with the VMAT technique, high-energy photons, at 60 Gy, 2 Gy/fraction, and 5 fractions/week, in 49 days. The therapy was well tolerated by the patient. The radiotherapy has not been discontinued or interrupted because of relevant side effects. The evolution was marked by complete remission and the absence of recurrence after one year of post-therapeutic follow-up.

• #44 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  Ameloblastoma is a benign odontogenic tumor. It is locally invasive and unlimited growth capacity, with a propensity for recurrence if not entirely excised. The therapeutic challenge in this type of tumors is to have an adequate resection with a wide margin of normal tissue but also a functional and aesthetically acceptable reconstruction of the residual defect. The role of radiotherapy is currently demonstrated in inoperable cases. […] The patient benefited from exclusive radiotherapy at a dose of 60 Gy. […] The patient received exclusive external radiotherapy with the VMAT technique, high-energy photons, at 60 Gy, 2 Gy/fraction, and 5 fractions/week, in 49 days. The therapy was well tolerated by the patient. The radiotherapy has not been discontinued or interrupted because of relevant side effects. The evolution was marked by complete remission and the absence of recurrence after one year of post-therapeutic follow-up.

• #45 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  The choice of surgical approach is difficult and influenced by the risk of recurrence. However, the therapeutic decision must take into account several factors including the patient’s age, the anatomical location of the tumor, its extension, the radiological appearance, and the need for regular follow-up of the patient. […] The risk of recurrence is greatest in the first three years but can occur much later, 15 to 30 years later. Adequate periodic clinical and radiologic follow-up for at least ten years is highly essential. […] Radiotherapy finds its place in locally advanced forms or the event of a refusal of surgery. Radiotherapy with modulation of intensity is a real advance that allows delivering an adequate dose to the tumor while sparing the organs at risk.

• #46 Novel Targets for the Treatment of Ameloblastoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4438731/

  Ameloblastoma grows slowly, is locally invasive, and has a high recurrence rate, especially if not adequately removed at initial surgery. Therefore, the treatment of choice is jaw resection, which often results in significant morbidity. […] The very high incidence of activating BRAF mutations and the additional recurrent, mutually exclusive mutations in the MAPK pathway genes KRAS, NRAS, and HRAS strongly implicate this pathway as the main driver of ameloblastoma growth. In addition, the recurrent mutations in the FGFR2 gene suggest the role of this RTK as a potent activator of the MAPK pathway in ameloblastoma. Various targeted therapies inhibiting the activity of the MAPK pathway are currently available. […] Intriguingly, ameloblastoma cells harboring the BRAF V600E mutation were shown to be sensitive to vemurafenib treatment in vitro, suggesting that mutant BRAF inhibition could be beneficial in ameloblastoma. Considering the importance of MAPK pathway activation for ameloblastoma, MAPK pathway inhibitors should be evaluated as novel targeted therapy for this disease.

• #47 Novel Targets for the Treatment of Ameloblastoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4438731/

  The recurrent SMO mutations co-occurring with the MAPK pathway mutations suggest that hedgehog pathway could be a parallel, synergistic pathway contributing to ameloblastoma pathogenesis and a potential therapeutic target. […] Taken together, the unraveling of the mutation landscape in ameloblastoma has rationalized the development of novel noninvasive treatment options for the management of ameloblastoma. However, the best treatment approaches must be carefully considered before potential future clinical studies.

• #48 Anti-MAPK Targeted Therapy for Ameloblastoma: Case Report with a Systematic Review

  https://www.mdpi.com/2072-6694/16/12/2174

  Consideration was given to using the neo-adjuvant MAPK pathway inhibitor therapy, dabrafenib, to reduce the morbidity of the surgery by shrinking the size of the tumor and proceeding to a simple enucleation without injuring the alveolar nerve and the second molar. […] This study reported on 13 articles with 23 patients diagnosed with ameloblastoma or its variants and treated with targeted therapy focusing only on the MAPK pathway. BRAF V600E represents most of the mutated genes in that pathway for this review. […] The key benefit of neo-adjuvant molecular targeted therapies is that they can significantly reduce the surgical morbidity seen in radical surgery with either primary or recurrent ameloblastoma. This also emphasizes the necessity of systematic gene profiling for each tumor, allowing for the identification of potential targeted therapies with a multidisciplinary team. […] Anti-MAPK targeted therapy seems to be safe and efficient in treating ameloblastoma that is primary, recurrent, or metastasizing. It allows for a clinical, radiological, pathological, and symptom-relieving response for this rare but potentially devastating disease.

• #49 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Ameloblastoma.aspx

  Drugs that suppress the actions of mutant BRAF and MEK have the potential to be used in molecular targeted therapy for ameloblastoma. The mutated BRAF genes are inhibited by vemurafenib and dabrafenib; the mutation MEK gene is inhibited by trametinib, and the mutated FGFR2 genes are inhibited by ponatinib and regorafenib. […] Three molecular targeted therapy for BRAF V600E mutation have been approved by the US Food and Drug Administration: vemurafenib, dabrafenib, and trametinib for BRAF mutations and trametinib for MEK mutations.

• #50 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Ameloblastoma.aspx

  Drugs that suppress the actions of mutant BRAF and MEK have the potential to be used in molecular targeted therapy for ameloblastoma. The mutated BRAF genes are inhibited by vemurafenib and dabrafenib; the mutation MEK gene is inhibited by trametinib, and the mutated FGFR2 genes are inhibited by ponatinib and regorafenib. […] Three molecular targeted therapy for BRAF V600E mutation have been approved by the US Food and Drug Administration: vemurafenib, dabrafenib, and trametinib for BRAF mutations and trametinib for MEK mutations.

• #51 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Ameloblastoma.aspx

  Drugs that suppress the actions of mutant BRAF and MEK have the potential to be used in molecular targeted therapy for ameloblastoma. The mutated BRAF genes are inhibited by vemurafenib and dabrafenib; the mutation MEK gene is inhibited by trametinib, and the mutated FGFR2 genes are inhibited by ponatinib and regorafenib. […] Three molecular targeted therapy for BRAF V600E mutation have been approved by the US Food and Drug Administration: vemurafenib, dabrafenib, and trametinib for BRAF mutations and trametinib for MEK mutations.

• #52 Novel Targets for the Treatment of Ameloblastoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4438731/

  Ameloblastoma grows slowly, is locally invasive, and has a high recurrence rate, especially if not adequately removed at initial surgery. Therefore, the treatment of choice is jaw resection, which often results in significant morbidity. […] The very high incidence of activating BRAF mutations and the additional recurrent, mutually exclusive mutations in the MAPK pathway genes KRAS, NRAS, and HRAS strongly implicate this pathway as the main driver of ameloblastoma growth. In addition, the recurrent mutations in the FGFR2 gene suggest the role of this RTK as a potent activator of the MAPK pathway in ameloblastoma. Various targeted therapies inhibiting the activity of the MAPK pathway are currently available. […] Intriguingly, ameloblastoma cells harboring the BRAF V600E mutation were shown to be sensitive to vemurafenib treatment in vitro, suggesting that mutant BRAF inhibition could be beneficial in ameloblastoma. Considering the importance of MAPK pathway activation for ameloblastoma, MAPK pathway inhibitors should be evaluated as novel targeted therapy for this disease.

• #53 Discovery could pave way to new treatment for rare jaw tumor | News Center

  https://med.stanford.edu/news/all-news/2014/05/discovery-could-pave-way-to-new-treatment-for-rare-jaw-tumor.html

  Researchers have identified the mutations underlying a rare, understudied type of jaw tumor called ameloblastoma, and have also found FDA-approved drugs that may help treat the tumors. […] The Food and Drug Administration has already approved drugs for other cancers caused by these mutations. Now, the paper’s authors are pursuing funding for a pilot study to use one of these drugs to treat ameloblastoma. […] Doctors diagnose about 300 to 600 cases of ameloblastoma in the United States each year. Neither drugs nor radiation have been successful at eradicating the cancer, leaving surgery as the only option. […] Perhaps most promising, researchers found that there are already FDA-approved drugs for cancers with mutations in the same developmental pathway. A drug called vemurafenib is toxic to ameloblastoma cell cultures that harbor a BRAF mutation, they found. […] In April, West and McClary began collaborating with Dimitrios Colevas, MD, associate professor of oncology at Stanford, to plan a small pilot study to assess whether vemurafenib can shrink ameloblastoma tumors that have a BRAF mutation.

• #54 UF patient first to receive combination chemotherapy to treat rare jaw tumor – UF Health

  https://ufhealth.org/news/2015/uf-patient-first-receive-combination-chemotherapy-treat-rare-jaw-tumor

  A University of Florida Health patient has become the first person to receive a combination of oral therapies targeted to a specific gene mutation that has dramatically reduced a rare oral tumor called ameloblastoma. […] After years of enduring different treatments, Woods is now responding well to this new oral combination treatment. […] Kaye and others knew a cancer drug called dabrafenib was used in cancers such as melanoma to treat the BRAF mutation. […] Kaye said within days of treating Woods with the combination therapy, Woods noticed a reduction of the tumor in his face and jaw. […] This is the new arena of targeted therapy directed to the mutation, Kaye said. […] Colevas is now working to open a clinical trial to study new patients with ameloblastoma with the hope of improving the outcome and quality of life for new patients undergoing surgery.

• #55 Anti-MAPK Targeted Therapy for Ameloblastoma: Case Report with a Systematic Review

  https://www.mdpi.com/2072-6694/16/12/2174

  Ameloblastoma is a type of tumor that usually forms in the jaw; while typically benign, it grows aggressively and often recurs after treatment. Traditional treatment involves extensive surgery, which can significantly affect a patient’s quality of life. Recent research has focused on a new approach, targeting a specific cellular pathway known as the MAPK pathway, which appears to be involved in the development of these tumors. In this study, we reviewed the outcomes of 23 patients treated with this targeted therapy to assess its safety and effectiveness. The results were promising: most patients experienced significant tumor reduction, and the side effects were generally mild. This suggests that MAPK pathway inhibitors could be a viable alternative to surgery, potentially offering improved outcomes for patients with ameloblastoma, minimizing surgical risks, and preserving quality of life. This advancement could greatly impact the approach to treating this challenging condition.

• #56 How a simple drug transformed the future of three young ameloblastoma patients

  https://www.aofoundation.org/cmf/about-aocmf/blog/2022_01-blog-ariel-hirschhorn

  This treatment had never been administered in an upfront manner for this disease. […] The results were profound. As treatment progressed, we noticed new bone formation – his jaw has regenerated to almost its exact pre-disease state. […] We have managed to tailor precision medicine, which is a genetically based patient specific treatment, to ameloblastoma. […] In the cases we treated, the BRAF inhibitor resulted in substantial tumor regression, allowing for non-mutilating complete surgical removal, bone regeneration and organ preservation. […] Precision medicine can be a valuable tool in the hands of surgeons, giving us the ability to direct treatment towards organ preservation and tissue regeneration. […] Therefore, myself and the team here will continue to research and write articles and lecture at conferences. We want to drive change and introduce precision medicine-based treatment, which can potentially spare the need for extensive surgery. […] With this treatment, we have seen our patients become healthy again. For children, they can be spared the trauma of facial disfigurement, and allow them to return to their normal lives.

• #57 How a simple drug transformed the future of three young ameloblastoma patients

  https://www.aofoundation.org/cmf/about-aocmf/blog/2022_01-blog-ariel-hirschhorn

  This treatment had never been administered in an upfront manner for this disease. […] The results were profound. As treatment progressed, we noticed new bone formation – his jaw has regenerated to almost its exact pre-disease state. […] We have managed to tailor precision medicine, which is a genetically based patient specific treatment, to ameloblastoma. […] In the cases we treated, the BRAF inhibitor resulted in substantial tumor regression, allowing for non-mutilating complete surgical removal, bone regeneration and organ preservation. […] Precision medicine can be a valuable tool in the hands of surgeons, giving us the ability to direct treatment towards organ preservation and tissue regeneration. […] Therefore, myself and the team here will continue to research and write articles and lecture at conferences. We want to drive change and introduce precision medicine-based treatment, which can potentially spare the need for extensive surgery. […] With this treatment, we have seen our patients become healthy again. For children, they can be spared the trauma of facial disfigurement, and allow them to return to their normal lives.

• #58

  https://link.springer.com/article/10.1007/s12105-024-01734-2

  The aim of the present study was to provide what we believe to be the first comprehensive description of changes in tumor morphology and selective molecular markers in either BRAFi- or combined BRAFi-MEKi-treated ameloblastomas. […] The present study aimed to provide a novel description and measurable assessment of the histomorphologic modifications and selective molecular changes in BRAF-mutated, target-treated ameloblastomas. […] The suggested scoring system may add insights especially for tumors with partial response in terms of assessing which compartment of the tumor has not responded as expected and aid the clinical team for planning additional adjuvant treatment options aimed at jaw preservation. […] Treatment of ameloblastoma with targeted therapy is predictable and time related, enabling jaw preservation treatment strategy.

• #59 Anti-MAPK Targeted Therapy for Ameloblastoma: Case Report with a Systematic Review

  https://www.mdpi.com/2072-6694/16/12/2174

  Consideration was given to using the neo-adjuvant MAPK pathway inhibitor therapy, dabrafenib, to reduce the morbidity of the surgery by shrinking the size of the tumor and proceeding to a simple enucleation without injuring the alveolar nerve and the second molar. […] This study reported on 13 articles with 23 patients diagnosed with ameloblastoma or its variants and treated with targeted therapy focusing only on the MAPK pathway. BRAF V600E represents most of the mutated genes in that pathway for this review. […] The key benefit of neo-adjuvant molecular targeted therapies is that they can significantly reduce the surgical morbidity seen in radical surgery with either primary or recurrent ameloblastoma. This also emphasizes the necessity of systematic gene profiling for each tumor, allowing for the identification of potential targeted therapies with a multidisciplinary team. […] Anti-MAPK targeted therapy seems to be safe and efficient in treating ameloblastoma that is primary, recurrent, or metastasizing. It allows for a clinical, radiological, pathological, and symptom-relieving response for this rare but potentially devastating disease.

• #60

  https://link.springer.com/article/10.1007/s12105-024-01734-2

  Identification of the BRAF V600E driver mutation in mandibular ameloblastomas as well as other mutations usually associated with maxillary ameloblastomas almost a decade ago has led to the search for targeted therapy for ameloblastomas of the jaws. […] Reported attempts to treat ameloblastomas with BRAF inhibitors (BRAFi) [with/without mitogen-activated protein kinase (MEK) inhibitors (MEKi)] as a last line treatment, have been successful for seven patients with recurrent inoperable conventional ameloblastomas, even some with lung metastatic deposits. […] BRAF-targeted therapy was used effectively for the first time in a neoadjuvant protocol in a small series of young patients with unicystic, mural type ameloblastoma. […] These young patients were part of a larger series of 11 patients (eight unicystic mural type, three conventional ameloblastomas), successfully treated with neoadjuvant BRAFi (with/without MEKi).

• #61 Anti-MAPK Targeted Therapy for Ameloblastoma: Case Report with a Systematic Review

  https://www.mdpi.com/2072-6694/16/12/2174

  Consideration was given to using the neo-adjuvant MAPK pathway inhibitor therapy, dabrafenib, to reduce the morbidity of the surgery by shrinking the size of the tumor and proceeding to a simple enucleation without injuring the alveolar nerve and the second molar. […] This study reported on 13 articles with 23 patients diagnosed with ameloblastoma or its variants and treated with targeted therapy focusing only on the MAPK pathway. BRAF V600E represents most of the mutated genes in that pathway for this review. […] The key benefit of neo-adjuvant molecular targeted therapies is that they can significantly reduce the surgical morbidity seen in radical surgery with either primary or recurrent ameloblastoma. This also emphasizes the necessity of systematic gene profiling for each tumor, allowing for the identification of potential targeted therapies with a multidisciplinary team. […] Anti-MAPK targeted therapy seems to be safe and efficient in treating ameloblastoma that is primary, recurrent, or metastasizing. It allows for a clinical, radiological, pathological, and symptom-relieving response for this rare but potentially devastating disease.

• #62 How a simple drug transformed the future of three young ameloblastoma patients

  https://www.aofoundation.org/cmf/about-aocmf/blog/2022_01-blog-ariel-hirschhorn

  This treatment had never been administered in an upfront manner for this disease. […] The results were profound. As treatment progressed, we noticed new bone formation – his jaw has regenerated to almost its exact pre-disease state. […] We have managed to tailor precision medicine, which is a genetically based patient specific treatment, to ameloblastoma. […] In the cases we treated, the BRAF inhibitor resulted in substantial tumor regression, allowing for non-mutilating complete surgical removal, bone regeneration and organ preservation. […] Precision medicine can be a valuable tool in the hands of surgeons, giving us the ability to direct treatment towards organ preservation and tissue regeneration. […] Therefore, myself and the team here will continue to research and write articles and lecture at conferences. We want to drive change and introduce precision medicine-based treatment, which can potentially spare the need for extensive surgery. […] With this treatment, we have seen our patients become healthy again. For children, they can be spared the trauma of facial disfigurement, and allow them to return to their normal lives.

• #63 Ameloblastoma | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17438

  Since malignant ameloblastoma is typically a slow-growing tumor, more active treatment approaches such as chemo or radiotherapy may not be necessary. Close patient follow-up for a minimum of five years is necessary to monitor for recurrence. […] Practitioners follow the most current recommendations from the American Joint Committee on Cancer and the National Comprehensive Cancer Network for more detailed treatment modalities, indications for neck dissections, chemo, and radiotherapy, etc. […] There is a Phase 2 study at Stanford University titled A Pilot Study of Dabrafenib and Trametinib for Patients With BRAF Mutated Ameloblastoma which studies dabrafenib and trametinib in treating patients with ameloblastoma and a specific mutation in the BRAF gene. […] Treatment completion will be by a surgeon trained in head and neck surgery, typically an oral and maxillofacial surgeon, otolaryngologist, plastic surgeon, or oncologic surgeon.

• #64 Ameloblastoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ameloblastoma/diagnosis-treatment/drc-20449426

  Ameloblastoma treatment may depend on your tumor’s size and location, and the type and appearance of the cells involved. Treatment may include: […] Surgery to remove the tumor. Ameloblastoma treatment usually includes surgery to remove the tumor. Ameloblastoma often grows into the nearby jawbone, so surgeons may need to remove the affected part of the jawbone. An aggressive approach to surgery reduces the risk that ameloblastoma will come back. […] Radiation therapy. Radiation therapy using high-powered energy beams might be needed after surgery or if surgery isn’t an option. […] Due to the risk of recurrence after treatment, lifelong, regular follow-up appointments are important.

• #65 Pathology Outlines – Ameloblastoma

  https://www.pathologyoutlines.com/topic/mandiblemaxillaameloblastoma.html

  Metastasizing ameloblastoma: extremely rare and there is currently no established treatment protocol; to be distinguished from ameloblastic carcinoma, an overtly malignant odontogenic neoplasm […] […] […] Longterm follow up is recommended for all types of ameloblastoma due to the potential for delayed presentation of recurrent disease; recurrent ameloblastoma may be difficult to treat.

• #66 Ameloblastoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ameloblastoma/diagnosis-treatment/drc-20449426

  Ameloblastoma treatment may depend on your tumor’s size and location, and the type and appearance of the cells involved. Treatment may include: […] Surgery to remove the tumor. Ameloblastoma treatment usually includes surgery to remove the tumor. Ameloblastoma often grows into the nearby jawbone, so surgeons may need to remove the affected part of the jawbone. An aggressive approach to surgery reduces the risk that ameloblastoma will come back. […] Radiation therapy. Radiation therapy using high-powered energy beams might be needed after surgery or if surgery isn’t an option. […] Due to the risk of recurrence after treatment, lifelong, regular follow-up appointments are important.

• #67 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  The choice of surgical approach is difficult and influenced by the risk of recurrence. However, the therapeutic decision must take into account several factors including the patient’s age, the anatomical location of the tumor, its extension, the radiological appearance, and the need for regular follow-up of the patient. […] The risk of recurrence is greatest in the first three years but can occur much later, 15 to 30 years later. Adequate periodic clinical and radiologic follow-up for at least ten years is highly essential. […] Radiotherapy finds its place in locally advanced forms or the event of a refusal of surgery. Radiotherapy with modulation of intensity is a real advance that allows delivering an adequate dose to the tumor while sparing the organs at risk.

• #68 Radiotherapy for large recurrent ameloblastoma of the mandible previously treated by surgery: A case report

  https://www.oatext.com/radiotherapy-for-large-recurrent-ameloblastoma-of-the-mandible-previously-treated-by-surgery-a-case-report.php

  The choice of surgical approach is difficult and influenced by the risk of recurrence. However, the therapeutic decision must take into account several factors including the patient’s age, the anatomical location of the tumor, its extension, the radiological appearance, and the need for regular follow-up of the patient. […] The risk of recurrence is greatest in the first three years but can occur much later, 15 to 30 years later. Adequate periodic clinical and radiologic follow-up for at least ten years is highly essential. […] Radiotherapy finds its place in locally advanced forms or the event of a refusal of surgery. Radiotherapy with modulation of intensity is a real advance that allows delivering an adequate dose to the tumor while sparing the organs at risk.

• #69 Pathology Outlines – Ameloblastoma

  https://www.pathologyoutlines.com/topic/mandiblemaxillaameloblastoma.html

  Metastasizing ameloblastoma: extremely rare and there is currently no established treatment protocol; to be distinguished from ameloblastic carcinoma, an overtly malignant odontogenic neoplasm […] […] […] Longterm follow up is recommended for all types of ameloblastoma due to the potential for delayed presentation of recurrent disease; recurrent ameloblastoma may be difficult to treat.

• #70 Ameloblastoma: Symptoms, Causes, Treatment, and Diagnosis

  https://www.lybrate.com/topic/ameloblastoma

  After completing treatment for Ameloblastoma, it is essential to follow post-treatment guidelines to achieve the best possible outcome. […] Individuals should schedule regular follow-up appointments with their doctor to monitor the healing process and detect any potential signs of recurrence. […] Good oral hygiene is crucial. To maintain good oral health, patients should clean their teeth twice daily and floss frequently. […] A well-balanced diet rich in lean proteins, fruits, and vegetables can promote the body’s natural healing processes and enhance general health. […] The outcomes of ameloblastoma treatment can differ. Sometimes, treatment is able to completely remove the tumor and stop it from coming back. However, there is a risk of recurrence with any type of treatment. […] Anyone diagnosed with ameloblastoma is eligible for treatment, regardless of age or other health factors.

• #71 Ameloblastoma: Symptoms, Causes, Treatment, and Diagnosis

  https://www.lybrate.com/topic/ameloblastoma

  After completing treatment for Ameloblastoma, it is essential to follow post-treatment guidelines to achieve the best possible outcome. […] Individuals should schedule regular follow-up appointments with their doctor to monitor the healing process and detect any potential signs of recurrence. […] Good oral hygiene is crucial. To maintain good oral health, patients should clean their teeth twice daily and floss frequently. […] A well-balanced diet rich in lean proteins, fruits, and vegetables can promote the body’s natural healing processes and enhance general health. […] The outcomes of ameloblastoma treatment can differ. Sometimes, treatment is able to completely remove the tumor and stop it from coming back. However, there is a risk of recurrence with any type of treatment. […] Anyone diagnosed with ameloblastoma is eligible for treatment, regardless of age or other health factors.

• #72 Ameloblastoma: Symptoms, Causes, Treatment, and Diagnosis

  https://www.lybrate.com/topic/ameloblastoma

  After completing treatment for Ameloblastoma, it is essential to follow post-treatment guidelines to achieve the best possible outcome. […] Individuals should schedule regular follow-up appointments with their doctor to monitor the healing process and detect any potential signs of recurrence. […] Good oral hygiene is crucial. To maintain good oral health, patients should clean their teeth twice daily and floss frequently. […] A well-balanced diet rich in lean proteins, fruits, and vegetables can promote the body’s natural healing processes and enhance general health. […] The outcomes of ameloblastoma treatment can differ. Sometimes, treatment is able to completely remove the tumor and stop it from coming back. However, there is a risk of recurrence with any type of treatment. […] Anyone diagnosed with ameloblastoma is eligible for treatment, regardless of age or other health factors.

• #73 Ameloblastoma: Symptoms, Causes, Treatment, and Diagnosis

  https://www.lybrate.com/topic/ameloblastoma

  After completing treatment for Ameloblastoma, it is essential to follow post-treatment guidelines to achieve the best possible outcome. […] Individuals should schedule regular follow-up appointments with their doctor to monitor the healing process and detect any potential signs of recurrence. […] Good oral hygiene is crucial. To maintain good oral health, patients should clean their teeth twice daily and floss frequently. […] A well-balanced diet rich in lean proteins, fruits, and vegetables can promote the body’s natural healing processes and enhance general health. […] The outcomes of ameloblastoma treatment can differ. Sometimes, treatment is able to completely remove the tumor and stop it from coming back. However, there is a risk of recurrence with any type of treatment. […] Anyone diagnosed with ameloblastoma is eligible for treatment, regardless of age or other health factors.

• #74 Ameloblastoma: Symptoms, Causes, Treatment, and Diagnosis

  https://www.lybrate.com/topic/ameloblastoma

  While chemotherapy is not typically used as a primary treatment for ameloblastoma, it may be used in advanced or recurrent cases that are resistant to other treatments. […] Regular follow-up appointments with a dental professional or oral and maxillofacial surgeon are important to monitor for any signs of recurrence or complications following treatment. […] The precise course of treatment will depend on the size and location of the tumor, the patient’s general health, and their medical background, among other things. […] The primary treatment for ameloblastoma is surgical removal of the tumor. Several surgical techniques may be performed, depending on the tumor’s size, location, and extent. […] In rare cases where the tumor is particularly large or has spread extensively, a complete removal of the jaw (maxillectomy or mandibulectomy) may be necessary.

• #75 Perspective Chapter: Ameloblastoma – Present and Future Concepts of Managing | IntechOpen

  https://www.intechopen.com/chapters/83748

  In addition, recent literature has provided us with breakthrough in the understanding of genetic mutations and signaling pathways crucial in ameloblastoma pathogenesis. […] This chapter will address evidence-based treatment options and contemporary concepts of managing ameloblastoma. […] Current management concept of ameloblastoma is still controversial. To date, standard treatment is radical resection with a wide bone margin. However, various treatment methods have been recommended with respect to many factors, such as type and clinical presentation of tumor. […] Surgical approach can be furtherly divided into radical and conservative surgery. […] Non-surgical methods include radiotherapy and/or chemotherapy. Recent advances in signaling pathways and genetic understanding related to pathogenesis of ameloblastoma resulted with the development of molecular targeted therapies as a valuable treatment option in management of the disease.

• #76 Perspective Chapter: Ameloblastoma – Present and Future Concepts of Managing | IntechOpen

  https://www.intechopen.com/chapters/83748

  Still a gold standard in ameloblastoma treatment, radical surgery is favored for all aggressive types of primary and recurrent ameloblastomas. […] Relatively high recurrence rate of ameloblastoma presents a major challenge. […] Conservative treatment has found its purpose in treating less aggressive types of ameloblastoma. […] Considering the high recurrence rate of conservatively treated conventional type of ameloblastoma it is crucial to emphasize the right indication. […] Decompression is a valuable method most commonly used to preoperatively reduce the size of cysts. […] Over the past decade, novel molecular targeted therapies are evolving alongside with dramatically improved understandings of biological behavior of ameloblastoma. […] The development of molecular targeted therapies implicates MAPK and SHH pathway inhibition as an effective treatment modality for ameloblastoma. Further clinical research is mandatory for standardization of treatment methods.

• #77 Perspective Chapter: Ameloblastoma – Present and Future Concepts of Managing | IntechOpen

  https://www.intechopen.com/chapters/83748

  Still a gold standard in ameloblastoma treatment, radical surgery is favored for all aggressive types of primary and recurrent ameloblastomas. […] Relatively high recurrence rate of ameloblastoma presents a major challenge. […] Conservative treatment has found its purpose in treating less aggressive types of ameloblastoma. […] Considering the high recurrence rate of conservatively treated conventional type of ameloblastoma it is crucial to emphasize the right indication. […] Decompression is a valuable method most commonly used to preoperatively reduce the size of cysts. […] Over the past decade, novel molecular targeted therapies are evolving alongside with dramatically improved understandings of biological behavior of ameloblastoma. […] The development of molecular targeted therapies implicates MAPK and SHH pathway inhibition as an effective treatment modality for ameloblastoma. Further clinical research is mandatory for standardization of treatment methods.

• #78 Perspective Chapter: Ameloblastoma – Present and Future Concepts of Managing | IntechOpen

  https://www.intechopen.com/chapters/83748

  Still a gold standard in ameloblastoma treatment, radical surgery is favored for all aggressive types of primary and recurrent ameloblastomas. […] Relatively high recurrence rate of ameloblastoma presents a major challenge. […] Conservative treatment has found its purpose in treating less aggressive types of ameloblastoma. […] Considering the high recurrence rate of conservatively treated conventional type of ameloblastoma it is crucial to emphasize the right indication. […] Decompression is a valuable method most commonly used to preoperatively reduce the size of cysts. […] Over the past decade, novel molecular targeted therapies are evolving alongside with dramatically improved understandings of biological behavior of ameloblastoma. […] The development of molecular targeted therapies implicates MAPK and SHH pathway inhibition as an effective treatment modality for ameloblastoma. Further clinical research is mandatory for standardization of treatment methods.

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