Effect of preservation of the inferior and posterior borders on recurrence of ameloblastomas of the mandible.

OBJECTIVE: The purpose of this study was to evaluate the experience and results of using a rational radical conservative approach in the surgical treatment of mandibular ameloblastomas. STUDY
DESIGN: A retrospective analysis of every patient with an ameloblastoma of the mandible treated in the Department of Oral Medicine and Oral Surgery at the Jordan University of Science and Technology between 1989 and 1999 was conducted. All were operated on by the author, who used a uniform surgical protocol in every case. All soft tissues in contact or overlying the lesion and a wide margin of cancellous bone related to the tumor were destroyed. The compact bone comprising the lower border of the mandible and the posterior border of the ascending ramus together with the nutrient periosteum attached to them were preserved, thus maintaining the continuity of the mandible and the facial contours. When teeth, soft tissues, or both were involved, they were destroyed. All patients were reviewed annually for a follow-up period of 3 to 10 years (mean, 6.5 years) by the same clinician.
RESULTS: All ameloblastomas were located in the mandible; 21 were in the angle/molar region and the ascending ramus, and 2 cases were in the anterior region. There was no clinical or radiographic evidence of recurrence observed during the follow-up period.
CONCLUSION: Ameloblastoma has a high rate of local recurrence if it is not adequately removed. The findings of this study to date suggest that the technique of rational radical conservative resection may have a place in the treatment of ameloblastoma of the mandible and is worthy of further trial.