Complex treatment of huge, massive growing ameloblastoma in teenage, a case report

Abstract

Background: The ameloblastoma is one of the benign epithelial odontogenic tumors that arise from proliferating odontogenic epithelium. Unrestrained growth can cause significant destruction of functional tissue. In growth and adolescence, in addition to functional damage, there is also a risk of aesthetic losses. Case presentation: In the present case, we show an extensive ameloblastoma of the right lower jaw in an 11-year-old girl, which was discovered by incidental finding during an orthodontic examination. After extensive resection of the right lower jaw, the reconstruction was carried out using two avascular bone grafts from the anterior iliac crest. After removal of the osteosynthesis material at the age of 12 years and complete functional adaptation of the graft, a mandibular advancement was carried out after finishing the skeletal growth. In combination with the removal of the osteosynthesis material, a bone augmentation of the right lower jaw took place one year later followed by the insertion of dental implants 4 months later. After the prosthetic restoration of the dental implants, a completely functional and aesthetic rehabilitation has been achieved. Conclusions: We can show that an extensive resection of the lower jaw does not necessarily have to be associated with functional and aesthetic losses, especially during growth and without relevant donor site morbidity. A well-thought-out concept of surgical resection and reconstruction can lead to complete rehabilitation.

Keywords

• Ameloblastoma
• Reconstruction
• Mandible
• Bone graft
• Bone remodeling