Extensive ameloblastoma of the jaws: surgical management and immediate reconstruction using microvascular flaps.
OBJECTIVE
Ameloblastoma is a rare histological benign but locally aggressive tumor with a marked tendency for recurrence. Especially larger, aggressive lesions require a more radical surgical approach resulting in large jaw defects. The purpose of this study is to analyze the long-term functional and esthetic results after immediate reconstruction of large jaw defects using microvascular flaps.


METHODS
A review of 7 cases of giant ameloblastoma (2 in the maxillary and 5 in the mandibular region) is presented. The lesions were between 4 and 8 cm in diameter. All patients were treated by a radical surgical protocol. All cases were immediately reconstructed using microvascular grafts from either the scapula or the iliac crest bone. Dental implants were inserted in all patients after removal of the osteosynthesis material.


RESULTS
All patients were prosthetically rehabilitated. All implants survived throughout the observation time. The esthetic and functional outcomes were satisfying in all patients. No case of recurrence of the tumor could be observed so far.


CONCLUSIONS
According to our opinion, immediate reconstruction is the treatment of choice after radical surgical excision of ameloblastoma. This 1-step procedure decreases the number of surgeries and allows earlier prosthetic rehabilitation.
Zemann
Wolfgang
W
Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, Austria. wolfgang.zemann@meduni-graz.at
Feichtinger
Matthias
M
Kowatsch
Eberhard
E
Kärcher
Hans
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000534:rehabilitation / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D007573:Jaw Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply