title: Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis.
abstract: BACKGROUND
  Ameloblastoma is the second most common odontogenic tumor, known to be slow-growing, persistent, and locally aggressive. Recent data suggests that ameloblastoma is best treated with wide resection and adequate margins. Following primary excision, bony reconstruction is often necessary for a functional and aesthetically satisfactory outcome, making early diagnosis paramount. Despite earlier diagnosis potentially limiting the extent of resection and reconstruction, an understanding of the growth rate and natural history of ameloblastoma has been notably lacking from the literature.
  
  
  METHODS
  A systematic review of the literature was conducted by reviewing relevant articles from PubMed and Web of Science databases. Each article's level of evidence was formally appraised according to the Centre of Evidence Based Medicine (CEBM), with data from each utilized in a meta-analysis of growth rates for ameloblastoma.
  
  
  RESULTS
  Literature regarding the natural history of ameloblastoma is limited since the tumor is immediately acted upon at its initial detection, unless the patient voluntarily refuses a surgical intervention. From the limited data, it is derived that the highest estimated growth rate is associated with solid, multicystic type and the lowest rate with peripheral ameloblastomas. After meta-analysis, the calculated mean specific grow rate is 87.84% per year.
  
  
  CONCLUSIONS
  The growth rate of ameloblastoma has been demonstrated, offering prognostic and management information, particularly in cases where a delay in management is envisaged.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Surgery, Monash University, Clayton, Victoria, Australia; Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Chae
authors.affiliation: Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Surgery, Monash University, Clayton, Victoria, Australia; Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia.
authors.forename: Nicolas R
authors.initials: NR
authors.lastname: Smoll
authors.affiliation: Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Surgery, Monash University, Clayton, Victoria, Australia; Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter-Smith
authors.affiliation: Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Surgery, Monash University, Clayton, Victoria, Australia; Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia; Department of Surgery, James Cook University Clinical School, Townsville, Queensland, Australia.
authors.forename: Warren Matthew
authors.initials: WM
authors.lastname: Rozen
mesh_terms: D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000473:pathology*; D005260:Female; D006801:Humans; D007573:Jaw Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult