El ameloblastoma es el tumor benigno mas comun, representa el 1% de todos los tumores odontogenicos y comprende del 11 al 18% de las lesiones de los maxilares. El 80% de los casos se han descrito en la mandibula en la zona del cuerpo y angulo, afecta por igual a hombres y mujeres, con una mayor prevalencia entre la tercera y la cuarta decada de vida. Este tumor se presenta con diferentes aspectos clinicos, radiograficos e histopatologicos y aunque es una patologia benigna, es localmente invasora, se le atribuye una alta tasa de recidiva. El objetivo de este articulo es presentar la experiencia lograda con el diagnostico y tratamiento de diez casos de ameloblastomas en pacientes entre los doce y los setenta y tres anos; el 80% de ellos localizados en la mandibula, que producian diferentes manifestaciones clinicas tales como: asimetria facial, desplazamiento dental, resorcion radicular, alteracion de la oclusion, dolor, dificultad para la masticacion y fractura patologica. Se realizo una clasificacion radiografica de acuerdo con su imagen en uniloculares o multiloculares. Histopatologicamente se agruparon segun la variante observada, ademas, se describen diferentes alternativas de tratamientos y las complicaciones surgidas. Dos pacientes habian sido intervenidos porque presentaron previamente quiste dentigero en la misma zona y otros dos casos consultaron por recidiva de ameloblastoma luego de cinco anos de ser intervenidos en otras instituciones. ABSTRACT . Ameloblastoma is the most common benign tumor, It represents 1% of all odontogenic tumors and comprises 11 to 18% of all maxillary lesions. Eighty percent of the cases described are located in the body of the mandible and its angle; it affects males and females equally, and its more prevalent during the third and fourth decades of life. This tumor has diverse clinical, radiographical and histo-pathological aspects. Although it is considered a benign pathology, it is locally invasive and has a high rate of recurrence. The objective of this article is to present the experience obtained with the diagnosis and treatment of ten cases of ameloblastoma in patients ranging from 12 and 73 years of age. Eighty percent of theses cases were located in the mandible and were causing different clinical manifestations such as: facial asymmetry, dental displacement, root resorption, alteration in the occlusion, pain, masticatory difficulty and pathological fractures. According to their image a radiographic classification was made, identifying them as unilocular and multilocular. Histopathologically, they were grouped according to the observed variant. Different treatment alternatives are described, as well as the complications encountered. Two patients had previous surgery for dentigerous cysts in the same area. Two cases had recurrent ameloblastoma five years after their surgical interventions performed in other institutions.
Tópico:
Oral and Maxillofacial Pathology
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4
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FuenteRevista Facultad de Odontología Universidad de Antioquia