Ruhin-Poncet B, Bouattour A, Picard A, Menard P, Capron F, Bertrand J-C
Service de stomatologie et de chirurgie maxillofaciale (Pr Bertrand), hôpital Pitié-Salpêtrière, assistance publique des Hôpitaux de Paris, université Pierre-et Marie-Curie-Paris-6, Paris, France.
Rev Stomatol Chir Maxillofac. 2011 Nov;112(5):269-79. doi: 10.1016/j.stomax.2011.05.004. Epub 2011 Jul 13.
Ameloblastomas and keratocysts are the most frequent epithelial odontogenic tumors of the jaws. They have a high recurrence rate. This retrospective study reviews the features of ameloblastomas operated on in our unit from 1994 to 2007.
The studied parameters were sex, ethnic origin, age at diagnosis, clinical signs, radiographic presentation, site distribution, histological type, treatment, and follow-up records.
One hundred and sixteen patients were included (with 239 surgical samples). The mean age was 36 years, with a majority of Europeans, 60% of multilocular radiolucent lesions with root resorption, mandibular location (93%). Twenty-one percent of the patients presented with an impacted tooth, the third molar in 79% of cases. Fifty percent of the lesions were from 5 to 13cm in length, 10% longer than 13cm. The most common histological type was follicular ameloblastoma. Patients were treated by enucleation in 82% of cases and radical mandibular resection with reconstruction in 11% of cases. The follow-up was documented for 96% of the patients with a 44% recurrence rate. Seventy-four percent of patients with a double recurrence presented with a "follicular" ameloblastoma.
We prefer a well-performed enucleation which preserves surrounding bone. The high rate of follicular type recurrence should more systematically lead to a combined treatment: periostectomy and tooth extraction. Our data was compared with previously published large series.
成釉细胞瘤和角化囊肿是颌骨最常见的上皮性牙源性肿瘤。它们具有较高的复发率。本回顾性研究回顾了1994年至2007年在我们科室接受手术的成釉细胞瘤的特征。
研究参数包括性别、种族、诊断时年龄、临床体征、影像学表现、部位分布、组织学类型、治疗方法及随访记录。
共纳入116例患者（239个手术样本）。平均年龄36岁，大多数为欧洲人，60%的多房性透射性病变伴有牙根吸收，位于下颌骨（93%）。21%的患者伴有阻生牙，其中79%为第三磨牙。50%的病变长度为5至13厘米，10%的病变长度超过13厘米。最常见的组织学类型是滤泡型成釉细胞瘤。82%的病例采用摘除术治疗，11%的病例采用下颌骨根治性切除并重建。96%的患者有随访记录，复发率为44%。74%复发两次的患者表现为“滤泡型”成釉细胞瘤。
我们更倾向于进行良好的摘除术以保留周围骨质。滤泡型复发率高应更系统地采用联合治疗：骨膜切除术和拔牙术。我们的数据与先前发表的大型系列研究进行了比较。
