Neagu David, Escuder-de la Torre Oscar, Vázquez-Mahía Inés, Carral-Roura Nicolás, Rubín-Roger Guillermo, Penedo-Vázquez Ángel, Luaces-Rey Ramón, López-Cedrún José-Luis
MD. Maxillofacial Surgery Department, University Hospital A Coruña, Spain.
MD. Head of Maxillofacial Surgery Department, Hospital Parc Tauli Sabadell, Spain.
J Clin Exp Dent. 2019 Jan 1;11(1):e70-e75. doi: 10.4317/jced.55452. eCollection 2019 Jan.
Ameloblastoma is an odontogenic tumor that represents 1% of all tumors in the oral cavity and it is clinically classified in three types. Currently, solid and multi-cystic are considered locally aggressive, with high recurrence rates with conservative treatment.
Objective of the present review is to assess whether the surgical treatment should be conservative or radical. English articles published between 2009-2014, with available summary and in humans were included.
241 articles were found, 188 were excluded because analyzing. 53 articles were analyzed and finally 14 were selected for this review.
The optimal surgical treatment of ameloblastoma should minimize recurrences, restore function and aesthetic and present a minimal morbidity in the donor area. Surgical planning must be performed based on the patient comorbidities, the size and location of the tumor, the techniques available for reconstruction and the surgeon's experience-Radical surgery appears to be the most recommended option in multicystic / solid and advanced unicystic tumors, along with long-term follow-up for the possibility of recurrence beyond 10 year. Conservative surgery combined with a support technique and long-term follow-up is reserved for the unicystic and multicystic / solid types if small extension. Prospective and randomized studies for ameloblastoma are recommended. Ameloblastoma, surgery, enucleation, radical.
成釉细胞瘤是一种牙源性肿瘤，占口腔所有肿瘤的1%，临床上分为三种类型。目前，实性和多囊性成釉细胞瘤被认为具有局部侵袭性，采用保守治疗时复发率较高。
本综述的目的是评估手术治疗应采用保守还是根治方式。纳入2009年至2014年间发表的、有可用摘要且针对人类的英文文章。
共检索到241篇文章，其中188篇因分析原因被排除。对53篇文章进行了分析，最终选择14篇纳入本综述。
成釉细胞瘤的最佳手术治疗应使复发率降至最低，恢复功能和美观，且供区发病率最低。手术规划必须基于患者的合并症、肿瘤的大小和位置、可用于重建的技术以及外科医生的经验。对于多囊性/实性和晚期单囊性肿瘤，根治性手术似乎是最推荐的选择，同时需进行长期随访以监测10年以上复发的可能性。对于小范围的单囊性和多囊性/实性成釉细胞瘤，可采用保守手术联合支持技术并进行长期随访。建议开展关于成釉细胞瘤的前瞻性和随机研究。成釉细胞瘤、手术、摘除术、根治性。
