Centre of maxillo-facial surgery and dentistry Kyiv regional clinical hospital Sholudenka street, 1A, ap 45. 04116, Kyiv, Ukraine
Med Oral Patol Oral Cir Bucal. 2021 Mar 1;26(2):e181-e186. doi: 10.4317/medoral.24104.
The ameloblastoma management is still challenging to the high recurrence rates and significant morbidity associated with radical treatment. The purpose of this 10-year retrospective study was to analyze the influence of ameloblastoma type and treatment strategy on the long-term outcomes and recurrence rates.
The retrospective analyses of 64 histologically-confirmed ameloblastoma cases was performed. The possible risk factors for recurrence and the development of complications were estimated statistically.
The treatment strategy applied for this group of patients was the following: thirty-four patients (53.1%) were treated conservatively with enucleation or extended bone curettage. Radical treatment (bone resection) was applied in 30 (46.9%) cases. The follow-up period ranged from 2 to 10 years (mean value 4.28 ± 3,26). General recurrence rate consisted 32.8%. This study did not find significant correlations between clinical or histopathological features of the ameloblastoma and the recurrence rate. The only factor that significantly influence recurrence rate was the treatment strategy (41% in conservative treatment vs 15% in radical treatment, p<0.05). Postoperative complications were observed in 42 patients (65.6%) and included face asymmetry and disfigurement (17.2%), temporary paresthesia of the inferior alveolar nerve (IAN) - 23.4%, permanent paresthesia of IAN - 20.3%, paresis of a marginal branch of the facial nerve - 6.3%, infection 12.5%, and swelling - 20.3%. The complication rates, esthetic and functional deficiency were significantly higher in radically treated patients (p<0.05) Conclusions: Our study confirms that higher recurrence rate is associated with conservative treatment for ameloblastoma, while radical treatment leads to an increased number of postoperative complications that affect the patient's quality of life.
由于根治性治疗相关的高复发率和显著发病率，成釉细胞瘤的治疗仍然具有挑战性。本 10 年回顾性研究的目的是分析成釉细胞瘤类型和治疗策略对长期结果和复发率的影响。
对 64 例经组织学证实的成釉细胞瘤病例进行回顾性分析。统计分析了复发和并发症发生的可能危险因素。
本研究中，为该组患者应用的治疗策略如下：34 例（53.1%）患者采用剜除术或扩大骨刮除术进行保守治疗。30 例（46.9%）患者采用根治性治疗（骨切除术）。随访时间为 2 至 10 年（平均 4.28 ± 3.26 年）。总的复发率为 32.8%。本研究未发现成釉细胞瘤的临床或组织病理学特征与复发率之间存在显著相关性。唯一显著影响复发率的因素是治疗策略（保守治疗组为 41%，根治性治疗组为 15%，p<0.05）。术后并发症在 42 例患者（65.6%）中观察到，包括面部不对称和畸形（17.2%）、下牙槽神经（IAN）暂时性感觉异常（23.4%）、IAN 永久性感觉异常（20.3%）、面神经边缘支麻痹（6.3%）、感染（12.5%）和肿胀（20.3%）。根治性治疗患者的并发症发生率、美观和功能缺陷显著更高（p<0.05）。
本研究证实，成釉细胞瘤的保守治疗与更高的复发率相关，而根治性治疗会导致更多的术后并发症，从而影响患者的生活质量。
