Plexiform unicystic ameloblastoma. A variant of ameloblastoma with a low-recurrence rate after enucleation.

The term, plexiform unicystic ameloblastoma, refers to a pattern of epithelial proliferation that has been described in dentigerous cysts, primarily in persons in the second and third decades of life and predominantly in the posterior part of the mandible. This article provides the first study on the biologic behavior of these lesions. Of 28 examples treated by enucleation/curettage, and for which adequate follow-up information was obtained, only three recurred. This figure (10.7%) compares very favorably with the 55% to 90% recurrence rate quoted for ameloblastomas of all types that have been treated by curettage and is similar to that found in other types of unicystic ameloblastoma. The plexiform unicystic ameloblastoma is concluded from this study to be an undifferentiated histologic variant of unicystic ameloblastoma and not a separate entity. Enucleation with long-term follow-up information is adequate for tumors that have proliferated into the lumen of the cyst, but more extensive surgery is recommended for those that involve the periphery of its fibrous connective wall. This study has also shown that plexiform unicystic ameloblastomas are not always associated with unerupted teeth, in which case they probably occur over a wider age range than those resembling dentigerous cysts.