About Ameloblastoma
What Is Ameloblastoma?
Ameloblastoma Causes and Risk Factors
Ameloblastoma is tumor that occurs in the jaws. The exact pathophysiologic causes of ameloblastoma are still unknown. However, it is believed to result from abnormalities in genes that control the growth and production of cells in the jaw. These genetic changes can be inherited or acquired..
Ameloblastoma is not known to be caused by anything a person does or does not do, and there are no known lifestyle changes that can prevent it.
What Are the Symptoms of Ameloblastoma?
Ameloblastomas are slow-growing tumors. They may be present for years without causing noticeable symptoms and may first be found during a routine dental exam or dental X-ray. Symptoms usually develop as the tumor enlarges and affects nearby bone, teeth, or soft tissues.
As ameloblastoma progresses or becomes more severe, the following symptoms may occur:
- Swelling or a lump in the jaw or on one side of the face
- Facial asymmetry
- Changes in how the teeth fit together
- Teeth that shift position or become displaced
- Expansion of the jawbone
- Difficulty opening the mouth or moving the jaw
- Changes in the bite, such as the upper and lower teeth no longer lining up normally
- Loose teeth or tooth loss
Some people may also notice numbness, tingling, or altered sensation in the lower lip, chin, teeth, or jaw if nearby nerves are affected.
Pain is not always present with ameloblastoma, but it can occur, especially if the tumor becomes large, affects nearby tissues, causes pressure on nerves, or becomes infected.
These symptoms can have many causes and may vary from person to person. If you have swelling in the jaw or face, loose or shifting teeth, changes in your bite, difficulty opening your mouth, or other concerning symptoms, talk with a dentist, oral and maxillofacial surgeon, or other healthcare professional for an accurate diagnosis and appropriate care.
How is Ameloblastoma Diagnosed?
To diagnose ameloblastoma, the following examinations, tests, and procedures are commonly performed:, the following examinations, tests, and procedures are commonly performed:
- Physical exam: The healthcare provider will check the jaw, face, mouth, teeth, and gums for signs that may suggest a jaw tumor, such as swelling, a lump or mass, jaw expansion, changes in bite, loose teeth, or areas of tenderness.
- Imaging studies: Dental X-rays, panoramic radiographs, CT scans, cone beam computed tomography (CBCT), or MRI scans may be used to evaluate the affected area. Imaging can help show the size, location, and extent of the tumor and whether nearby bone, teeth, soft tissues, or other structures are involved. Specific examples of imaging studies that may be performed include:
- CT scan: This imaging test provides detailed cross-sectional images and can help show the extent of bone involvement and the tumor’s relationship to nearby structures.
- Panoramic radiograph: This dental X-ray captures a wide view of the mouth and jaws and may show a jaw lesion’s size, location, and effects on nearby teeth or bone.
- Cone beam computed tomography (CBCT): CBCT produces 3D images of the jaws and teeth and can help define the lesion’s size, location, and relationship to surrounding bone and dental structures.
- Biopsy: A tissue sample is taken from the affected area and examined under a microscope to confirm the diagnosis and identify the histologic type or subtype of ameloblastoma.
It's important to consult with your healthcare provider about which specific examinations, tests, and procedures are appropriate for your individual situation.
How is Ameloblastoma Treated?
Treatment for ameloblastoma depends on the size and location of the tumor, its histologic type or subtype, how far it extends into nearby bone or soft tissue, and the person’s overall health. The goals of treatment are to remove the tumor as completely as possible, lower the chance of recurrence, and preserve or restore functions such as chewing, swallowing, speech, nutrition, dental health, and facial appearance.
Treatment options may include:
- Surgery: Surgery is the main treatment for most ameloblastomas. The type of surgery depends on the tumor’s size, location, histologic type or subtype, and how far it extends into nearby bone, teeth, or soft tissue.
- Radical surgery: Wide local excision or en bloc resection is often used for conventional solid or multicystic ameloblastoma. It involves removing the tumor with a margin of surrounding bone and tissue to help achieve complete removal. Depending on the tumor’s location and extent, this may include removal of part of the lower jaw or upper jaw. This approach aims to lower the risk that the tumor will return.
- Conservative surgery: This approach removes the tumor with less surrounding healthy tissue and bone than more extensive surgery. It may be considered for selected tumors, such as unicystic ameloblastoma or small lesions in appropriate locations, but it can carry a higher risk of recurrence and requires close long-term follow-up.
- Radiation therapy: Radiation therapy is not commonly used as a first treatment for ameloblastoma. It may be considered in selected situations, such as when surgery is not possible, when a tumor cannot be completely removed, when the tumor returns and further surgery would cause major harm, or when the tumor has malignant features.
After treatment, long-term follow-up is important because ameloblastoma can return months or years later, and recurrence can also occur after longer intervals. Follow-up visits may include clinical exams and imaging tests to check for recurrence and monitor healing, dental function, and jaw reconstruction if these were part of treatment.
Recovery and supportive care after ameloblastoma treatment may include:
When a large part of the jaw must be removed, reconstructive planning may begin before surgery. This may involve specialists in oral and maxillofacial surgery, head and neck surgery, reconstructive surgery, dentistry, prosthodontics, speech therapy, nutrition, and rehabilitation.
Additional care may be recommended during recovery or after the initial treatment to help address changes in appearance, chewing, swallowing, speech, dental function, or other functional effects of ameloblastoma and its treatment. These may include:
- Speech therapy: A speech-language pathologist can help people adjust to changes in speech, chewing, and swallowing after jaw surgery or reconstruction.
- Nutrition: A dietitian may help with food choices, meal planning, and nutrition support to make it easier to chew and swallow foods, especially during recovery.
- Reconstructive surgery: Reconstructive surgery may help restore the shape and function of the jaw and face after part of the jaw has been removed.
- Dental implants or prosthetic teeth: Teeth that were lost from ameloblastoma or removed during surgery may be replaced with dental implants, dentures, bridges, or other prosthetic teeth when appropriate. These options can help restore chewing function and appearance.
It is important to work with a healthcare team with expertise in managing ameloblastoma to determine a treatment plan that includes consideration for individual factors and preferences.