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Unicystic Ameloblastoma : Treatment

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Treatment of Unicystic Ameloblastomas: The clinical and radiologic findings in the majority of unicystic ameloblastomas are suggestive of an odontogenic cyst. As a result most of these are removed by enucleation. The diagnosis of unicystic ameloblastoma becomes apparent only after microscopic examination of the cyst wall. For luminal type lesions, enucleation is adequate treatment. Adequate sampling is essential to rule out mural invasion by tumor cells.

If the lesion turns out to be a unicystic ameloblastoma, mural type (islands of follicular ameloblastoma infiltrating the fibrous cyst wall), some surgeons advocate prophylactic local resection of the area. Others recommend close radiographic observation to monitor for recurrence. In any case, long-term follow up is necessary.

The earlier reports which suggested a less aggressive behavior for unicystic ameloblastomas have been recently challenged. The recurrence rate is 10% to 20%. Mural type has the highest recurrence rate amongst the three subtypes with conservative treatment.

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