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Ameloblastoma : Radiology

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On plain films, 80-90% of ameloblastomas appear as multilocular radiolucent lesions with a classical expansile soap bubble appearance (if locules are large) or honeycombed appearance (if locules are small). The tumor has well-demarcated scalloped borders and no matrix calcifications. There may be erosion of adjacent tooth roots. Larger lesions can erode through cortex into adjacent soft tissues. An unerupted tooth, frequently mandibular 3rd molar, is associated with the lesion. Some cases appear as unilocular radiolucent lesions resembling other cystic and non-cystic lesions that can arise in this location.

Desmoplastic ameloblastomas differ radiologically from the conventional ameloblastomas. They have a mixed radiopaque and radiolucent appearance due to osseous metaplasia within the dense fibrous septa. Moreover, they tend to occur anteriorly in the jaws with equal distribution between the mandible and the maxilla.

This plain radiograph shows a large cystic lesion within the body of the left mandible extending from adjacent to the root of 33 to the mesial aspect of the 37. A single dental fragment is seen along the intervening mandibular alveolar bone. No internal sequestrum seen. No definite fracture on this single projection. No periapical lucencies seen to suggest dental abscess formation. Case courtesy of Prof Oliver Hennessy, Radiopaedia.org. From the case rID: 33677

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