AMELOBLASTOMA. BENIGN ODONTOGENIC TUMORS


Ameloblastoma. Benign odontogenic tumors

Ameloblastoma

There are many tumors that affect the jawbone, with a variety of forms and different manifestations in the oral cavity or the whole body, depending on their development and the space they occupy.

Most often these odontogenic tumors develop from enamel remnants or other structures left over after the evolutionary processes of the teeth have ceased.

The dental lamina is the foundation on which the buds that will form dental units are located. Once the teeth have completed their development, this hard lamina resolidifies and disappears completely from the alveolar bone structures.

If, however, as a result of the body’s own mechanisms, the fragmentation of the dental lamina is incomplete, the remaining remnants may form the starting point for cysts or benign tumors.

Dental ameloblastoma is a benign tumor originating in dental structures and is the most common form to occur.

As a benign tumor, although it can grow to a considerable size, it never infiltrates surrounding tissues. Most commonly, ameloblastoma develops in the mandible, mostly in the lateral regions, close to the vertical ramus, in the region of the molars, of the last teeth on the arch.

There are several forms of ameloblastoma but the most common remain intraosseous unichystic and polycystic ameloblastoma.

Intraosseous ameloblastoma are the most common type of ameloblastoma and occur in young people over the age of 20. They are rare in adolescents and extremely rare in children under 10 years of age.

They are manifested by increased activity of the cells responsible for bone destruction, the osteoblasts, and by pressure and distension, they erode the bone, generating round lesions with a lack of substance.

Radiologically, bone demineralization is observed. The bone, being a hard structure, appears on radiographs as light-colored, whitish. The same is true of the teeth, which are white due to the dense hard structures that compose them.

On the other hand, less dense structures such as mucous membranes, pulp chamber or lesions with less substance appear dark, towards black. Therefore, the jawbone appears white and the lesion created by the ameloblastoma is darker in color.

Evolution

The course of ameloblastoma is slow, long, steadily increasing in size to significant values.

As the size of the ameloblastoma increases, a number of changes occur in the regions concerned, as follows:

The contour of the face changes as the ameloblastoma progresses, especially in advanced forms. Thus, in the early forms, the patient does not notice any change, because the ameloblastoma develops without pain.

The facial tissues remain unchanged in color and consistency. They will be loosened, however, by the growth of the ameloblastoma

The teeth enclosed in the developing ameloblastoma will become mobile. The teeth are anchored within the dental sockets, with bone and ligaments responsible for their proper fixation. The main characteristic of ameloblastoma is the reduction of the bone matrix, so the teeth will lose their supporting structures.

With the appearance of dental mobility, functions such as chewing, phonation, swallowing and breathing are also disturbed.

If the ameloblastoma is significantly enlarged, in severe cases, spontaneous bone fracture can occur through damage to the bone matrix.

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