Clinical,Radiographic and Histopatological evaluate of ameloblastomas treated conservativaly and curettage with ultrasonic surgery

Treatment of ameloblastomas is controversial. On one hand there is a school advocating major segmental or bloc resection for ameloblastoma with a reqruitment of 1-1.5 cm of clinically and radiographically normal bone and uninvolved margins.' On the other hand, there is a school advocating more conservative surgical management by enuclation with adjacent bone curettage The aim of this study was to evaluate the clinical, radiographic, and histopathological findings and of one case of ameloblastomas over 50 years treated conservatively with enucleation and curettage with ultasonic surgery. A 50-year old woman was referred to the Department of Oral Surgery of the University of Chieti-Pescara complaining of swelling at the left posterior mandible. CT examination shwovs intense destruction of bone trabeculae was observed from the midline ascending to the mandibular body, mandibular ramus and angle at the right side. We made a gingival crevicular incision with vertical releasing incisions to create a trapezoid-shaped flap. After mobilization of the full-thickness vestibular mucoperiostal flap, vestibular ostectomy was done with a ultrasonic surgery device (NSK Variosurgery Dentalica, Milano, Italy), the lesion was exposed and it was enucleated through this access. After enucleation of the lesion a curettage is performed by ultrasonic surgery the walls of the bone cavity. The histopathological diagnosis is follicular ameloblastoma. After 12 and 24 months after surgery the radiography exhibited a new bone formation was evident. Subsequent check-ups have been performed for 12 and 24 months to date, there have been no signs of recurrence. Each case is unique and has to be considered in the clinical context and the relationship of the lesion to surrounding tissues, histological type and recurrences rate. In conclusion ultrasonic surgery device facility the remove of lesion and bone healing.