ABSTRACT
OBJETIVO: Determinar a validade do enxerto autólogo de crista ilíaca não vascularizado no tratamento cirúrgico do ameloblastoma de mandíbula. MÉTODO: Nos Serviços de Cirurgia de Cabeça e Pescoço e Semiologia Bucal do Complexo Hospitalar Heliópolis, de 1980 a 2000, foram tratados 31 pacientes com ameloblastoma de mandíbula, dos quais sete receberam enxerto de crista ilíaca autólogo, fixos com placa de titânio do sistema A-0 (quatro casos) e aço inox (três casos), sendo portadores da variedade folicular (seis casos) e plexiforme (um caso). RESULTADOS: Nesta análise, foi utilizado o Teste de Hipótese para a média populacional com a variança desconhecida, houve exposição da placa em três casos (40 por cento) quando a neoplasia ultrapassava a linha média e em quatro casos (60 por cento) não incidiu nenhuma complicação. CONCLUSÕES: Apesar da incidência de exposição de placa, o método é indicado na reconstrução da mandíbula de pacientes com ameloblastoma.
BACKGROUND: To determine of the real validity of non vascularized iliac crest graft in the surgical treatment of ameloblastoma of the mandible. METHODS: From 1980 to 2000, at the Head and Neck and Oral Semiology Services of Heliópolis Hospital, 29 patients were submitted to differents approaches, from which 7 received a non-vascularized autologus iliac crest graft fixed with A-0 titanium (4 cases) or inox (3 cases) systems plates for folicular (6 cases) and plexiform (1 case) ameloblastomas. RESULTS: We used a test of hypothesis for the population mean with unknown in variance. There was plate exposition in 3 cases (40 percent), when the tumor overpass midline, and complete sucess in 4 cases (60 percent) with no complications of this reconstructive approach for mandible ameloblastoma. CONCLUSIONS: In spite of the incidence of plate expesure, this technique is indicated for mandible reconstruction in patients with amelablastoma.
ABSTRACT
BACKGROUND: Odontogenic ameloblastoma (OA) of the jaws is a rare neoplasia of the oral cavity (0.78 percent) with a 5:1 mandible/maxilla relation, with the molar region and the ascendant ramus being the most affected areas. Comparing our results with the literature demonstrated to us that this tumor may be considered to be a worldwide problem due to the similarity in clinical findings among different ethnic groups CASE SERIES: The purpose of this study of 20 patients with ameloblastoma of the mandible and maxilla diagnosed at the Stomatology and Head and Neck Services of Heliópolis Hospital, São Paulo, Brazil, from 1980 to 1997, was to establish the histopathologic pattern of classification of those tumors through optical microscopy and the relation of this histopathology to therapeutic management. Using the Regeze, Kerr and Courtney classification (1978), we diagnosed follicular tumor in 11 cases, plexiform in 6 cases and unicystic in 3 cases, and performed surgical resection with a safety margin of 1.5 to 3.0 cm in the follicular and plexiform cases and bone curettage in the unicystic cases