Review of six cases of maxillary ameloblastoma from the west indies re-entry cryosurgery as prophylactic surgical intervention / Revisión de seis casos de ameloblastoma maxilar de criocirugía de reentrada de west indies como intervención quirúrgica profiláctica

Maxillary ameloblastoma is a rare histopathological entity. A total of six cases of histologically confirmed maxillary ameloblastoma from the West Indies is reviewed. Three of the cases were taken from a total of 47 histologically confirmed ameloblastoma over a 15-year period (1980- 1995) from two major maxillofacial units in Jamaica. Two other cases were from documentation in Jamaica between 2000 and 2002, one of which occurred in a 13-year old girl (these two patients have been followed-up periodically to 2006). The sixth case was from the records of the maxillofacial department of the University of the West Indies in Trinidad and Tobago. This last patient, at a recent review, has inoperable recurrence. These cases were reviewed with respect to demographics (patient's age and gender), location and extent oftumour, radiological features, concurrent involvement ofthe mandible, treatment with special emphasis on current treatment modality and follow-up. The findings do not differ from what has been documented by other authors from other parts ofthe world. Because of the radiographic anatomy of the maxilla, recurrence may be detected late despite such occurring earlier following initial surgical management. It is for this reason that we suggest re-entry cryosurgery for prevention ofrecurrence for maxillary ameloblastoma. The only case ofmaxillary ameloblastoma that had re-entry cryosurgery continues to benefit from absence ofrecurrence at periodic follow-ups at four years post-primary surgical management (which was enucleation).

El ameloblastoma maxilar es una entidad histopatológica rara. Se examinan un total de seis casos ameloblastoma maxilar en West Indies, histológicamente confirmados. Tres de los casos fueron tomados de un total de 47 ameloblastomas histológicamente confirmados en un periodo de 15 años (1980-1995) en dos unidades maxilofaciales de Jamaica. Otros dos casos proceden de documentación en Jamaica entre 2000 y 2002, uno de los cuales ocurrió en una niña de 13 años (estos dos pacientes tuvieron un seguimiento periódico hasta el 2006). El sexto caso proviene de las historias del departamento maxilofacial de la Universidad de West Indies en Trinidad y Tobago. Este último paciente - en una revisión reciente - presentaba una recurrencia inoperable. Estos casos se examinaron con respecto a los datos demográficos (la edad y el género del paciente), la situación y magnitud de tumor, rasgos radiológicos, compromiso concurrente de la mandíbula, tratamiento con énfasis especial en la modalidad del tratamiento actual y el seguimiento. Los hallazgos no difieren de lo documentado por otros autores de otras partes del mundo. Debido a la anatomía radiográfica del maxilar superior, la recurrencia puede ser detectada tarde, a pesar de que ocurra temprano tras el tratamiento quirúrgico inicial. Es por esta razón que sugerimos la criocirugía de reentrada para prevenir la recurrencia del ameloblastoma maxilar. El único caso de ameloblastoma maxilar que tuvo criocirugía de reentrada continúa beneficiándose de la ausencia de recurrencia en los seguimientos periódicos a cuatro años de tratamiento quirúrgico post-primario (que consistió en una enucleación).

Non-syndromal multiple buried supernumerary teeth: report of two cases from the English-speaking Caribbean and a review of the literature

Multiple supernumerary teeth affecting all four quadrants of the jaw are a rare dental anomaly which has become a chance finding on routine dental panoramic tomography (DPT). In this paper, two cases from the English-speaking Caribbean are reported. The role of radiography in the diagnosis and management of this rare developmental dental anomaly is emphasized. The paper stresses the importance of ruling out associated syndromes such as Gardner's Syndrome, cleidocranial dysostosis and cleft lip and palates, as multiple supernumerary teeth are usually related to such conditions. There is a review of the literature as it relates to supernumerary teeth.