RESUMO
AIM: The aim of this study was to analyse the long-term treatment results of mandibular ameloblastomas over a 28-year period and determine the most appropriate method of management of these tumours. METHODS: Sixteen patients with a diagnosis of mandibular ameloblastoma treated in our Department between January 1977 and December 2004 were selected for this retrospective study. Data included gender, age at surgery, symptoms, tumour type, size and site of lesion, radiological findings, primary surgical methods, complications, recurrences, and follow-up period. RESULTS: There were eight male and eight female patients. Their age ranged from 15 to 74 years (average 43.4 years). The dominant symptom was facial deformity (9 cases). From analysis of ortopantomographs or radiographs, four cases were unilocular and 12 cases were multilocular, and its size ranged from 2 to 11 cm. Observation time varied from 5 to 27 years after treatment. Histologically prevalence of follicular type was observed. The treatment selected was segmental resection in three cases (18.6%), a resection with bone margin in six cases (37.5%) and conservative treatment by means of enucleation was carried out in seven patients (43.8%). Recurrences were observed in three patients. All these cases have been primarily treated through conservative surgical technique, i.e., by enucleation. CONCLUSION: In summary, conservative treatment enucleation should be used only in the treatment of unicystic ameloblastoma, while the radical approach, resection with some safe margin, should be the first choice in the treatment of solid, multicystic mandibular ameloblastoma to avoid recurrence.
