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Odontogenic tumors are considered relatively rare and destructive neoplasms of the jaw bones. They arise from remnants of odontogenic tissue and belong to benign odontogenic tumors with locally aggressive behavior. Although the incidence of odontogenic tumors varies from 1% to 32%, ameloblastoma is, along with odontoma, the most common benign odontogenic tumor. It is predominantly located in the lower jaw (up to 80%), and most patients diagnosed with ameloblastoma are between the ages of 30 and 60. The current WHO 5th classification distinguishes five different types: conventional/multicystic, unicystic, metastatic, peripheral, and adenoid. The slow-growing nature and lack of symptoms are considered responsible for the delayed diagnosis of ameloblastoma. Considering the severe clinical implications with a high recurrence rate, it is of utmost importance to provide sufficient guidelines and standardize the surgical approach. The current treatment concept for ameloblastoma is still controversial. To date, the standard treatment is radical resection with a wide bone margin. However, different treatment methods are recommended depending on many factors, such as the type and clinical picture of the tumor. Regardless of the type, the treatment of ameloblastoma is surgical or non-surgical. The surgical approach can be further divided into radical and conservative surgery. These approaches are often intertwined, and conservative methods such as decompression are valuable in preoperative tumor volume reduction. Non-surgical methods include radiotherapy and/or chemotherapy. Recent advances in the signaling pathways and genetic understanding related to the pathogenesis of ameloblastoma have resulted in the development of molecularly targeted therapies as a valuable treatment option. Details of the modern surgical approach and the mentioned treatment methods are presented through the presentation of the treatment of two patients with unicystic ameloblastomas of the mandible at the Clinical Institute for Oral Surgery, KBC Zagreb |
