Abulkhodoud, Hayat Jamal S.

DMD4B

Ameloblastoma

Definition

•(from the early English word amel, meaning enamel + the Greek word blastos, meaning germ)

•Ameloblastoma is a rare disorder of the jaw involving abnormal tissue growth.

•The resulting tumors or cysts are usually not malignant (benign) but the tissue growth may be
aggressive in the involved area.

•On occasion, tissue near the jaws, such as around the sinuses and eye sockets, may become
involved as well.

• The tissues involved are most often those that give rise to the teeth so that ameloblastoma may
cause facial distortion.

•Malignancy is uncommon as are metastases, but they do occur.

Pathophysiology

•Ameloblastomas arise from remnants of ameloblast or dental lamina, dentigerous cysts, or basal
layer of oral mucosa.

•Ameloblasts, which are part of the odontogenic epithelium, are responsible for enamel production
and eventual crown formation.

•There is evidence that suppression of matrix metalloproteinase-2 may inhibit the local
invasiveness of ameloblastoma, however, this was only demonstrated in vitro.

•There is also some research suggesting that integrin may participate in the local invasiveness of
ameloblastomas.
•The ameloblastoma is an ectodermal odontogenic tumor of the jaws which apparently originates
from the Malassez rests in the periodontium, from the gingival epithelium, from the enamel organs,
or from ordinary dental cysts (dentigerous cysts, follicular cysts, or radicular cysts).

Epidemiology

•Ameloblastoma is a neoplasm of odontogenic epithelium, principally of enamel organ-type tissue

that has not undergone differentiation to the point of hard tissue formation.

•It accounts for about 1% of all oral tumors and about 9-11% of odontogenic tumors.

It is generally a slow-growing but locally invasive tumor.

Its peak incidence is in the third to fourth decades of life and the male: Female ratio is 1:1.

•Its incidence was 0.6 cases/million, and of 0.31 cases/million in a white population of South Africa.

• Ameloblastoma accounted for 60.3% of all odontogenic tumors in Indian population, with a mean
age of presentation of 30.2 years.

•A slight male predilection and major occurrence in the mandibular molar-ramus area were elicited.

•They are classified as unicystic, multicystic or solid, 86% of cases are multicystic
ameloblastomas.

•Ameloblastoma in the mandible can progress to great size and cause facial asymmetry,
displacement of teeth, malocclusion, and pathologic fractures.

Reference:

https://rarediseases.org/rare-diseases/ameloblastoma/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439660/

https://www.wikidoc.org/index.php/Ameloblastoma_pathophysiology