Ameloblastoma

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Ameloblastoma

Ameloblastoma is a tumor that originates from the cells that form the protective layer of teeth (enamel). Although basically benign, this tumor can grow larger and damage the surrounding area (aggressive) so it needs to be treated immediately.

Ameloblastoma is a very rare jaw tumor. This tumor is estimated to occur in only 1 in 1,000,000 people each year. This tumor is usually experienced by people aged 20-40 years.

Ameloblastoma usually originates from molars or wisdom teeth. If not treated promptly, this tumor can damage teeth, gums, and jawbone.

Causes of Ameloblastoma

Ameloblastoma occurs due to changes (mutations) in genes in the cells that form the tooth enamel layer, namely ameloblasts. This gene mutation causes these cells to continue to grow uncontrollably.

It is not yet known for sure what causes the gene changes in the ameloblast cells. However, ameloblastoma is thought to occur more often in people with genetic disorders and who have had prolonged gum disease, such as untreated dental cysts.

Symptoms of Ameloblastoma

Initially, ameloblastoma rarely causes symptoms. However, if the tumor has grown larger, ameloblastoma will cause lumps or swelling in the jaw. In addition to lumps, ameloblastoma sufferers can also experience the following symptoms:

  • Pain or soreness in the jaw
  • Difficulty opening mouth and chewing
  • Rows of teeth shifting

Generally, ameloblastoma develops slowly over months to years. However, in some cases, ameloblastoma can grow very quickly and aggressively. This condition can damage the nose, eye sockets, and skull.

In rare cases, ameloblastoma can also grow so large that it blocks the airway.

When to see a doctor

See a doctor immediately if you experience swelling or a lump growing in your jaw. The sooner ameloblastoma is diagnosed and treated, the greater the chance of recovery.

It should be noted that ameloblastoma is at risk of recurrence. Therefore, ameloblastoma patients who have recovered must still undergo routine check-ups every 1 year for 5 years, to ensure that the tumor does not grow back.

Diagnosis of Ameloblastoma

The doctor will ask questions about the patient’s symptoms and medical history. After that, the doctor will examine the teeth thoroughly.

To establish a diagnosis, the doctor will perform the following examinations:

  • X-ray , to see the location of the tumor
  • CT scan or MRI of the jaw, to determine the size, spread, and severity of the tumor.
  • Biopsy , to determine the type of tumor

Ameloblastoma Treatment

Ameloblastoma treatment aims to remove the tumor, improve the shape of the jaw, and prevent tumor cells from spreading to other organs. The method used depends on the size and location of the tumor, including:

1. Tumor removal surgery

Surgery is the primary treatment for ameloblastoma. Through surgery, doctors can also remove part of the jawbone in the area around the ameloblastoma to prevent the tumor from growing back.

2. Jaw reconstruction surgery

Jaw reconstruction surgery aims to improve the shape of the jaw to make it easier for patients to speak and eat. In this surgery, the doctor can also install dentures to replace teeth that were removed during the tumor removal surgery.

3. Ray therapy (radiotherapy)

Radiotherapy can be done after ameloblastoma is removed to prevent it from spreading to other organs. This therapy is also done on ameloblastoma that is so large that it cannot be removed by surgery.

4. Physical therapy (physiotherapy)

Physiotherapy is performed on patients who have difficulty swallowing, chewing, or speaking after surgery. This therapy aims to train patients to do these things so that patients can carry out daily activities normally.

Complications of Ameloblastoma

Ameloblastoma that is not treated for a long time can grow larger. Tumors that grow very large can damage the jawbone, as well as change the shape and arrangement of teeth (malocclusion).

In addition, in very rare cases, ameloblastoma can develop into a malignant tumor. This condition, called ameloblastic carcinoma, can spread to the lymph nodes in the neck and lungs.

Prevention of Ameloblastoma

Ameloblastoma is difficult to prevent because the cause is unknown. However, maintaining dental and oral health is a way that can be done to avoid the risk of ameloblastoma.

Some things that can be done to maintain dental and oral health are:

  • Have regular dental check-ups at least once every 6 months.
  • Consume complete and balanced nutritious food.
  • See a doctor immediately if you experience toothache , gum pain, injury, or broken teeth.

References :

Ghai, S. (2022). Ameloblastoma: An Updated Narrative Review of an Enigmatic Tumor. Cureus, 14(8), pp. 1–9.
Hresko, A., et al. (2022). Recurrent Ameloblastoma: Clinical Manifestation and Disease-Free Survival Rate. Journal of Oncology, 2022, pp. 1–6.
Medina, A., et al. (2021). Ameloblastoma: Clinical Presentation, Multidisciplinary Management and Outcome. Case Reports in Plastic Surgery & Hand Surgery, 8(1), pp. 27–36.
National Institutes of Health (2022). National Library of Medicine. Ameloblastoma.
Cleveland Clinic (2021). Diseases & Conditions. Ameloblastoma.
Mayo Clinic (2021). Diseases & Conditions. Ameloblastoma.
Medscape (2022). Mandibular Cysts and Odontogenic Tumors.
WebMD (2022). What is Ameloblastoma?
SOURCES:IDPH
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