Extensive ameloblastoma of the jaws: surgical management and immediate reconstruction using microvascular flaps

ObjectiveAmeloblastoma is a rare histological benign but locally aggressive tumor with a marked tendency for recurrence. Especially larger, aggressive lesions require a more radical surgical approach resulting in large jaw defects. The purpose of this study is to analyze the long-term functional and esthetic results after immediate reconstruction of large jaw defects using microvascular flaps.Study designA review of 7 cases of giant ameloblastoma (2 in the maxillary and 5 in the mandibular region) is presented. The lesions were between 4 and 8 cm in diameter. All patients were treated by a radical surgical protocol. All cases were immediately reconstructed using microvascular grafts from either the scapula or the iliac crest bone. Dental implants were inserted in all patients after removal of the osteosynthesis material.ResultsAll patients were prosthetically rehabilitated. All implants survived throughout the observation time. The esthetic and functional outcomes were satisfying in all patients. No case of recurrence of the tumor could be observed so far.ConclusionAccording to our opinion, immediate reconstruction is the treatment of choice after radical surgical excision of ameloblastoma. This 1-step procedure decreases the number of surgeries and allows earlier prosthetic rehabilitation.