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Park, Kim, Kwon, and Kim: Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics
Original Article

J Korean Assoc Oral Maxillofac Surg 2011;37(3):176-183.

Published online: 10 January 2011

DOI: https://doi.org/10.5125/jkaoms.2011.37.3.176

Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics

Ji-Hoon Park, Jin-Wook Kim, Tae-Geon Kwon, Chin-Soo Kim

Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea

Chin-Soo Kim Department of OMFS, School of Dentistry, Kyungpook National University 188-1 Samduck-dong 2ga, Jung-gu, Daegu, 700-412, Korea TEL: +82-53-600-7551 FAX: +82-53-426-5365 E-mail: kimcs@knu.ac.kr

Received 31 January 2011       Revised 16 May 2011       Accepted 3 June 2011

Copyright © 2011 Korean Association of Oral and Maxillofacial Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction

Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features.

Materials and Methods

For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation, this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated.

Results

The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred.

Conclusion

A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.

Keywords: Ameloblastoma, Recurrence, Radiologic findings

References

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Fig. 1.
Classification of anatomical location of lesions. Maxilla (1: right posterior, 2: anterior, 3: left posterior). Mandible (4: left angle & ramus, 5: left body, 6: anterior, 7: right body, 8: right angle & ramus).
jkaoms-37-176f1.tif
Table 1.
Distribution of age and gender
Age Male Female Total
No. % No. % No. %
0–9 0 0 1 1.6 1 0.6
10–19 22 25.6 15 24.6 37 25.3
20–29 16 18.7 14 22.9 30 20.4
30–39 22 25.6 9 14.8 31 21.2
40–49 11 12.7 9 14.8 20 13.6
50–59 6 6.9 7 11.5 13 8.8
60–69 8 9.4 5 8.2 13 8.8
70–79 1 1.1 1 1.6 2 1.3
Total 86 100 61 100 147 100

(Fisher's exact test, P=0.682)

Table 2.
Distribution of anatomic location
Location   Male Female
No. of cases % No. of cases %
Maxilla 1 1 1.2 3 4.9
  2 3 3.5 2 3.3
  3 2 2.3 3 4.9
Mandible 4 13 15.1 6 9.9
  5 17 19.8 18 29.5
  6 10 11.6 3 4.9
  7 23 26.7 13 21.3
  8 17 19.8 13 21.3
Total   86 100 61 100
Table 3.
Internal pattern of lesion
Internal pattern Male Female
No. of cases % No. of cases %
Unilocular 52 60.0 45 74.0
Multilocular 34 40.0 16 26.0
Total 86 100 61 100
Table 4.
Size of lesion on the panoramic view
Size (mm) Male Female
No. of cases % No. of cases %
10–19 4 4.7 4 6.6
20–29 8 9.3 5 8.2
30–39 12 14.0 16 26.2
40–49 20 23.3 14 23.0
50–59 12 14.0 9 14.8
60–69 14 16.3 8 13.1
70–79 4 4.7 3 4.9
80–89 5 5.8 1 1.6
90–99 2 2.2 0 0
100–109 3 3.5 1 1.6
110- 2 2.2 0 0
Total 86 100 61 100
Table 5.
Perforation of cortical bone
Perforation Male Female
No. of cases % No. of cases %
Yes 27 31.4 16 26.2
No 59 68.6 45 73.8
Total 86 100 61 100
Table 6.
Bord er pattern o f lesion
Border pattern Male Female
No. of cases % No. of cases %
Smooth 51 59.3 37 60.7
Irregular 35 40.7 24 39.3
Total 86 100 61 100
Table 7.
The impacted tooth
Impacted tooth Male Female
No. of patients % No. of patients %
Yes 22 25.6 20 32.8
No 64 74.4 41 67.2
Total 86 100 61 100
Table 8.
The root resorption
Root resorption Male Female
No. of patients % No. of patients %
Yes 50 58.1 26 42.6
No 36 41.9 35 57.4
Total 86 100 61 100
Table 9.
Distribution of anatomic location and recurrence
Location   Primary Recurrent
No. of cases % No. of cases %
Maxilla 1 3 2.6 0 0
  2 5 4.3 0 0
  3 3 2.6 0 0
Mandible 4 15 12.9 2 13.3
  5 25 21.6 1 4.0
  6 12 10.3 0 0
  7 28 24.1 5 17.9
  8 25 21.6 1 4.0
Total   116 100 9 7.8

(Fisher's exact test, P=0.631)

Table 10.
Internal pattern of lesion and recurrence
Internal pattern Primary Recurrent
No. of cases % No. of cases %
Unilocular 77 66.4 6 7.8
Multilocular 39 33.6 3 7.7
Total 116 100 9 7.8

(Fisher's exact test, P=0.647)

Table 11.
Size of lesion and recurrence
Size (mm) Primary Recurrent
No. of cases % No. of cases %
10–19 6 5.2 0 0
20–29 10 8.6 0 0
30–39 21 18.1 5 23.8
40–49 22 19.0 1 4.5
50–59 17 14.7 0 0
60–69 20 17.2 2 10
70–79 7 6.0 0 0
80–89 6 5.2 0 0
90–99 2 1.7 0 0
100–109 3 2.6 0 0
110- 2 1.7 1 50
Total 116 100 9 7.8

(Fisher's exact test, P=0.343)

Table 12.
Perforation of cortical bone and recurrence
Perforation Primary Recurrent
No. of cases % No. of cases %
Yes 35 30.2 0 0
No 81 69.8 9 11.1
Total 116 100 9 7.8

(Fisher's exact test, P=0.060)

Table 13.
Border pattern of lesion and recurrence
Border pattern Primary Recurrent
No. of cases % No. of cases %
Smooth 70 60.3 7 10
rregular 46 39.7 2 4.3
Total 116 100 9 7.8

Fisher's exact test, P=0.480)

Table 14.
The impacted tooth and recurrence
Impacted tooth Primary Recurrent
No. of patients % No. of patients %
Yes 35 30.2 4 11.4
No 81 69.8 5 6.2
Total 116 100 9 7.8

(Fisher's exact test, P=0.458)

Table 15.
The root resorption and recurrence
Root resorption Primary Recurrent
No. of patients % No. of patients %
Yes 64 55.2 7 10.9
No 52 44.8 2 3.8
Total 116 100 9 7.8

(Fisher's exact test, P=0.297)

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