• Imaging Science in Dentistry
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• 제43권3호
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• pp.201-207
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• 2013

A 40-year-old man suffered from a repeatedly recurrent desmoplastic ameloblastoma in the right maxillary anterior and premolar regions. During the first visit, the patient was provisionally histopathologically diagnosed with a developmental cyst, and it was confirmed to be unicystic ameloblastoma and resected. Four years later, the lesion recurred, and was diagnosed as a desmoplastic type of ameloblastoma and removed again. Then, 5 years after the second surgery, the lesion recurred again, and was diagnosed as a type containing a follicular pattern, recurrent ameloblastoma. A panoramic radiograph showed a multilocular and mixed radiolucent/radiopaque expansile lesion at the first visit, a unilocular cystic lesion confined to the premolar area at the second visit, and a small soap bubble appearance in the molar area in the final visit. Cone-beam computed tomographic images of the final recurrence of the tumor revealed multiple small cyst-like structures in the right maxillary anterior and posterior regions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권2호
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• pp.140-144
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• 2003

Ameloblastoma is cytologically a benign tumor, but is clinically characterized by infiltrative growth and high recurrency. The criteria for surgical treatment of ameloblastoma has not yet established and it is generally accepted that ameloblastoma be treated differently based on clinical types. The purpose of this paper is to consider effectiveness of enucleation in large-sized intraosseous ameloblastoma that has treated more frequently by radical treatment. 39 cases of the intraosseous ameloblastomas were treated by enucleation in the department of oral and maxillofacial surgery of Yonsei University, dental college from February 1990 to January 2001. 25 cases were selected because they were large in size that could produce facial disfigurement or pathologic fracture of jaws. They were radiographically characterized by the cortical bone that was expanded or eroded locally and histopathologically by 19 solid ameloblastomas and 6 intramural type of unicystic ameloblastomas. Among the 25 cases, 4 cases - 3 solid ameloblastomas and 1 intramural type of ameloblastoma - recurred. Recurrence rate was 16%. The compact bone which is not invaded by ameloblastoma was used as surgical margin of enucleation with accompanying chemical cauterization for killing the residual tumor cells. This may have been the reason for the low recurrence rate. So, it is considered that enucleation and long-term follow-up enable the large-sized intraosseous ameloblastomas that were characterized by almost destroyed cancellous bone and expanded or discontinued cortical bone to treat minimizing facial disfigurement and masticatory dysfunction and sociopsychological impact produced by radical treatment. I recommend that the large-sized intraosseous ameloblastomas without involvement to the surrounding soft tissues be first treated by enucleation.

• Imaging Science in Dentistry
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• 제35권4호
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• pp.207-213
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• 2005

Purpose: To classify and describe the characteristic features of MRI of some ameloblastoma variants. Materials and Methods: The MR images, CT images, and panoramic radiographs in 5 cases were retrospectively examined as follows. First, the contents of ameloblastomas were devided into two portions of either solid or cystic components on the basis of MR signal intensities. The signal intensity within the solid or cystic portions was classified as homogeneous or heterogeneous. Next, the characteristic internal feature of the lesion on T1W1 or T2WI was described. The signal intensities were classified into low, intermediate, slightly high, high, and strong high signal intensity. Results: Unicystic lesion showed homogeneous high signal intensity (SI) on T2W2 and the rim enhancement of the surrounding area including the mural nodule and the thick wall except the central portion on Gd- T1W1. Solid type revealed heterogeneous and high SI area with strong high SI area on T2W2. On Gd- T1W1, the area corresponding to the low signal spot on T1W1 and the strong high signal spot on T2W1 showed low SI. Hybrid type showed slightly enhanced capsular structures and low SI for the round bony septa and the areas connecting the mixed and cystic lesions on T2Wl and Gd-T1W1. Conclusion: MRI could easily assess the relationship between the mixed and cystic findings in ameloblastoma.

• Imaging Science in Dentistry
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• 제34권2호
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• pp.75-79
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• 2004

Purpose: To compare the proliferation potential of the epithelial cells between unicystic ameloblastoma (UA), dentigerous cyst (DC), and odontogenic keratocyst (OKC) and to correlate this proliferation potential with the radiographic features of these three pathoses. Materials and Methods: Immunohistochemical expression of PCNA, Ki-67, and cytokeratin as a proliferation marker were assessed for 15 cases of UA, 15 cases of DC, and 15 cases of OKC. The degree of immunochemical expression of three proliferation markers were correlated with the radiographic features, especially cortical expansion (negative and positive) and shape of border (scalloped and round). Results: Using PCNA and Ki-67, OKC showed the highest proliferation potential and UA the lowest. Statistically significant differences were found between the OKC and the UA (p < 0.05). However, no statistically significant difference was present according to the radiographic features in all pathoses. Using cytokeratin, there was no significant differences of proliferation potential among three pathoses. Conclusions : OKC epithelium has the most intense proliferation potential, followed by the dentigeous cyst and then unicystic ameloblastoma. There is no significant relation between the radiographic features and the proliferation potential of epithelium of these three pathoses.

• 치과방사선
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• 제28권2호
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• pp.355-362
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• 1998

법랑모세포종은 흔히 중년에 호발하는 질환으로 알려져 있지만 아동 및 청소년에서도 그 발생이 보고되고 있다. 그러나 어린 환자들에 발생한 법랑모세포종의 임상적, 방사선학적 및 조직학적 분석은 드물다. 본 연구는 1984년 8월에서 1998년 5월 사이에 부산대학교병원에서 법랑모세포종으로 진단받은 46명의 환자들중에서 18세 이하 환자 15명에 대한 후향적연구로서 아동 및 청소년에서의 법랑모세포종의 특징을 기술하고자하였다. 그 결과는 다음과 같다. 1. 46례의 법랑모세포종중에서 15(32.6％)례가 18세 이하의 아동에서 발생하였으며, 남자 9(60％)명, 여자 6(40％)명으로 1.5: 1의 남녀비를 나타내었다. 2. 15례 모두 하악에 발생하였으며, 이 중 11(66.7％)례가 대구치부와 하악지에 나타났다. 3. 15례 모두 하악 종창의 주소를 보였다. 4. 방사선학적으로, 11(73.3％)례는 단방성 병소를, 4(27.7％)례는 다방성 병소를 나타내었다. 피질골 종창은 14(93.3％)례에서, 치근흡수는 11(73.3％)례에서 나타났다. 5. 조직학적으로 총상형이 7(46.7％)례, 단낭성형이 6(40％)례, 그리고 여포형이 2(13.3％)례 였다.

• 치과방사선
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• 제23권2호
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• pp.291-299
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• 1993

This study was designed to evaluate the correlationship between radiologic classifications of cysts in oral region and glycosaminoglycan analysis of cystic fluids using cellulose acetate electrophoresis. The materials for this study consisted of 37 cases-8 periapical cysts, 10 dentigerous cysts, 10 primordial cysts, 2 residual cysts, 3 incisive canal cysts, 2 post-operative maxillary cysts, 1 mucocele on maxillary sinus, & 1 unicystic ameloblastoma-diagnosed as cystic lesions radiologically. The obtained results were as follows: 1. At the stepwise discriminant analysis, four variables-low mobility material, heparin, hyaluronic acid, & dermatan sulfate-were used to define diagnostic model for the odotogenic cyst. The model produced a sensitivity of 100% and a specificity of 85%. 2. The intensities of heparin and chondroitin-4-sulfate were greater in dentigerous cyst than periapical cyst(p<0.05). The intensity of chondroitin-4-sulfate was greater in primordial cyst than in periapical cyst(p<0.05). 3. It showed no statistically significant difference in glycosaminoglycan of the cystic fluids between dentigerous cyst and primordial cyst(p>0.05). 4. On the fluids of the cysts originated from maxillary sinus, there were especially high intensities of heparin and dermatan sulfate, and low intensity of chondroitin-4-sulfate. 5. On the fluids of unicystic ameloblastoma, there were high intensity of dermatan sulfate and low intenity of chondroitin-4-sulfate.

• Imaging Science in Dentistry
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• 제30권1호
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• pp.1-10
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• 2000

Purpose : 1. Retrospectively evaluate the accuracy of tentative diagnosis or impression from the clinico-radio-graphic materials of jaw lesions which showed mixed lesions associated with teeth. 2. To observe the diagnostic importance of the calcified part of the lesions which appear as radiopaque areas. Materials and Methods: 14 cases of jaw lesions which showed mixed lesions associated with teeth were reviewed. These lesions were mostly diagnosed as adenomatoid odontogenic tumors (6 cases) or calcifying odontogenic cysts with (4 cases) or without odontomas (4 cases). The calcified elements of the lesions which demonstrated various sizes and patterns of radiopaque shadows resembled odontoid tissues in some cases but could not be defined in some other cases radiographically. Results : The final histopathologic diagnosis confirmed adenomatoid odontogenic tumors in 4 of the 6 cases. The remaining 2 cases turned out to be odontoma and ameloblastic fibroodontoma. The 4 cases of calcifying odontogenic cysts with odontomas were correct in 3 cases but remaining 1 case was just odontoma. The 4 cases of calcifying odontogenic cysts were proved to be odontogenic keratocyst, calcified peripheral fibroma, unicystic ameloblastoma and squamous cell carcinoma. Conclusion : The diagnostic accuracy of the adenomatoid odontogenic tumors and calcifying odontogenic cysts were high when the lesions show typical appearance. The calcifications which show radiopaque areas could be odontomas or dystrophic calficifations or remnants of bone fragments from resorption.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권5호
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• pp.429-438
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• 2007

Transport distraction osteogenesis has been introduced recently to correct skeletal malformations and discrepancies in the maxillofacial area. To reconstruct 3-dimensitonal mandibular shape, this transport distraction can be considered with the use of reconstruction plate. A 23-years-old male having unilateral mandibular body and angle defects, who had been operated of partial mandibular resection due to unicystic ameloblastoma, was treated by transport distraction procedures with ThreadLock transport $distractor^{(R)}$ (KLS Martin Co., Germany) through the rail of reconstruction plate (Osteomed Co., USA). After being distracted 35 mm defect from mandibular angle to body, and consolidated for 16 weeks, allogenic bone graft on docking site was performed with removal of transgingival pin. For more than 13 weeks follow up period after consolidation period, gradual increase of radiopacity in the radiographic examination was shown, and the curved mandibular continuity according to the reconstruction plate was made firmly. These transport distraction osteogenesis in the mandible was able to be considered as the good and minimally invasive technique for the reconstruction of mandibular discontinuity. Young patient was also very satisfactory for these results.