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CASE STUDY 5

MANAGEMENT OF UNICYSTIC AMELOBLASTOMA IN A PREGNANT WOMAN

Case Management & Presentation by Dr. Kedar Muthe, MDS,
Professor, Dept. of Oral & Maxillo-facial Surgery,
College of Dental Sciences, Davangere

Surgical Management

SURGICAL MANAGEMENT

Surgical management :

Marsupialization of the lesion was planned under local anesthesia. Consent from the patient's gynecologist was obtained.

Operative Procedure:

An incision was placed in the retromolar region with an intention to marsupialize the lesion. On surgical exposure of the lesion, thick lining of the lesion was evident. However, no fluid whatsoever was encountered! The surgical procedure, was therefore, altered to enucleation.

Surgical Picture
Surgical Picture

To facilitate enucleation, the incision was extended posteriorly upto the coronoid notch. A crevicular incision was placed anteriorly upto the first molar. A vertical releasing incision was given to expose the anterior and lateral border of the ramus of the mandible. The lesion was enucleated from the ramus alongwith the displaced second and third molars.

Surgical Picture
Surgical Picture

The cavity was thoroughly curetted in the body region below the first molar. Thin cortical bone from the anterior and lateral margins of the cavity was trimmed. Carnoy's solution was used for chemical cauterization. Primary closure was effected with 3.0 silk sutures.

Surgical Specimen
Surgical Picture
 
Histopathological examination and diagnosis:

On sectioning, a single cystic cavity was seen with ameloblastomatous differentiation in the epithelial lining and ameloblast-like cells at the basal layer. Connective tissue was fibro-cellular with extravasated RBCs and few multi-nucleated giant cells. Osteoid tissue was also seen in some areas.

The clinical, radiographic and histological features were suggestive of a diagnosis of Unicystic Ameloblastoma.

 

Surgical Management

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