Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis

Ameloblastoma is the second most common odontogenic tumor, known to be slow-growing, persistent, and locally aggressive. Recent data suggests that ameloblastoma is best treated with wide resection and adequate margins. Following primary excision, bony reconstruction is often necessary for a function...

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Bibliographic Details
Published in:PloS one 2015-02, Vol.10 (2), p.e0117241-e0117241
Main Authors: Chae, Michael P, Smoll, Nicolas R, Hunter-Smith, David J, Rozen, Warren Matthew
Format: Article
Language:English
Subjects:
Adult
Aged
Ameloblastoma
Ameloblastoma - pathology
Defects
Diagnosis
Female
Growth rate
Hospitals
Humans
Information management
Jaw Neoplasms - pathology
Literature reviews
Male
Management
Meta-analysis
Middle Aged
Natural history
Odontogenic tumors
Online databases
Plastic surgery
Reconstruction
Skin & tissue grafts
Studies
Surgery
Systematic review
Tumors
Young Adult
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Summary:Ameloblastoma is the second most common odontogenic tumor, known to be slow-growing, persistent, and locally aggressive. Recent data suggests that ameloblastoma is best treated with wide resection and adequate margins. Following primary excision, bony reconstruction is often necessary for a functional and aesthetically satisfactory outcome, making early diagnosis paramount. Despite earlier diagnosis potentially limiting the extent of resection and reconstruction, an understanding of the growth rate and natural history of ameloblastoma has been notably lacking from the literature. A systematic review of the literature was conducted by reviewing relevant articles from PubMed and Web of Science databases. Each article's level of evidence was formally appraised according to the Centre of Evidence Based Medicine (CEBM), with data from each utilized in a meta-analysis of growth rates for ameloblastoma. Literature regarding the natural history of ameloblastoma is limited since the tumor is immediately acted upon at its initial detection, unless the patient voluntarily refuses a surgical intervention. From the limited data, it is derived that the highest estimated growth rate is associated with solid, multicystic type and the lowest rate with peripheral ameloblastomas. After meta-analysis, the calculated mean specific grow rate is 87.84% per year. The growth rate of ameloblastoma has been demonstrated, offering prognostic and management information, particularly in cases where a delay in management is envisaged.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0117241