Tumor processes are able to develop in any organ and tissue of the body. They are malignant or differ in benign course. Tumors can show up in the most unusual places. For example, ameloblastoma, which affects the bone tissue of the jaw.
The concept of
According to the definition, ameloblastoma is a tumor formation of the maxillofacial arrangement.
The structure of the formation is almost identical to the tissue of tooth enamel, it develops from dental rudiments.
With the development of the tumor process, deformation jaw changes occur, the ability to chew food deteriorates, the teeth become loose and shift.
Other names for the tumor are adamantoblastoma or adamanthinoma.
May also be found in children, adamanthinam accounts for about 7% of the total number of benign formations of dentoalveolar localization in patients of childhood.
The most common tumor is found in the initial stages of development in the first six months, which has a positive effect on the success of therapeutic interventions.
Reasons for the formation of
Experts have not yet made a final conclusion regarding the etiology of the disease.
Many scientists are inclined to believe that inorganic malfunctions or severe damage to the jaw tissues can become prerequisites for ameloblastoma.
Among the provoking factors adamanthinam specialists distinguish:
- Systematic damage to the integrity of the oral mucosa, caused by carious processes, a seal or prosthesis;
- Absence of treatment of long-flowing inflammatory processes like sinusitis, periodontitis, etc.;
- Mechanical jaw injuries, bruises, injuries, fractures.
Often, the cause of the pathology is the installation of a denture, which is associated with allergenicity and rejection of the materials from which they are made.
External factors such as tobacco smoking, ionizing radiation or radiation exposure, etc., can provoke a tumorous process in the jaw.
It is impossible to determine the cause independently, because only an expert based on diagnostic data will be able to reliably determine the etiology of ameloblastoma.
Forms and localization of
There are several classifications of adamanthinoma. According to histological characteristics, the tumor is distinguished:
- Granular-cell - in the tumor epithelium there are granules of acidophiles;
- Basal cell - symptomatic of such ameloblastoma is similar to basal cell carcinoma;
- Acanthomatous - keratin accumulations inside the tumor;
- Pleomorphic - its structure is a network of epithelial cords;
- Follicular - follicles are found in the connective tissue stroma.
Clinically, the pathology is divided into a solid and cystic tumor. Cystic adamantinoma occurs much more often. It is characterized by the presence of partially connecting or individual cysts.
In contrast to cystic tumor, solid ameloblastoma has a spongy structure, it can contain cysts.
Ameloblastoma of the mandible
Among adamantine, the lower jaw localization of the tumor is more common. Such formations most often develop asymptomatically or are accompanied by uncharacteristic signs resembling other tumors, so diagnosis should be carried out as accurately as possible.
Photo of a patient with ameloblastoma of the lower jaw
The tumor grows slowly, gradually manifesting as deformations in the lower jaw. The share of ameloblast of such a localization accounts for about 90% of cases of the total number of tumors of this kind.
of the Upper Jaw
Maxillary localization of the tumor is quite rare. When ameloblastoma affects the upper jaw, the patients have problems with nasal breathing, visual disturbances such as a split image in the eyes, tear, skin dysuria.
Sometimes, in the area of the tumor, there is a pain that resembles toothaches. When the maxillary location of ameloblastoma usually defective changes in the jaw do not occur, because the tumor sprouts in the sinus of the upper jaw.
However, if the formation sprouts into the orbit and nasal cavity, then there is deformation of hard tissue, displacement of the eyeball and alveolar bone.
Symptoms of tumor
Ameloblastoma develops slowly and asymptomatically, therefore quite often patients simply do not notice signs of pathology. But gradually the tumor process begins to acquire specific symptoms associated with jaw deformation.
Then adamantinoma is manifested by such symptoms:
- Asymmetry of the face, which may be minor or pronounced bright;
- Swelling in the affected area;
- When bone tissue is involved in the tumor process, a pain symptom arises in patients, which many perceive as a toothache;
- Gradually the teeth loosen and shift;
- In the future, the cortical plate becomes thin, which causes the appearance of a characteristic crunch;
- When probing a tumor, a bone swelling of a spindle-shaped shape is felt. If the bone is thinned, then under pressure it bends easily;
- If viewed from the side of the mouth, then a deformed change in the alveolar process is noticeable;
- With maxillary tumor localization, palatal deformity occurs, and ameloblastoma itself can germinate into the orbit and nasal cavity;
- With the neglect of the tumor process, fistulas are formed in the oral cavity that produce purulent-serous mucus.
If the patient ignores the development of the tumor and draws with a referral to a specialist, then malignancy of the tumor can occur, which is observed in 4% of cases.
Diagnosis of the disease
To determine the pathology, a thorough diagnosis is necessary, because ameloblastoma is similar in symptoms to other tumors.
A qualified diagnostic approach will protect the patient from erroneous treatment.
For the detection of pathology, radiography is used, which helps to determine the shape and size of the tumor, the extent of pathology and the extent of bone lesions.
The basis for the treatment with ameloblast is surgical removal by jaw resection. Removal is carried out under general anesthesia under stationary conditions. The patient is left in the hospital after surgery to avoid possible complications.
To avoid recurrence of the tumor, its location is treated with a concentrated phenolic solution that necroticizes the elements of the tumor epithelium.
If the tumor has reached a significant size, then partial jaw exarticulation( disruption of integrity) or resection is carried out. If the ameloblastoma is complicated by purulent processes, during the operation, simultaneously with the removal of the tumor, the purulent focus is eliminated.
The surgical operation does not end with treatment, since the patient is necessarily shown rehabilitation, including corrective, symptomatic and antibiotic therapy.
Eating after surgery involves the exclusion of hard and coarse food, and after it must necessarily wash your mouth.
If the patient loses part of the jaw, then the plastic surgery of the bone tissue with the installation of special structures is used to restore the jawbone functions.
Prognosis and prophylaxis
Predictions are generally positive, provided that the tumor was detected at the initial stage of formation, and surgical treatment was carried out in a timely manner.
Ameloblastoma is prone to recurrence, and in some cases can be of a malignant nature( approximately in 1-4% of cases).
The degeneration of adamanthinoma occurs in the case of neglect of the tumor or with an incorrect approach to treatment. But even if the tumor is malignant, it practically does not metastasize lymphogenically.
If the patient has recently turned to specialists, then the risk of disfiguring the face and breaking the jaw functions is high.
Specific prevention of such formations is not developed, therefore the only way to prevent pathology is to exclude provoking factors.
For this purpose it is necessary to visit the dentist with a periodicity of six months for the purpose of preventive examination, timely treatment of the teeth, avoid traumatic injuries, etc. If there are signs of pathology, you should visit the dentist immediately.
The video shows the history of a patient with a restored jawbone, after suffering ameloblastoma: