Mandibular Ameloblastoma: Frequency and Risk Factors for Recurrence Within a North African Population

Abstract

Background: Ameloblastoma is a rare benign odontogenic tumor that occurs mainly in the mandible. It is characterized by a high tendency to recurrence. The aim of this study was to determine the frequency of recurrence and to investigate the risk factors (RF) for recurrence in mandibular ameloblastoma (MA). Methods: We conducted a retrospective descriptive study including patients with MA in the maxillofacial surgery department of Charles Nicolle Hospital over a 26-year period (1997-2022). Results: The recurrence rate after the first treatment was 30%. Recurrence- free survival was significantly associated with anterior location ( P = .033). The recurrence rate was higher for unilocular tumors. The presence of intra-tumoral bone septa was significantly associated with a lower recurrence-free survival rate ( P = .042). In cases where the tooth was included in the tumor, patients did not significantly experience recurrence ( P = .043). Cortical rupture (CR) was significantly associated with a higher rate of recurrence ( P = .045). From a tumor size of 5 cm, the recurrence rate was estimated at 58%. Radical treatment was associated with a non-significantly high rate of recurrence-free survival. Extraction of 2 teeth upstream and downstream of the tumor was significantly associated with a low recurrence rate ( P < .001). Multicystic histological type had a statistically significant higher recurrence rate than unicystic ameloblastoma ( P = .049). Conclusion: This updated RF study would enable us to classify AM patients according to their level of risk of recurrence, and thus adjust their surgical management.