Ameloblastoma. Causes and symptoms of a jaw tumor

All tissues of the body, including bone tissue, can be affected by the tumor process. With the development of the oncological process in the maxillary – facial bones, there is destruction of bone tissue, which is manifested by a violation of the asymmetry of the face. This is how a benign odontogenic tumor ameloblastoma manifests itself.

Tumor of the jaw. Ameloblastoma incidence

In the practice of surgical dentistry, ameloblastoma is the most common form of odontogenic tumor of the jaw. The lower jaw is most commonly affected. The tumor process with the same frequency affects women and men, mainly at a young age. The development of ameloblastoma in children is not excluded.

According to statistics, in most patients, such a jaw tumor is detected in the early stages (in the first few months), which is a positive prognosis in treatment. There are cases when ameloblastoma was detected in the early stages by chance during x-rays for other dental diseases. Ameloblastoma often recurs, with an unfavorable course, malignancy of the process is possible.

Causes of jaw swelling. Classification of ameloblastomas

At the moment, there are several hypotheses regarding the causes of the development of ameloblastoma. It is assumed that the presence of the disease is associated with the pathology of the development of the tooth germ. Other scientists are sure that the tumor of the jaw grows from odontogenic epithelial remnants (Islets of Malasse). The exact reasons have not yet been determined.

According to clinical manifestations, 2 forms of the process can be distinguished – cystic tumor of the jaw and massive (solid).

• Cystic – more common. It is characterized by the presence of single or partially interconnected cysts. Cysts are internally lined with a thin epithelial membrane.
• Solid – consists of spongy tissue, sometimes contains cysts of various sizes, which are not determined radiologically. These cysts during a long process can merge into one or more large cavities.

According to microscopic characteristics, several types of jaw tumors are distinguished:

• Follicular type– there are separate follicles of epithelial cells located in the stroma, which consists of connective tissue.
• Pleomorphic amloblastoma – is a network of branched odontogenic strands of epithelial cells.
• Acanthomatous - characterized by squamous metaplasia. Keratin is formed inside the areas of tumor cells.
• Basically – cellular has similarities with basal – cellular cancer. Granular – the cellular form contains many acidophilic granules in the epithelium.

Ameloblastoma is characterized by the presence of two types of cells – cylindrical and stellate. Cylindrical ones are important in relapses of the process due to the presence of long epithelial processes that extend into healthy tissue beyond the boundaries of the growth of the jaw tumor.

Clinical manifestations of a tumor of the jaw. Ameloblastoma symptoms

The tumor of the jaw develops very slowly, at first the patient may not notice any changes in appearance or well-being.

Later, the jaw is deformed. This is manifested by a violation of the symmetry of the face and swelling of the tissues of the face on the side of the lesion. The severity of asymmetry can be different. With the development of a tumor in the upper jaw, which is quite rare, the tumor remains invisible for an even longer time, as it grows into the maxillary sinus.

When a jaw tumor grows, the bone tissue is affected. In this case, the patient already feels pain, which is often taken as a toothache. The process of loosening and displacement of teeth begins. Gradually, the jaw is deformed, and on palpation, a bumpy or smooth swollen area of ​​\u200b\u200bthe bone can be determined. In the oral cavity, deformation of the alveolar process is observed.

The skin over the site of the lesion remains unchanged for a long time. There is a possibility of tumor germination in the orbit and nasal cavity. There may be complications of the process in the form of fistulas in the oral cavity with serous – purulent discharge.

Methods of diagnosis and treatment of the jaw in ameloblastoma

For the correct treatment of the jaw, it is necessary to confirm and differentiate the diagnosis. The diagnosis is made by the dentist during examination based on the anamnesis. It is necessary to differentiate the diagnosis from dental cysts, cystadenoid carcinoma of the salivary gland and squamous cell carcinoma.

To confirm the diagnosis, X-ray of the alveolar process in the occlusion and orthopantomography are used. The most informative is the cytological examination of the punctate formation. With it, blood cells, squamous epithelium, fatty - & nbsp; granular cells, cholesterol crystals, fibrous fibrin and stellate cells.

Treatment of the jaw consists of surgical excision of the affected areas within healthy tissues. The amount of surgery depends on the location and size of the tumor. With the timely removal of the tumor, it is possible to do without a violation of the function of the jaw and disfigurement of the face.

To prevent recurrence of the tumor, the walls of the formation are treated with a phenol solution during surgery to necrotize the epithelial elements of ameloblastoma. In the postoperative period, antibiotics and symptomatic therapy are prescribed.

 In case of loss of jaw function after treatment, bone grafting and orthopedic constructions are used. In many cases, the assistance of a psychologist is required during the rehabilitation period.