낭종성 법랑아세포종의 임상병리학적 연구

A clinical and histopathologic study of cystic ameloblastoma

The cystic ameloblastoma is ameloblastoma from a cyst lining and also has termed as mural ameloblastoma, unicystic ameloblastoma or cystogenic ameloblastoma. The purpose of this study is to investigate on the clinical and histopathologic pattern of cystic ameloblastoma and the relationship and difference of cystic ameloblastoma to conventional ameloblastoma. The ameloblastoma is generally thought to behave in a locally invasive manner with a definite tendency to recur and need to be excised completely with an adequate margin of normal bone. But the cystic ameloblastoma exhibits a lower rate of recurrence following enucleation or curettage and occurs in younger age than ameloblastoma. The material for this study was obtained from the files of the 70 patients who were operated in the Department of Oral and Maxillofacial Surgery, SeouI National University Hospital, and confirmed histopathologically as cystic ameloblastoma, during the period from Jan, 1980 to Feb, 1989. The results were as follows: 1. The average age was 22.8 years with a peak incidence in the second and third decades (73%). 2. 65 cases(93%) were in the mandible and 5 cases(7%) in maxilla. The molar and ramus area was most common location, and in many case, involvement of condyle and coronoid process and impacted or dislocated mandibular third or second molar were seen. 3. 33 cases(47%) were associated with an impacted tooth and their average age was 19.7 years, whereas the average age of the lesions without impacted tooth was 25.7 years, 57 cases(81%) were unilocular lesion and the average age was 21.9 years, whereas 26.9 years in the multilocular lesion. 4. In the chief complains of the initially visited patients, asymptomatic swelling or facial asymmetry were most common. 5. In the initial diagnosis through clinical and roentgenographical exam, the dentigerous cyst was most common, and then ameloblastoma and cystic ameloblastoma. 6. In the operation methods, enucleation was done in 58 cases and then 8 cases recurred. The recurrence rate of enucleation in cystic ameloblastoma was 12.8%