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− | Neoplastic
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− | *Different from peripheral ameloblastoma - cystic changes and follicular arrangement of ameloblasts and stellate reticulum cells, resembling the basic structure of the [[Enamel Organ|enamel organ]].
| + | Also known as: '''''Adamantinoma''''' |
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− | With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
| + | ==Introduction== |
− | </small>[[Category:Teeth_-_Proliferative_Pathology]]
| + | [[File:Ameloblastoma dog.jpg|250px|right|thumb|Amelobalstoma]] |
− | [[Category:Neoplasia]][[Category:To_Do_-_Clinical]] | + | The central or intraosseous ameloblastoma is one of the most common '''odontogenic tumours''', originating from the dental lamina. |
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| + | Different schools of thought exist on the differentiation between central ameloblastomas originating in bone, and [[Ameloblastoma, Peripheral|peripheral ameloblastomas]] (also known as acanthomatous epulis). |
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| + | This tumour is '''poorly differentiated''' and can arise from '''any part of the gingiva''' with no specific site predilection. |
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| + | Central ameloblastomas are '''locally invasive and destructive to bone''', but they are '''slow growing''' and do not metastasise. |
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| + | The tumours have been reported to occur in dogs and cattle and occasionally in cats and horses. |
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| + | ==Clinical Signs== |
| + | Clinical signs of any oral tumours include: '''halitosis''', oral bleeding, '''dental disruption or loss''', facial deformity, salivation and an '''obvious mass'''. |
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| + | ==Diagnosis== |
| + | '''Grossly''', the tumour may appear soft and fleshy on its gingival surface, but it may extend much deeper into the bone. It may be solid but often shows a multiple cystic structure. |
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| + | Teeth at the site may be mobile, moved or absent. |
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| + | '''Radiography''' of the affected area may reveal: loose or absent teeth, decreased radio-opacity of the mandible or maxilla due to local destruction, cystic opacities within the mass. |
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| + | '''CT''' may enable a more detailed examination of the area. |
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| + | '''Biopsy of the mass and histopathology''' will enable a definitive diagnosis: histological appearance of an ameloblastoma is a follicular arrangement of ameloblasts and stellate reticulum cells. There may be occasional keratinisation. |
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| + | ==Treatment== |
| + | As metastasis does not occur, '''complete resection''' is indicated, and is usually curative. |
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| + | Depending on the location of the mass, this may involve various forms of mandibulectomies or maxillectomies to allow '''wide excision''' of the tumour and the underlying bone. |
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| + | If complete resection is not feasible, '''surgical debulking followed by radiotherapy''' is also possible. |
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| + | The '''prognosis is usually good''' if complete resection is possible, and animals usually make a good functional recovery with an acceptable cosmetic appearance for the owners. |
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| + | {{Learning |
| + | |flashcards = [[Veterinary Dentistry Q&A 02]] |
| + | }} |
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| + | ==References== |
| + | Wiggs, R. (1997) '''Veterinary dentistry: principles and practice''' ''Wiley-Blackwell'' |
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| + | Slatter, D. (2002) '''Textbook of small animal surgery''' ''Elsevier Health Sciences'' |
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| + | {{Lisa Milella reviewed |
| + | |date = 13 August 2014}} |
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| + | {{Waltham}} |
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| + | {{OpenPages}} |
| + | [[Category:Teeth_-_Proliferative_Pathology]] |
| + | [[Category:Neoplasia]][[Category:Dental Diseases - Dog]][[Category:Dental Diseases - Cat]][[Category:Dental Diseases - Cattle]][[Category:Dental Diseases - Horse]] |
| + | [[Category:Oral Proliferations]] |
| + | [[Category:Lisa Milella reviewed]] |
| + | [[Category:Waltham reviewed]] |