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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]].
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Also known as: '''''Adamantinoma'''''
<small>
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With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
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==Introduction==
</small>[[Category:Teeth_-_Proliferative_Pathology]]
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[[File:Ameloblastoma dog.jpg|250px|right|thumb|Amelobalstoma]]
[[Category:Neoplasia]][[Category:To_Do_-_Clinical]]
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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==
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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==
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'''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==
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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
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|flashcards = [[Veterinary Dentistry Q&A 02]]
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}}
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==References==
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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
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|date = 13 August 2014}}
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{{Waltham}}
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{{OpenPages}}
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[[Category:Teeth_-_Proliferative_Pathology]]
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[[Category:Neoplasia]][[Category:Dental Diseases - Dog]][[Category:Dental Diseases - Cat]][[Category:Dental Diseases - Cattle]][[Category:Dental Diseases - Horse]]
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[[Category:Oral Proliferations]]
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[[Category:Lisa Milella reviewed]]
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[[Category:Waltham reviewed]]
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