Ameloblastoma

Ameloblastoma is a rare, slow-growing odontogenic tumor in your jaw. “Odontogenic” means that tumors start from the cells that make up teeth. Ameloblastomas are made of the cells that form tooth enamel. Most of the time, they start behind your back teeth in your lower jaw (mandible).

They’re usually benign (noncancerous) but aggressive. They don’t often spread to distant body parts. But they can grow into your jawbone and the soft tissue in your mouth, damaging your jaw and teeth. They can also come back after treatment (recur).

If you have an ameloblastoma, you’ll need surgery to remove it. Early treatment and close monitoring afterward can keep these tumors from causing harm.

Types of ameloblastoma

Healthcare providers study tumor cells to classify these growths. Types include:

• Conventional ameloblastoma: This type is most common. It grows faster than the others and often spreads from your jaw to nearby parts of your mouth. Often, it grows back after surgery.
• Unicystic ameloblastoma: These tumors are less likely to spread than the conventional type.
• Peripheral ameloblastoma: These rare tumors grow more slowly than the other types and don’t often recur.

In rare cases, ameloblastomas can be or become malignant. Cancerous types include:

• Metastasizing ameloblastoma: This tumor looks benign under a microscope. But it isn’t. It can spread to other parts of your body, like your neck lymph nodes and lungs.
• Ameloblastic carcinoma: These tumors may start as cancer. Or they may start out as benign but become cancerous.

Symptoms of ameloblastoma

This condition progresses slowly. You can have an ameloblastoma for 10 to 20 years before you notice an issue. As the tumor grows, one side of your face may start to look different, or you may have problems with your teeth.

Signs and symptoms of ameloblastoma include:

• Painless swelling in your jaw that only affects one side of your face
• A new growth that looks like you’ve tucked nuts or small marbles inside your cheek
• Teeth with pink or red spots or that chip and shatter easily
• Trouble moving your jaw
• Red and swollen gums
• A misaligned bite
• Loose or shifting teeth

Ameloblastoma causes

They form when the cells that create tooth enamel keep growing even after your enamel is in place. Experts don’t know why this happens.

Many people with this condition have common gene changes, like abnormal BRAF and SMO genes, that fuel tumor growth. The changes likely happen during your lifetime. This means that medical experts don’t think that the abnormal genes are hereditary. Researchers are studying these genes to find targeted therapies that destroy the tumor cells.

Risk factors

Anyone can develop this condition, but most people are diagnosed between the ages of 30 and 60. Diagnoses are more common in Africa and Asia.

Complications of this condition

Without treatment, ameloblastomas can damage your face and jaw. They can cause facial disfigurement and make it difficult to chew and swallow. With continued growth, these tumors can invade tissue in your brain and central nervous system and block airways. When this happens, ameloblastoma can be fatal. But life-threatening complications are rare.

Seeking treatment early on can often prevent these worst-case scenarios.

How doctors diagnose this condition

Your dentist may spot the growth on a dental X-ray. They’ll refer you for more tests if they suspect an issue. Tests may include:

• Imaging tests: X-rays and CT scans show the tumor’s location and size. With malignant types, you may need a PET scan so your healthcare provider can check for cancer spread.
• Biopsy: Your provider will collect tissue from the tumor so it can be analyzed in a lab. This confirms the diagnosis.

How is ameloblastoma treated?

Surgery that removes the tumor and some nearby tissue is the best treatment for ameloblastoma. The goal is to preserve as much healthy tissue as possible while being sure that no microscopic disease remains. Radical surgeries usually require a lengthy recovery period. It may take several weeks or even months to recover.

Surgery types include:

• Radical surgery: This treatment is most common. Your surgeon will remove the tumor and a large amount of bone and tissue to reduce the chance of the tumor growing back. They may remove part or all of your lower jaw (mandibulectomy) or your upper jaw (maxillectomy).
• Conservative surgery: Your surgeon will remove the tumor and a small amount of tissue and bone. This may be an option for small tumors that are unlikely to invade nearby structures.

If you’re not able to have surgery, you may need radiation therapy to get rid of the tumor. If you have a malignant ameloblastoma, you may need radiation with or without chemotherapy after surgery. The goal is to destroy tumor cells that surgery may have missed.

Additional treatments following surgery

You may need more treatments before you get back to feeling like yourself again.

You may need:

• Reconstructive surgery: Working with a plastic surgeon can help restore your appearance. Surgery often involves using bone from one part of your body to rebuild your jaw.
• Dental implants: You may need implants or dentures to replace the teeth removed during surgery.
• Speech therapy: A speech-language pathologist can help you adjust to changes in your jaw and face so you can chew, eat and speak.
• Nutrition guidance: A dietitian can help you choose nutritious foods that are easy to chew and swallow. They can provide guidance if you need tube feedings while your jaw heals.

When should I see my healthcare provider?

You’ll need follow-up visits after treatment so your provider can check for recurrence. Ameloblastomas can come back even years after surgery.

If it grows back, you’ll need more treatment.

What can I expect if I have this condition?

Your outlook depends on your health, where the tumor is located and whether surgery got rid of all of it.

Most people treated for ameloblastomas need lifelong monitoring to check for recurrences. The risk of recurrence is greater if you had conservative surgery that doesn’t remove as much bone and tissue.

Ask your provider how your diagnosis and treatment will impact your outlook.

What is the life expectancy of someone with ameloblastoma?

Ameloblastomas aren’t usually life-threatening as long as you get treatment and attend follow-up visits. The malignant types are so rare that there isn’t enough data to know how these conditions impact life expectancy.

Talk to your healthcare provider if you’re concerned that your condition may affect how long you’ll live.