The Many Faces of Ameloblastoma
About 80% of ameloblastomas are found in the mandible. Radiographically, they are most commonly seen in the posterior mandible but can occur anywhere in the mandible. Twenty percent are found in other parts of the body, mostly in the face. They may, rarely, occur in the maxilla and skullbase (for which CT scans are recommended). Panoramic x-rays, also called panorex films, orthopantomograms or pantomograms, are adequate for assessing ameloblastomas of the mandible. The procedure is simple, with the patient’s chin placed in an immobilizer while the xray beam moves in an arc in front of the patient, taking a full view of the mandible in 1-2 minutes. Because the beam converges at a midpoint in the oral cavity, the resulting image “spreads out” the mandible from angle to angle (but overlaps and is hazier at the mentum).
In early stages, ameloblastomas start out as a unilocular cystic lucency, similar in appearance to any other odontogenic cyst. They are usually well-defined with scalloped borders and tend to displace, rather than destroy teeth. Typically expansile & multilocular, they have been described by such terms as “honeycomb” & “soap bubble”.
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