Conservative treatment of ameloblastic fibroma a case report with review of literature.

INTRODUCTION AND

IMPORTANCE

Ameloblastic fibroma (AF) is a benign mixed odontogenic tumor composed of epithelial and mesenchymal tissues. It accounts for approximately 1.5-4.5 % of all odontogenic tumors and is most commonly diagnosed during the first and second decades of life. Due to documented cases of malignant transformation, the optimal therapeutic approach for AF remains a subject of debate.

CASE PRESENTATION: A 15-year-old female patient presented with pain, swelling, and purulent discharge in the right posterior mandible. Panoramic radiography revealed a unilocular radiolucent lesion associated with tooth 48. The patient had no significant medical history.

CLINICAL DISCUSSION: An incisional biopsy was performed with the presumptive diagnosis of odontogenic keratocyst, followed by decompression tube placement. Histopathological examination confirmed the diagnosis of ameloblastic fibroma. Given the patient's age and the low likelihood of malignant transformation, a conservative treatment approach was adopted, consisting of enucleation, curettage, peripheral osteotomy, and extraction of retained teeth. Due to the compromised lingual and vestibular cortices at the mandibular basal border-observed on computed tomography (CT)-a reconstruction plate was placed to prevent pathological fracture.

CONCLUSION

AF is a rare, often asymptomatic odontogenic tumor. Therapeutic management remains controversial due to its recurrence rate (18.3 %-43.5 %) and potential for malignant transformation (reported in one-third of cases). In this case, at the 9-month follow-up, the patient exhibited preserved mandibular function, remained asymptomatic, and showed no clinical or radiographic evidence of recurrence. Conservative treatment with rigorous long-term monitoring may be the preferred approach for young patients to optimize functional outcomes and quality of life. No generative artificial intelligence (AI) tools were used in the conception, design, data collection, analysis, or interpretation of the research presented in this manuscript. Furthermore, no AI-assisted technologies were employed in the drafting, editing, or revision of the manuscript.