Unicystic ameloblastoma: Diagnostic challenges and uncommon treatment strategy: Case report.

INTRODUCTION

Unicystic ameloblastoma (UA) is frequently associated with an impacted tooth with a challenging diagnosis and decision making. The aim of this article is to emphasize a novel approach of treatment with tooth reimplantation after conservative treatment.

PRESENTATION OF CASE: A 7-year-old boy consulting with a chief complaint of swelling in the upper left front region. Intraoral examination revealed a non-tender swelling extending from 61 to 63. Radiographic examination showed a well-defined, unilocular radiolucency associated to tooth 21. Initial diagnosis was a dentigerous cyst and was treated conservatively (enucleation and tooth reimplantation). Final diagnosis was an UA, intraluminal form. After 6 years, no signs of recurrence were observed, and teeth 21 and 22 showed healthy root development.

DISCUSSION: UA is the least encountered variant of all types of ameloblastomas and more commonly affects the mandible's posterior region than the maxilla. Differential diagnosis in the presence of radiolucent images is a dilemma, especially when a tooth is impacted in association with the lesion. Decision-making can be challenging, particularly regarding the appropriateness of initial radical extensive surgery in children. We opted to a conservative treatment. This procedure resulted in fewer complications and preserved the permanent teeth and as much bone as possible to avoid aesthetic deformities.

CONCLUSION

This case report focuses on a novel approach to the treatment of UA. This case report confirms that for UA conservative treatment is possible, with preservation of tooth and alveolar bone, particularly in young patients.