What is an ameloblastoma of the jawbone?
Ameloblastoma of the jawbone develops from cell remnants of embryonic dental anlagen. It belongs to the benign, odontogenic (= originating from the teeth) tumors. An ameloblastoma of the jawbone often causes no symptoms and is often discovered very late or by chance. As it usually grows into neighboring healthy tissue, it can damage the jawbone and the dentition. Therefore, the oral surgeon usually removes an ameloblastoma by means of surgery. Regular and long-term follow-up care is then important, as the tumor often recurs. Only in very rare cases does ameloblastoma form metastases (secondary tumors).
Age and frequency
Ameloblastoma accounts for only one percent of all tumors and cysts of the jawbone. Nevertheless, it is one of the most common odontogenic tumors. In most cases (80 percent), it develops in the lower jaw, particularly in the area of the molars. An ameloblastoma of the jawbone can generally occur at any age. However, the peak age is usually between the third and fifth decade of life. Young people under the age of 18 very rarely suffer from ameloblastoma.
Ameloblastoma of the jawbone: causes and risk factors
An ameloblastoma of the jawbone leads to uncontrolled growth of tissue. This has its origin in cell remnants of embryonic tooth structures, more precisely in epithelial remnants
- of the dental ridge,
- of the so-called Malassez epithelium and
- of the enamel organ (tissue for the formation of tooth enamel).
Sometimes an ameloblastoma of the jawbone can also develop within an odontogenic cyst. A cyst is a fluid-filled cavity that is separated from the surrounding tissue by a membrane of connective tissue. Cysts can be caused by inflammation and developmental disorders. If the starting point for the cyst is a tooth, experts speak of an odontogenic cyst. The exact trigger for the uncontrolled tissue overgrowth is not yet known. Changes in the genetic material may play a role in this.
Symptoms: Ameloblastomas only cause symptoms at a late stage
An ameloblastoma of the jawbone generally grows very slowly and usually causes no symptoms, especially in the early stages of the disease. For this reason, affected people often notice ameloblastoma very late. For example, a painless swelling in the area of the jaw only appears once the tumor has reached a certain size. In the case of very large tissue growths, the jawbone is sometimes so impaired that a so-called spontaneous fracture can occur under normal load and without external force. In rare cases, the teeth also suffer from the tumor. Then you can
- Dissolve tooth roots,
- Loosen teeth or
- be displaced.
Sometimes inflammation also occurs. Ameloblastomas in the upper jaw can also obstruct nasal breathing and lead to nosebleeds.
Diagnosis with us
The diagnosis of ameloblastoma is not always easy. We therefore not only have to record the symptoms, we also need information from imaging and histological examinations. The combination of the various procedures helps to rule out other clinical pictures and make a clear diagnosis.
Medical history and physical examination
At the beginning of the diagnosis process, we ask you to describe the symptoms you are suffering from and how long they have existed (medical history). For example, we will ask you the following:
- Are you in pain?
- How long has the swelling been there?
- Have you had complaints in the past or do you currently have complaints in the jaw area or with your teeth?
- Have teeth shifted or loosened?
This is followed by a physical examination. We will inspect and palpate your jaw and any swelling that may be present. The oral cavity and teeth are also examined more closely.
Imaging techniques
Imaging procedures can help to determine the extent of the tissue growth and confirm the suspicion of an ameloblastoma. However, a clear diagnosis is not yet possible.
- X-ray examination: In the case of an ameloblastoma, the X-ray image often shows areas of the jawbone in which the bone substance has dissolved. It can also be used to visualize tooth root decay or teeth trapped by tissue overgrowth.
- Magnetic resonance imaging: This procedure provides even more precise images and can provide information on whether a cyst is causing the symptoms, for example.
Examination of the tissue
A histological examination can provide precise information about whether you actually have an ameloblastoma. To do this, we take a tissue sample and have it examined under a microscope in the laboratory. Specialists can assess whether an ameloblastoma is present and what type it is based on the appearance and nature of the cells removed. However, the histological classification has no great significance for the course of the disease and its treatment.
Ameloblastoma of the jawbone: prevention, early detection, prognosis
It is difficult to prevent ameloblastoma. To date, there is little reliable knowledge about what ultimately triggers tissue proliferation. Early detection is also not possible. As an ameloblastoma does not usually cause any pain, many patients often only notice it at an advanced stage of the disease. In general, you should have swelling or pain in the jaw area checked out as early as possible. We can determine the exact cause of the symptoms and initiate appropriate treatment. This allows you to minimize complications and late effects.
Progression and prognosis: Ameloblastoma of the jawbone
An ameloblastoma usually grows very slowly and is a benign tumor. However, as it grows aggressively into the bone marrow tissue of the jawbone, experts also refer to it as “semi-malignant”. If left untreated, the tumor continues to grow. This can sometimes lead to complications such as the loosening of teeth or broken bones in the jaw. To prevent further growth, the ameloblastoma must be removed by surgery. In about a quarter of cases, the tissue overgrowth recurs, so that further surgery may be necessary. Only very rarely does ameloblastoma spread to other parts of the body and form metastases (secondary tumors).
Ameloblastoma of the jawbone: treatment by surgery
To date, there are no drugs that can stop the uncontrolled tissue growth of an ameloblastoma of the jawbone. Therefore, surgical removal of the entire tumor is usually necessary.