Conservative treatment of ameloblastic fibroma a case report with review of literature
Year: 2025
Type: article
Study design: Case Report
Abstract: 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. 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. 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. 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. • Ameloblastic fibroma is most commonly diagnosed in the first and second decades of life. • 30% of patients were between their third and sixth decades of life, highlighting the importance of considering this condition as a differential diagnosis even in adult patients • It is estimated that one-third of Ameloblastic Fibrosarcomas cases develop from Ameloblastic Fibroma. • The majority of cases (86.9%) occurred in the mandible, with 80% located in the posterior region, 5% in the anterior region, and 15% involving both anterior and posterior regions
Authors: Gerardo Bardales Arguelles, Francisco Díaz Ayala, Claudette Marcelle Arambú Turcios, Gustavo Alberto Sierra Larios, Hugo Romero Alvarenga, Juan José Guifarro Sierra
Language: English
Subfield: Oral Surgery
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4416987118