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Ghandhi D, Ayoub AF et al. J Oral Maxillofac Surg 2006; 64: 1010–1014

Ameloblastomas are locally invasive and may recur. A variety of surgical approaches have been advocated. This retrospective study reviewed 50 cases in San Francisco and Glasgow treated over a 20 year period, including 9 unicystic lesions which were only diagnosed on the basis of subsequent histopathological examination.

In both centres, no radically-treated lesions recurred. One unicystic lesion was radically excised and was the only one not to recur, as the others were all conservatively treated at first. Treatment for the 41 solid or multicystic tumours was conservative in 21 cases and radical for 20. Recurrence occurred in 18 of these conservatively treated tumours.

The authors discuss the treatment of the unicystic lesions which had no diagnosis prior to histopathological examination, and recommend biopsy for cystic lesions over 3 cm in size. The recurrence rate for other forms was 80% and dependent on conservative treatment, so the authors advise more aggressive treatment than previously recommended.