Ameloblastoma Associated with Impacted #31

Patient: this was 15 year old Vietnamese female with an unremarkable medical history. She presented to us after not seeing a dentist for many years. This case came from my previous office in West Hartford, CT before I relocated to my dental practice in Orange, CT.

Description: We performed routine radiographs on her which included bitewing x-rays and a panoramic x-ray. We had already noted clinically that #31 had not yet erupted even though her other 3 twelve year molars were completely erupted. A large radiolucency was noted around #31.  A periapical radiograph was taken of the area as well.

The panoramic x-ray is below:

Panoramic X-ray showing radiolucency of an ameloblastoma with unerupted #31.

And the periapical x-ray is also seen:

Periapical X-ray showing radiolucency of an ameloblastoma with unerupted #31.

 

The patient was referred to an oral and maxillofacial surgeon. The surgery was performed and a diagnosis of ameloblastoma was confirmed.  The size of the cancer required excision of the cancerous tissue and removal of 32, 31, and 30.  It was also decided to remove the patient’s other wisdom teeth at that time.  The post-operative panoramic radiograph is below.  It is of lower quality as the oral surgeon reproduced it for us on lower quality paper.

Panoramic X-ray of #31 Ameloblastoma post-surgery

There were no serious complications post-surgically and the patient has recovered fully. It is likely the patient will need significant bone grafting should she desire dental implants in the position of 30 and 31.  Had this not been detected as early as it was, the patient could have required more radical resection of her mandible.