Ameloblastic fibroma after mandibular osteotomy :Report of a rare case
Objectives: Ameloblastic fibroma (AF) is a very rare mixed odontogenic tumor (2% of all odontogenic tumors). It is considered as a non-extensive non-aggressive tumor but recurrence remain possible.The aim of this case is to quote an exceptional etiology of this tumor that is usually associated with unerapted/included teeth .
Methods: A 32-year-old Caucasian female presented with a mobility of the 2nd and 3rd mandibular molars without swelling or pain. She was operated 8 years ago at our department of a bimaxillary osteotomy for a class III malocclusion. No radiological abnormalities were detected before surgery. The panoramic radiography and CT scan images revealed a voluminous multilocular radiolucent lesion (40 mm) that involved the ramus and right mandibular angle associated to osteosynthesis material . The lesion was completely enucleated with curettage and extraction of the two mobile molars included in the cyst .An histological analysis was performed .
Results: Upon histological examination, findings were consistent with an AF with a myxoid remodeling without any sign of malignancy .We decided to maintain our conservative approach and to keep a close surveillance in order to detect a possible recurrence .As it’s a new case, we don’t have a follow up yet .
Conclusions: The most remarkable finding in our case is the circumstances in which this tumor occurred . Is it really a complication of mandibular Sagittal split osteotomy or just a unique coincidence? Although recurrences of ameloblastic fibromas are rare, long-term follow-up is recommended.