Potential role of active decompression and distraction sugosteogenesis for the management of ameloblastomas: Report of two cases and review of the literature

Ameloblastomas are aggressive odontogenic entities well-known for their high tendency to recur. Clinical presentation includes lesions discovered on routine examination or radiographs, pathologies causing facial swelling, pain, cortical expansion, tooth mobility, root resorption, and paresthesia. Radiographic findings comprise large unilocular or multilocular radiolucencies with well-defined borders associated to an impacted tooth. Ameloblastomas are classified as unicystic, multicystic/solid, and peripheral. Treatment options include marsupialization, decompression, enucleation, or curettage with or without adjuvant measures such as Carnoy's solution, marginal resection, and segmental resection. Recently, active decompression with distraction sugosteogenesis (ADDS) was introduced for the conservative management of odontogenic cystic conditions. The purpose of this paper is to present 2 cases of a conventional ameloblastoma treated by means of ADDS. The purpose of this novel approach is to significantly reduce the amount of time required to decompress cystic-like lesions. In these cases, ADDS proved to be a viable treatment because it demonstrated a reduction in size of the initial lesion by new osseous formation within 2 weeks of placement of the device. The cases presented in this paper demonstrate that ADDS could be a valuable treatment modality for this type of ameloblastoma, although further research is necessary to validate this philosophy.