Background: Ameloblastoma are benign but locally invasive neoplasms that represent 10% of all odontogenic tumors. Despite its benign characteristics, ameloblastoma has a high recurrence rate after treatment with a recurrence rate of 55-90%. It is important to identify the risk factors of recurrence to improve patient’s quality of life in oral and maxillofacial surgery. Methods: Patients who underwent surgery at the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital for 5 years from 2017-2021 and were diagnosed with ameloblastoma as a result of postoperative histological examination were included. The patients were divided into two groups, recurrent and non-recurrent, and comparative analysis was performed according to various factors. Results: First, when the lesion was involved with the inferior alveolar nerve (IAN), recurrence was more likely than when it was not. Next, recurrence occurs more often when cortical bone perforation is observed than when it is not. In particular, when resorption is shown on the lingual cortical bone, a remarkable tendency of recurrence is shown. Moreover, in radiographic characteristics, the multicystic type showed a higher recurrence tendency than the unicystic type. Conclusion: When the lesion is multicystic, perforating the cortical bone, infiltrating the adjacent soft tissue, or involving the IAN, a high recurrence rate is shown. The results of this retrospective analysis of the recurrence trend of ameloblastoma over a 5 years period are to contribute significantly to insight and reduction of recurrence rates in treatment for polymorphic lesion in oral and maxillofacial area.

It is well documented that giant cells can be observed in some types of odontogenic tumors such as central odontogenic tumor and dentinogenic ghost cell tumor. However, the presence of stromal giant cells has only rarely been reported in ameloblastoma, although being the most common epithelial odontogenic tumor. In this study, we present a novel case of peripheral ameloblastoma associated with peripheral giant cell granuloma arising in the mandibular alveolar mucosa of a 65-year-old male patient. The possible pathogenesis of this combined lesion will be discussed, in addition to the review of previous reports of ameloblastoma accompanied by stromal giant cells.

Dentigerous cyst is considered one of the representative cystic lesions, which accounts for approximately 15%-30% of the odontogenic cysts. Although its recurrence rate is low, a small proportion of dentigerous cysts converted into ameloblastomas, squamous cell carcinomas, and mucoepidermoid carcinomas. Here we present an uncommon case characterized by histopathological transformation from a dentigerous cyst to an ameloblastoma, and further investigate the factors contributing to its conversion.

Mucormycosis is an aggressive opportunistic fungal infection that can be found in the oral cavity. The fungus usually affects the immunocompromised patients and tends to invade and block blood vessels, resulting in significant tissue necrosis and invasive mucormycosis. However, a non-invasive form of mucormycosis is mostly asymptomatic and found accidentally in the immunocompetent normal hosts, manifested by localized overgrowth of the fungus. Here, we report a rare case of asymptomatic non-invasive mucormycosis of the mandible that was incidentally diagnosed in wide resection specimen of liver transplant patient who had previously underwent surgery of excision and simultaneous alloplastic bone graft due to mandibular ameloblastoma. Histopathological examination of the specimen revealed that there was neither vasculitis nor tissue necrosis, but numerous fungal hyphae were located only within the alloplastic graft materials in decalcified tissue sections. Awareness of the possibility of life-threatening mucormycosis in immunocompromised patients should be emphasized because it can be inactive or reactivated depending on the immune state of patients.

국내에 유통되는 식품용 기구 및 용기·포장 중 4종류(유리제, 도자기제, 법랑 및 옹기류)의 재질, 총 198건을 수거하여 식품으로 이행 가능성이 있는 중금속(납, 카드뮴, 비소 및 안티몬)에 대하여 이행량을 ICP-MS 로 조사하였다. 식품유사용매는 4% 초산을 사용하여 25oC를 유지하면서 24시간 방치한 액을 시험용액으로 하였으며, 시험법 검증을 위하여 검량선, 검출한계, 정량한계, 회수율, 정밀성 및 측정불확도를 산출하였다. 이행량 조사 결과 유리제의 경우 납과 카드뮴은 각각 N.D.-752.21 μg/L, N.D.- 1.99 μg/L 이고, 도자기제는 납, 카드뮴 및 비소가 각각 N.D.-1,955.86 μg/L, N.D.-74.06 μg/L, N.D.-302.40 μg/L 이며, 법랑의 납, 카드뮴 및 안티몬은 각각 N.D.-4.48 μg/L, N.D.- 7.00 μg/L, N.D.-52.00 μg/L 이였다. 그리고 옹기류의 납, 카드뮴 및 비소는 각각 N.D.-13.68 μg/L, N.D.-0.04 μg/L, N.D.-6.71 μg/L 수준으로 확인 되었다. 이와 같은 결과를 근거로 유리제 등으로부터 식품으로 이행 가능한 중금속의 위해도는 총 섭취량대비 4.83% 이하로 비교적 안전한 것으로 판단된다. 또한, 본 연구결과는 국내에서 유통중인 유리제 등의 식품용 기구 및 용기·포장은 모두 국내의 기준·규격에 적합함을 확인하였다.

Ameloblastoma is an odontogenic tumor characterized by various sites of metastasis, malignant transformation, and a high recurrence rate over time. Ameloblastic carcinoma(AC) is the term reserved for an ameloblastoma with histologic evidence of malignancy in the primary tumor. AC is classified into two types: most ACs occur de novo, and only few cases of malignant transformation of ameloblastoma become apparent. Here, we report a case of AC, arising from recurrent acanthomatous ameloblastoma on the maxillary sinus, in a 60-year-old male patient. The mass was first diagnosed as acanthomatous ameloblastoma; subsequently, surgical curettage was performed thrice while partial maxillectomy was performed twice. On the fifth recurrence, the tumor was identified as AC.

Ameloblastoma is a benign odontogenic tumour of epithelial origin and comprises 1% of maxillomandibular tumors or cysts. The incidence of pathological changes such as ameloblastoma from the follicle of impacted third molar was reported to have low incidence. However, there are many reports that asymptomatic third molars are related with various pathological conditions. A case of ameloblastoma secondary to third molar extraction and subsequent sagittal split ramus osteotomy (SSRO) had not been reported. At the right ramus area, radiolucent lesion had been noted at 6 years after the surgical extraction of the third molar followed by SSRO for the mandibular prognathism. The lesion was proved to be the basal cell type ameloblastoma. There had been no significant bony lesion before or 1 year after the SSRO. The tumour was successfully removed and there was no evident recurrence at 4 year of the follow up after the removal of the ameloblastoma. There are some reports suggesting the pathologic potential of the pericoronal tissues of impacted third molars to develop odontogenic keratocysts and ameloblastomas. The current case reports a rare possibility of ameloblastic change at the site of uneventful healing after third molar extraction and orthognathic surgery.

Ameloblastic fibrosarcoma (AFS) is an extremely rare malignant odontogenic tumor characterized with benign ameloblastic cells islands and malignant mesenchymal component. While two-thirds of AFS seem to arise de novo, but one-third develops from recurrent ameloblastic fibroma (AF) or ameloblastic fibro-odontomas (AFO). Pathological distinction of malignant transformation is essential for appropriate treatment. The patient was a 28 years old man. Since the primary tumor was excised, the mass recurred 2 years later. The recurrent tumor was diagnosed as AFS. Chief complaint was pain in the right mandible. Computer tomography finding revealed multilocular intrabony lesion with radiopaque substance in the primary lesion. In the recurrent lesion cortical bone destruction was found. Microscopically, both the primary and recurrent lesions showed benign ameloblastic follicles with myxoid or highly cellular mesenchymal proliferation. The histological difference between primary and recurrent lesions were that foci of dental hard tissue composed of enamel and dentin were found only in the primary lesion, whereas nuclear pleomorphism was aggrevated in the recurrent lesion. The histological criteria determining malignancy were discussed.

Odontogenic cyst and odontogenic tumor shares developmental source. However, they have different histopathologic features, and they are classified respectively. Odontogenic cyst and tumor can share same physical region. It is called a hybrid lesion, a lesion showing the combined histopathological characteristics of two or more previously recognized odontogenic tumor and/or cysts of different categories. In this study, a hybrid lesion was researched. 61-year old man was referred to our department with a multilocular radiolucency in right mandibular angle. Incisional biopsy was carried out, and the patient was diagnosed with ameloblastoma. Odontogenic keratocyst was found with the tumor, and it was thought to be evolved via neoplastic transformation from lining epithelium of the keratocyst. After reviewing studies reporting hybrid lesions from odontogenic cyst and tumor, formation of a hybrid lesion was most frequent from a dentigerous cyst and an adenomatoid odontogenic tumor. A hybrid lesion commonly lead to misdiagnosis, and the prognosis is not always transparent. The close relationship between the odontogenic cyst and tumor has to be kept in mind in the diagnosis and treatment of the lesions in maxillofacial area.

Calcifying cystic odontogenic tumor (CCOT), also known as calcifying odontogenic cyst or Gorin cyst is a rare developmental lesion which arises from odontogenic epithelium. It has been classified as a benign odontogenic neoplasm related to odontogenic apparatus by the World Health Organization. CCOT may be associated with other odontogenic tumors, most frequently odontoma, a finding that is a rare event in other types of odontogenic cysts or tumors. This report describes a case of hybrid odontogenic tumor composed of CCOT and ameloblastic fibroma-odontoma of the impacted right maxillary canine region that occurred in a 14-year-old female.

Peripheral ameloblastoma, a rare and unusual variant of odontogenic tumor, representing 1% of all ameloblastomas. The extraosseous location is the peculiar feature of this type of tumor, which is otherwise similar to the classical ameloblastoma. This paper describes a case of peripheral ameloblastoma in a 43-year-old female affecting the left retromolar pad area of the mandible which was clinically diagnosed as a pyogenic granuloma. Histologically, the tumor showed of follicular ameloblastoma in continuity with a surface oral epithelium.

Ameloblastic fibro-odontoma has been defined as a lesion similar to ameloblastic fibroma by WHO, as it shows inductive changes which forms enamel and dentin. Ameloblastic fibro-odontoma is a very rare mixed dentition tumor in children, and the symptom shows indolent edema in maxillary and mandibular molar area. The prevalence is two times higher in male than in female, and two times higher in maxilla than in mandible. Radiologically, it shows clear border and characteristics of both fibroma and odontoma histologically. This review reports a case that a 4-year old female visited in dental clinic of this school for edema as chief complaint in Feb, 2012. Emergency surgical curettage was performed right after initial diagnosis as odontoma, then confirmed diagnosis as Ameloblastic fibro- odontoma after biopsy. Currently, after 6 month, no sign of recurrence can be seen. Ameloblastic fibro-odontoma is very rare mixed dentition tumor. Moreover, as it is the case of female maxilla, this case is worth of publishing. Furthermore, accurate diagnosis of Ameloblastic fibro-odontoma is difficult. This review is published for accurate diagnosis through differential diagnosis of several important mixed dentition tumors.

Abstract. The keratoameloblastoma is a benign lesion of the jaws, which is a rare histologic variant of the ameloblastoma. There is a variation in the histopathologic appearance of reported cases under the appellation of keratoameloblastoma. The keratoameloblastma has usually keratin formation by the ameloblastomatous epithelium and varies in size. English literature reports only 14 cases of keratoameloblastma. We described an additional case of the tumor developed in the right mandible of a 26-year-old woman. It was presented as an expansile and radiolucent lesion. Histologically, solid tumor islands were seen with some microcystic space within a fibrous stroma resembling an ameloblastoma. In addidion, a hyperchromatic columnar basal cell layer and parakeratin within the microcyst simulating an odontogenic keratocyst

Several recent studies have detected genetic and cytogenetic alterations in epithelial odontogenic tumors. However, the detailed mechanisms of oncogenesis, cytodifferention, and tumor progression remain unknown. p63 as p53 homolog gene has been identified at loci 3q27-29. The p53 signaling cascade has an important role in oncogenesis or cyto- differentiation of odontogenic epithelium. Recently, several syndromes associated with p63 gene mutations have shown to include various tooth abnormalities of both the primary and permanent dentition. But little is known about p63 expression in odontogenic tumors, especially ameloblastomas. The purpose of this study were to examine various expression of p63 in ameloblastomas by immunohistochemistry and to clarify the possible biological role of p63 in ameloblastomas. 15 specimens including 6 follicular, 4 plexiform, 3 acanthomatous, and 2 granular cell types were fixed in 10% neutral formalin. 4um thick sections were used for routine H&E and immunohistochemical examinations. After immuno- histochemical satining, they were examined at a final magnification of 400X. For each case a minimum of 1000 nuclei located in the central and peripheral layers were counted in up to 10 consecutive microscopic fields per case. The immunoreactive cells were evaluated semiquantitatively. Immunoreactivity for p63 in all the types of ameloblastomas was higher in peripheral neoplastic cells than in central neoplastic cells. Keratinizing cells in acanthomatous ameloblastoma and granular cells in granular cell ameloblastoma showed markedly decreased reactivity for p63 in acanthomatous and granular cell ameloblastoma. Labelling index of acanthomatous, plexiform, and granular cell type was 86±11%, 81±17% and 83±15% in peripheral area while 88±14%, 82±11% and 76±10% in central area, respectively. Labelling index of follicular type was 17±4% in peripheral area while 21±3% in central area. There was no significant relationship between plexiform, acanthomaous, and granular cell type, while significant relationships between follicular and acanthomatous type, between plexiform and follicular type, and between granular cell and follicular type, respectively. It suggested that p63 expression could paly an important role in the pathogenesis of ameloblastomas. Morever plexiform, acanthomatous, and granular cell type would show more aggressive proliferative potentiality than follicular type.

Ameloblastomas are benign odontogenic tumor and the most common neoplasm in jaws and they have locally invasive property and high recurrence rate. Four typical subtypes ameloblastomas are plexiform, follicular, granular cell and acanthomatous type, but their developmental states during tumorigenesis are uncertain. And thus authors studied about developing states of four types of ameloblastomas by immunohistochemical staining for cytokeratin 8/18 which was an intermediate filament of epithelial cell origin and for vimentin which was an intermediate filament of mesenchymal cell origin, and then by comparative analyses of the results. Authors selected seven cases for every four types of ameloblastomas, and then performed immunohistochemcial staining for cytkeratin 8/18 and vimentin to all selected specimen by using monoclonal antibodies about cytoleratin 8/18 and vimentin, LSAB(Labelled StreptoAvidin Biotin) reactant and HRP(Horse Radish Peroxidase) system. Labelling indices of cytokeratin 8/18 of plexiform and follicular types of ameloblastomas were significantly high values in the group of ameloblast-like cells and labelling indices of cytokeratin 8/18 of all types of ameloblastoma were high values in the group of transformed cells, but their differences were not significant. Labelling index of vimentin of plexiform ameloblastoma was significantly high value in the group of ameloblast-like cells and others showed comparatively lower values. Labelling index of vimentin of granular cell type of ameloblastoma in the group of transformed cells was significantly high value and others showed comparatively lower values. Consequently the most primitive form of ameloblastoma was plexiform, and more differenciated form was follicular type and granular cell type and acanthomatous type were most differenciated form of ameloblastomas

Elevated expression of survivin is strongly associated with tumorigenesis and even in human common cancers. The purpose of this study is to confirm whether survivin is associated with odontogenic tumor expecially in the development and growth in ameloblastomas. For the control group; 3 specimens obtained from normal oral mucosa without any inflammatory reaction were used. For the experimental group, specimens obtained from 17 subjects of ameloblastomas; follicular type, plexiform type, granular cell type, acantomatous type and unicystic ameloblastoma. All the specimens were embedded in paraffin, sectioned 5μm or more in thickness, and stained with hematoxylin- eosin stain method. For immunostain, the specimens were incubated with 1:200 diluted primary antibody, followed by the secondary antibody. The bound antibodies were visualized by addition of diaminobenzidine tetrahydrochloride (DAB) for 30 minutes at room temperature. The specimens were counterstained with Gill’s Hematoxylin and mounted. Intensity of survivin immunoreactivity specimens was quantitatively scaled using under the light microscope with the following criteria; Intensive reaction; +++, Moderate reaction; ++, Minimal reaction; +. Using the image analyzer (Korea Optical System), immunoreactivity of the tumor cells in various fields was measured and statistically analyzed with SPSS 17.0 Program. In control group, moderate positive reaction was noted in the cytoplasm of cells in the basal and spinous layer, but negative reaction was revealed in the nucleus. Expression of survivin was significantly increased in the cytoplasm of ameloblastomas as compared to that of control group (p<0.05). Expression of survivin in the nucleus and the cytoplasm of the tumor cells between subtype of ameloblastoma was not significantly different. These results suggest that expression of survivin is closely associated with the development, and growth of the ameloblastomas. However it is unlikely that survivin can be used as a marker for cellular malignancy.

Desmoplastic ameloblastoma (DA) and Ameloblastic fibroma (AF) show common histopathologic features such as enamel organ like epithelial islands or cords on the background of abundant fibrous stroma. Despite their similar histopathologic features, it was reported that they have different pathogenesis and clinical behavior. The purpose of this study was to rev iew clinicopathologic features of DA and AF among Korean subjects. 7 cases of DA and 4 cases of AF were retrieved from the files of Seoul National University Dental Hospital (SNUDH), and their clinical features, radiographic findings, and histopathologic features were reviewed and compared. DA occurred in 3 males and 4 females. They occurred from 24 to 62 years of age, showing the mean age of 42.7 years. 5 of the 7 tumors occurred in the maxilla, and all of them in the anterior region, showing predilection for the maxillary anterior regions. There was no recurrence. Radiographically, they showed well demarcated unilocular or multilocular radiolucency. AF occurred in 5 males and 2 female. They occurred from 6 to 29 years of age, showing the mean age of 14 years. All tumors occurred in the mandibular molar area. Recurrence was recognized in 1 case. Although DA and AF showed similar histopathologic features, they showed different clinical behaviors. While DA showed predilection for the anterior maxilla, AF did for posterior mandible. While DA occurred mainly in adults, AF did in adolescents. Recurrence was recognized not in DA but in AF. Therefore, DA and AF should be differentiated from each other in spite of similar histopathologic findings

The purpose of this study was to evaluate the role of integrin α3 and integrin β1 in the ameloblastomas. For this study, 10 specimens diagnosed as amoblastomas referred to the Department of Oral Pathology, School of Dentistry, Kyung Hee University, and 5 specimens of normal oral mucosa without any inflammatory changes were used as experimental and control groups, respectively. The ameloblastomas devided into follicular type, plexiform type, acanthomatous type, and granular cell type. All specimens; experimental and control group were fixed in 10% neutral formalin solution and embedded in paraffin, and then the serial tissue sections were made 5㎛ in thickness and processed for immunohistochemical observation. The specimens were incubated with primary antibody against integrin α3 or integrin β1, each was diluted at 1 : 100, followed by the Supersensitive non-biotin horse radish peroxidase detection system with DAB as chromogen. After counterstaining with Gill's hematoxylin stain method and mounted, and examined under the light microscope. Based on the intensity of the immunoreactivity, intensity of the immunity was scored no epithelial stain, weak or focal epithelial stain, moderate or focal intensive epithelial stain, intense generalized epithelial staining for the epithelial, and connective tissue component in ameloblastomas, and normal oral mucosa on each. Attained results as follows. Expression of integrin α3 in the oral mucosa, weak reaction was noted on the all layers of epithelium, and submucosa. Expression of integrin β1 in the oral mucosa, intense reaction on the superficial layer, moderate reaction in basal layer were shown. Expression of integrin α3 in ameloblastomas, it was noted that weak reaction on the ameloblast like cells in the all types and rarely in basement membrane. Expression of integrin β1 in ameloblastomas, intense reaction on the tumor cell ,and partly in the nuclei in follicular type was noted, And moderate reaction on the tumor cell in plexiform , acathomatous types, but weak reaction in granular cell type was shown. This results result suggest that integrin α3 may influenced negligibly, but the integrin β1 influenced significantly the development of the ameloblastomas considering the response is increased on the region with highly cellular activities

Desmoplastic ameloblastoma(DA) is histologically characterized by extensive stromal collagenization or desmoplasia. ln this study, anti-cytokeratin 8/18, 13, 19 for pathogenesis as well as anti-PCNA for cellular proliferation, were used to det ect the expression of these proteins in the desmoplastic ameloblastoma Basal layers of tumor nest were negatively stained by CKl3, while suprabasal and inner cells were positive for CK13. CK8/18 and CK 19 was negatively stained in the peripheral portion of tumor nest in DA, whereas CK 8/18 was in central portion and CKl9 was positive in the su prabasal and some of central portion of the cel l nest. PCNA index of DA was 60 ::!: 14.6% to 95 ::!: 17 .2%. The peripheral tumor cells of the islets presented higher PCNA labeling index, while some cells in the central area of foll icle containing squamous like cells also presented negative PCNA labeling index. Especially tumor islands showed higher PCNA index than in main tumor mass. lt suggested that desmoplastic ameloblastoma might be composed of many different tumor cell types‘ and have hi gher pr이 ife r a ting activity in tumor islands of the desmoplastic stroma

This is a case reporL of a ra re mi xed odontogenic tumo r, amelob lastic fibro-odontoma in the poste1'ior of r ight ma nd tlbe A 2-year - olcl ma le pa ti enL was referred to our department ['or large tumorous lesion 011 ri ght mandible Radiograph ic examination s howed la rge radi opaque and rad iolu cent lesion with impacted and unerupted tooth, #44‘ #45 , #46 #85 , AJ'Ler s urgi cal enuclea Li on & cu rettage of t he mass , the tumor was confirmed to ameloblastic fibro-odontoma. lt was composed with c1 enta l orga ns a ncl is la nd of odontogeni c epithelium embedded in a cell - ri ch mesenchymal s troma, AIso‘ we ca rri ed out an immunohi stochemical study. The resul ts s howed positive CK7 staining. and showed weekly positi ve for Bcl - 2‘ Ki - 67 s Laining, while CEA, CK8‘ CKl2, CKl6 showed l1egative, Follow-up studies have shown no tumot recurrence for 2 yea rs ,