12 yr old female c/o swelling in lower jaw. Diffuse swelling present in lower vestibule wid tilted 31,32,41. Radiograph shows impacted 33,34 and radiolucency extending from 41 to 36. Incisional Biopsy suggest Plexiform Unicystic ameloblastoma, another biopsy report from other centre suggest Adenomatoid Odontogenic Tumor. I am confuse how to manage the case. If it's Unicystic Ameloblastoma how do I proceed in such a young female pt??

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The difference between AOT and ameloblastoma radiographically is "Knife edge shaped resorption" of the roots of teeth in case of ameloblastoma. In this case no knife edge resorption of roots is seen of tooth adjacent to the swelling. Also ameloblastoma appears as a soap bubble appearance or honeycomb pattern or tennis racket appearance. This is AOT for me. Best diagnostic procedure- prepn. of h/p slide

Thnks dude Dr.
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It's AOT for me On radiographs, the adenomatoid odontogenic tumor presents as a radiolucency (that dark area) around an unerupted tooth extending past the cementoenamel junction. Or An extra-follicular AOT, originating from the epithelial lining of a unicystic ameloblastoma.

Thnks a lot Dr. Sir
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Dr. Jana Rama Rao Sir

Any way two different reports from two different biopsy centres . More chances r unicystic ameloblastoma . So u have to extract the over retained deciduous teeth and open the cyst and enecluate every thing and take one more iopa for any remnants of cystic lesion residues and be careful that the impaction at the lower border of the left mandibular region more prone to fracture site so more precautionary measures has to Take at the time of curretting the cystic lesion . And repeated irrigation should be done . The age is 12 years so the healing and osteogenesis can be very quick in this age . Nothing to worry . Except the deeply impacted teeth may cause unnecessary complications at the time of removal . If it is placed more labially r lingually no Problem but if it rooted in the base of the border then the weak bone may prone to fracture . If the unicystic ameloblastoma r Adenomatoid odontogenic tumor the end Operative procedure is u have to open the cyst and enucleate the cystic debris clearly and betadiene irrigation is compulsory for aseptic precautions. U may think the odontogenic tumor may transform in to malignant tumour . The odontogenic tumor in this age may not transform in to odontogenic sarcoma . Please educate the pt and discuss nothing to worry , improve more confidence levels in Pt mind and go for surgical procedures . Post operative surgery please recommend more of calcium supplementation . 1 ostocalcium , r reju clacium. 2 egg , milk , fish , protein food . 3 fresh fruits and drum sticks and green Leafy vegetables advisable . 4 sea food more of calcium supplementation . 5 vit C . 6 antibiotics according to h/o of allergy 7 nsaid all doses r in pediatric dose only . Councilling and self confidence levels in the pt should be improved .

Thnks a lot Sir for such elaborate suggestion
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