At the early stage of life, the oral cavity may undergo some changes which majorly involve the eruption and regrowth of all the teeth. Meanwhile, during the happening of this natural process, several abnormalities can be observed in a few cases. For example, in some cases the eruption of teeth may not complete and the piece of any un-erupted teeth, a whole un-erupted tooth, delayed eruption, alteration in this specified series of dental eruption may lead to the adoption of some seriously dangerous disease (tumors). In this condition, the vulnerable sites are the mandible and maxilla of the oral cavity.
The dental enamel or lamina (dentin) consists of ameloblastic tissues which may lead to the growth of the odontogenic cyst from their lining resulting in the ameloblastic fibroma.
The condition of un-erupted teeth may account for 50% of the cases of ameloblastic fibroma.
What is Ameloblastic Fibroma?
Ameloblastic fibroma is an extremely rare neoplasm that is characterized by the odontogenic cyst growing from the dental enamel or lamina (dentin) in the oral cavity. It is mainly formed due to the proliferation of both mesenchymal tissues and odontogenic epithelium skipping the formation of enamel and dental lamina (dentin) and resulting in a uni-ocular tumor.This condition is considered to be less aggressive in nature as compare to the ameloblastomas.
It may vary in size ranging from smaller to the larger ones which affect the patients and choice of treatments in a quite different way. The size may vary from 1cm to 8.5cm and found in the form of solid masses. It is a mixed type of tumor that can be only a hemartomatous (commonly known as odontoma) in nature or purely neoplastic. These type of odontogenic tumors are divided into two types depending upon the nature of growth which includes;
Ameloblastic fibroma: these are benign in nature.
Ameloblastic fibrosarcoma: these are malignant in nature.
The histology of both of these types is very similar in nature so merely the histopathological studies are not enough to differentiate the cases of malignancies from the benign ones. So professionals may suggest some other radiographic and clinical markers for the proper and accurate diagnosis of the disease.
These kinds of tumors mainly target the population in their early decades of life (population of 15-25 years of age) when the odontogenesis is going on. Odontogenesis is characterized by the eruption and the regrowth of teeth. The very first case of ameloblastic fibroma was reported in 1891 and the term also described in the same year by Krause.
Ameloblastic Fibroma Symptoms
As these tumors are non-aggressive in nature and do not penetrate as well so the presentation of the clinical signs and symptoms of this disease may depend upon the size of the tumor. As the tumors in smaller sizes may not show any symptoms and stay as asymptomatic tumors resulting in a tough diagnosis. But eventually, the expansion of the jaws can be seen in this case too.
Meanwhile, the larger tumors show symptoms of the specified tumor and lead to the proper diagnosis of the disease at proper time. These symptoms may include;
- Ultimate expansion of the jaws
- Severe pain in the jaws
- Mild swelling of the jaws
- The proliferation of the mesenchymal tissues as well as the odontogenic epithelium
- Absence of the enamel and dentin (dental lamina)
- Presence of Uni-locular or multi-locular sloid masses or radiolucency
Ameloblastic Fibroma Causes
The exact underlying cause of the ameloblastic fibroma is not known well yet. As it is a very rare type of tumor that is located in the mandible or maxilla region. But it is reported that mandible is more prone to the adoption of these tumors which accounts for 83-90% of the cases. Meanwhile, very few cases in the maxilla region have been reported. As this tumor mainly grows in the era of life when the odontogenesis is ongoing, so several causes can be evaluated from this information. These causes are enlisted below;
- An un-erupted teeth
- Delayed dental eruption
- Alteration in this specified series of the dental eruption.
Ameloblastic Fibroma Treatment
First of all, the proper diagnosis of the disease is considered mandatory for the choice of an efficient treatment option.
Professionals may recommend surgical or non-surgical methods to properly treat this condition. But mainly enucleation and curettage are considered to be the most effective ones. It involves complete removal along the horizontal cleavage which leads to the lower chances of recurrence.
As the tumor is well encapsulated and formerly attached to the bony part in the oral cavity so it can be removed easily without the fear of bleeding and leaking. Because of this feature professionals mostly recommend enucleation as the treatment option but in case of a broad and progressive tumor, radical therapy is suggested depending upon the ailment of the patient.
