Enucleation with Peripheral ostectomy Alone & in combination with Chemical Fixation for the treatment of Luminal Unicystic Ameloblastoma

Abstract

Objective: To compare the efficacy of enucleation with peripheral ostectomy alone & in combination with chemical fixation for the treatment of luminal unicystic ameloblastoma.

Methodology: This Randomized Controlled Trial study was conducted in the Oral and Maxillofacial Surgery Department / Dental Section, Aziz Fatima Hospital (AFMDC) Faisalabad in period of one year from March 2021 to March 2022. The study included 134 patients who had been diagnosed with unicystic ameloblastoma and were scheduled for surgery. To confirm the diagnosis of unicystic ameloblastoma, an incisional biopsy and clinical and radiographic evaluation were performed. All cases were given the same course of treatment, which included enucleation, peripheral ostectomy, and chemical cauterization using Carnoy's solution. Enucleation of the entire lesion was performed, then peripheral ostectomy was performed until good bleeding bone was found all around. The cavity was filled with gauze that had been soaked in Carnoy's solution, and it was left there for 5 minutes.

Results: The mean age of group A was similar to group B (26.097 ± 5.742 vs. 25.121 ± 5.112, P-value > 0.05). Majority of the patients in both groups were in age group of 21-30 years (67.16% vs 62.69%). The most common site of the pathology was posterior mandible in both groups consisting of 68.66% patients in group A and 73.13% patients in group B (P-value > 0.05). The success rate in terms of no recurrence of combination group of enucleations with chemical fixation was significantly better with less rate of recurrence (16.42% vs. 31.34%, P-value = 0.043) in comparison to enucleation alone group.

Conclusions: Enucleation followed by the application of Carnoy's solution is a good conservative treatment for Unicystic Ameloblastoma. Surgery outcomes and other potential problems are improved by prompt intervention, peripheral ostectomy, and use of Carnoy's solution.