Introduction
Ameloblastoma is a locally aggressive benign jaw tumor, with high rate
of recurrence. It is an odontogenic tumor arising from residual
epithelium of the tooth germ, though aetiology remains
uncertain1. The tumour has a higher predilection for
the mandible (80-90%) than the maxilla. It is often diagnosed in the
2ndand 3rd decade in the sub-Saharan
African population while a more advanced age is reported in the European
literature.
Ameloblastoma is the commonest jaw tumor and is characterized by various
histological subtypes. There has been recent reclassification of this
tumour into; conventional, unicystic, extraosseous/peripheral and
metastasizing (malignant) ameloblastoma. The unicystic variant tends to
occur in the younger age groups2,3,4.
The management of ameloblastoma is resection of the affected jaw with a
safety margin of more than 1.5cm and reconstruction to restore form and
function of the resultant surgical defect. The affected patients among
black Africans tend to present to the hospitals late with massive
tumors, an observation that has been attributed to a range of factors.
Some of these factors include; poverty, lack of awareness, traditional
beliefs and possibly asymptomatic nature of the disease. (5). This late
presentation pose a great challenge in the management as its often
characterized by the difficult intubation during general anaesthisia
that at times require tracheostomy. There is also a threat of damage to
major blood vessels and nerves within the proximity as well as
reconstruction challenges due to the huge defect created after tumor
resection. Extensive tumours may require multiple or staged surgical
procedures that at times involve initial reconstruction with titanium
implant and later own bridging of the continuity defect with a bone
graft. There is usually a lot of time spent intra-operatively when
trying to shape the reconstruction implant into the correct anatomical
position. The use of 3D printed models can allow for pre-operative
bending of plates into the desired shape, thus reducing the time spent
in surgery.
We present a case of an extensive ameloblastoma in a middle aged male
that was managed with the aid of 3D printed models.