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International Journal of Oral Implantology



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Int J Oral Implantol (Berl) 9 (2016), No. 2     16. June 2016
Int J Oral Implantol (Berl) 9 (2016), No. 2  (16.06.2016)

Page 189-193, PubMed:27314127

Solid ameloblastoma mimicking a periodontal defect: A diagnostic dilemma
Sinha, Deepti / Dormaar, Titiaan / Salvo, Natalia / Politis, Constantinus / Bornstein, Michael M. / Jacobs, Reinhilde
Purpose: To report a rare presentation of an ameloblastoma mimicking an endo-periodontal lesion.
Materials and methods: In this case report, we present the unusual clinical course of a 78-year-old Caucasian male patient, seeking single tooth implant rehabilitation at location 42 (lower right lateral incisor), initially unsuccessfully treated at different clinics for a persistent endo-periodontal lesion associated with this tooth, by both an endodontist and a periodontologist, which finally lead to tooth loss.
Results: CBCT imaging of the anterior mandible region revealed a persistent radiolucency and subsequent enucleation of the lesion in the partially healed extraction socket revealed the true underlying diagnosis: a solid follicular ameloblastoma. A re-entry with biopsy was planned after radiological confirmation of lesion growth 1 year later, reconfirming the diagnosis and necessitating partial segment resection of the mandible.
Conclusions: In the presence of lesions refractory to therapy, consideration towards a broader differential diagnosis and an appropriate investigation should be undertaken before the decision on implant placement.

Keywords: ameloblastoma, cone beam computed tomography, dental implant, mandible, periapical lesion, periodontal defect