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The unilocular radiolucency with scalloped border combined with the jaw expansion, location and age of this patient are all a good clinical and radiographic presentation for (uni)cytic ameloblastoma.
Cystic ameloblastomas constitute 13% of all ameloblastomas. They are radiographically unilocular and in 90% of the time are associated with the crown of an impacted tooth. The other 10% are unilocular radiolucency usually associated with teeth such as between teeth. The cystic ameloblastoma patients are much younger in age and are around 14-20 years of age.
Ameloblastoma, if not treated, can reach very large sizes, causing facial disfigurement. It loosens, displaces and resorbs adjacent teeth. Ameloblastomas are usually not painful unless infected, in which case they can be mildly painful. Parasthesia and anesthesia are extremely rare, unless the lesion is very large in size. Also, cystic ameloblastoma tends to expand rather than perforate the cortical bone; if the latter occurs with extension into the adjacent soft tissue, it has a higher tendency for recurrence and therefore a worse prognosis than cases in which the ameloblastoma is completely encased by bone. Curettage is the treatment of choice for the unicystic type.
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