Spontaneous Mandible Regeneration After Segmental Resection in a Pediatric Patient With Ameloblastoma

Abstract

Background: The purpose of this case report is to highlight the understated regenerative potential of the pediatric mandible, which favors early aggressive management and delayed secondary reconstruction of the mandible in the management of ameloblastoma, a well-known pathology.

Methods: This is a case of an otherwise healthy 12-year-old girl presented with complaints of loose teeth and right facial swelling. An orthopantogram was obtained, which revealed a unilocular radiolucent lesion of the right mandible. The lesion was biopsied to be plexiform ameloblastoma, and the patient underwent segmental mandibulectomy and temporary reconstruction with custom reconstruction mandibular bar with future plans for microvascular reconstruction.

Results: Patient was followed postoperatively with serial orthopantograms and 3-dimensional computed tomography at 17 months that revealed progressive mandibular regeneration avoiding need for further reconstruction.

Conclusions: Delayed reconstruction of the mandible in the pediatric population can be minimized with early aggressive management of a solid ameloblastoma. The ideal environment for regeneration of the mandible should be taken into consideration during treatment planning: the absence of infection, rigid fixation, patient age, and an intact periosteum.

Keywords: Ameloblastoma; mandible reconstruction; mandible regeneration; pediatric craniofacial reconstruction.