Ameloblastoma recurrence treatment with custom prosthesis and sagittal osteotomy

Ameloblastoma is a benign but aggressive odontogenic tumor with a locally invasive growth pattern, often causing significant clinical challenges, including recurrence. Although its etiology remains unclear, previous theories suggest trauma, inflammation, and dental caries as possible contributing factors. The case report discusses a patient with recurrent ameloblastoma of the mandible, initially treated 22 years ago, with a Kirschner wire used for reconstruction, which was removed due to complications. Upon presentation, the patient showed significant facial asymmetry, mandibular deviation, and dental disocclusion. Radiographic imaging and biopsy confirmed the recurrence of ameloblastoma. Treatment was planned using Dolphin software® to achieve segmental resection of the lesion and simultaneous correction of the associated dentofacial deformity. This included restoring the dental occlusion to a class I relationship and centralizing the chin, with a contralateral sagittal osteotomy to accommodate the dentate region. The patient underwent surgery under general anesthesia, with lesion resection, osteotomy, and placement of a custom prosthesis. The postoperative period was uneventful, and the patient has been followed for four years with stable dental occlusion and restored facial aesthetics, with no signs of recurrence. This case highlights the feasibility of treating recurrent ameloblastoma with a custom prosthesis and a sagittal osteotomy to address associated deformities, both planned using advanced software, offering a comprehensive solution for complex mandibular tumors.