In March 2005, a 30-year-old patient presented to the Department of Dentistry Surgery at the left Uniestomatológica de la observation molar dicer en el Hospital San di Milano - Monico.
The patient had no relevant clinical symptoms, except for mild pain in the third molar area.
Extraoral examination did not reveal relevant signs and neck lymph node staging was normal.
Intraoral examination revealed partial mucosal inclusion of element 2.8, with no variations in color or consistency particular to palpation of the area under examination.
Radiographic analysis with orthopantomography, element 2.8 showed increased radiolucent areas.
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The patient, who had no systemic diseases, in March 2005 received extraction of element 2.8 and biopsy of adjacent tissues, dimensions of approximately 1.0 x 1.0 x 1.0 cm.
The diagnosis based on the histological report was plexiform ameloblastoma.
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In deepening the radiographic diagnosis through computerized axial tomography with programtascan shows the affectation of a wide area of the left maxilla that reached the base of the orbit.
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In May 2005, a hemi-maxillectomy with wide safety margins was performed under general anesthesia from the left upper first premolar, according to the principle, supported by many authors, who apparently inspire the therapy of healthy tumors.
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A subsequent histological analysis of the surgical specimen confirmed the diagnosis of plexiform ameloblastoma.
With regard to treatment by default, before surgery the jaws were immobilized and after bonding a simulation of surgical intervention was performed in the models of sling.
With the help of the CAT, the resection margins were established, with particular attention to the anterior margin, important to avoid damaging the correct positioning of the palatal prosthesis.
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The palatal obturation prosthesis was mucosupported and dento-retained with gan attachment elements 2.3 and controlaterally 1.4 and 1.5 and 1.7 and 1.8.
The adaptation of the proposed concept was adequate.
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Figure 9 shows that at 6 months in correspondence with the resection zone, well vascularized and normotrophic tissues were observed.
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The prosthesis has been periodically controlled and adapted to tissue conditions according to healing and the possibility of adding teeth will be estimated, keeping them out of occlusion, until the reconstruction phase with implants.
