Introduction
Ameloblastoma is a locally aggressive benign jaw tumor, with high rate of recurrence. It is an odontogenic tumor arising from residual epithelium of the tooth germ, though aetiology remains uncertain1. The tumour has a higher predilection for the mandible (80-90%) than the maxilla. It is often diagnosed in the 2ndand 3rd decade in the sub-Saharan African population while a more advanced age is reported in the European literature.
Ameloblastoma is the commonest jaw tumor and is characterized by various histological subtypes. There has been recent reclassification of this tumour into; conventional, unicystic, extraosseous/peripheral and metastasizing (malignant) ameloblastoma. The unicystic variant tends to occur in the younger age groups2,3,4.
The management of ameloblastoma is resection of the affected jaw with a safety margin of more than 1.5cm and reconstruction to restore form and function of the resultant surgical defect. The affected patients among black Africans tend to present to the hospitals late with massive tumors, an observation that has been attributed to a range of factors. Some of these factors include; poverty, lack of awareness, traditional beliefs and possibly asymptomatic nature of the disease. (5). This late presentation pose a great challenge in the management as its often characterized by the difficult intubation during general anaesthisia that at times require tracheostomy. There is also a threat of damage to major blood vessels and nerves within the proximity as well as reconstruction challenges due to the huge defect created after tumor resection. Extensive tumours may require multiple or staged surgical procedures that at times involve initial reconstruction with titanium implant and later own bridging of the continuity defect with a bone graft. There is usually a lot of time spent intra-operatively when trying to shape the reconstruction implant into the correct anatomical position. The use of 3D printed models can allow for pre-operative bending of plates into the desired shape, thus reducing the time spent in surgery.
We present a case of an extensive ameloblastoma in a middle aged male that was managed with the aid of 3D printed models.