The mechanism: how dental resorptions occur in ameloblastoma

Abstract

Knife-edge or blunt root resorptions characterize ameloblastomas and are pathognomonic for this tumor, because they differentiate ameloblastomas from simple bone cysts, odontogenic keratocysts and nasopalatine duct cysts, which do not lead to resorption of involved teeth. Despite the very high frequency and importance of these characteristics for a differential diagnosis, a microscopic examination should also be conducted before defining the diagnosis and the treatment plan for these cases. This paper describes a six-step hypothesis to explain the mechanism by which ameloblastomas promote the characteristic root resorptions found in association with these benign epithelial tumors, which have a fibrous capsule formed by islands and epithelial cords that mimic the dental lamina, invade neighboring tissues and release mediators (IL-1, EGF) of tooth and root resorption. This hypothesis may be one more explanation for the tooth resorptions sometimes found in orthodontic records, and may help differentiate the root resorptions that are specific to the orthodontic practice.

Imaging of odontogenic keratocyst of the jaw by panoramic radiography: a scoping review

“…Besides, OKC is unrelated with inflammation and there are no mediators that cause resorption so that the findings of root resorption in OKC are rare. 59 Other effect on the surrounding tissues in this study were lesions pressing on the inferior alveolar canal, deviation of the inferior alveolar nerve, thinning of the lower border of the mandible, and perforation of the lower mandible.…”

Radiolucent Lesions of the Jaws: An Attempted Demonstration of the Use of Co-Word Analysis to List Main Similar Pathologies

“…Detailed clinical and radiographic examinations would provide qualitative factors that would help clinicians reach a reasoned differential diagnosis. For instance, both ameloblastoma and OKC may form a large lesion that spans across multiple teeth, but the former frequently causes root resorption of the teeth in proximity whereas the latter does not [ 30 ]. Meanwhile, a dentigerous cyst originates in and only surrounds the crown of an unerupted tooth, whereas a radicular cyst surrounds the root tip of an erupted tooth with an infected pulp.…”

RANKL neutralisation prevents osteoclast activation in a human in vitro ameloblastoma-bone model

“…This will then lead to an abnormal amount of bone resorption, creating an empty cavity that the ameloblastoma tumour can grow into. 12 The RANKL antibody denosumab has been used efficiently in giant tumour cells to inhibit osteoclast activation in vitro . 13 Since the RANKL pathway may be significantly involved in ameloblastoma invasion, drugs neutralising this ligand are promising candidates to be used for treatment.…”