Conservative management of unicystic ameloblastoma: long-term outcomes from a 26-year retrospective study.

Objective: This study aimed to assess the long-term clinical outcomes of patients with unicystic ameloblastoma (UA) managed with conservative surgical approaches, with a particular focus on recurrence rates.

Materials and methods: A retrospective review was conducted over a 26-year period to analyze the clinicopathological data of patients diagnosed with UA. Initial management consisted of incisional biopsy, followed by marsupialization when clinically indicated. Definitive treatment involves enucleation with peripheral ostectomy or cryotherapy. The primary outcome measure was disease recurrence.

Results: A total of 26 patients were included. The mean follow-up duration was 8 years (range, up to 26 years). Initial marsupialization was performed in 23 patients and was effective in 89% of cases. Enucleation with peripheral ostectomy was employed as the definitive treatment in 24 patients. Recurrence was observed in one case, occurring 8 months after treatment in a patient who had initially undergone marsupialization followed by peripheral ostectomy.

Conclusions: Marsupialization is effective in reducing the size of UA while minimizing surgical morbidity. Enucleation with peripheral ostectomy or cryotherapy has proven successful in the definitive management of UAs, with a low recurrence rate. These findings underscore the value of conservative treatment strategies, particularly in young patients who require long-term follow-up.