The Comparative Evaluation of Conservative and Radical Surgical Approaches in the Management of Ameloblastoma: A Retrospective Study

Abstract

Background: Ameloblastoma is a benign but locally aggressive odontogenic tumor with a significant tendency for local recurrence. The optimal surgical approach remains controversial because conservative procedures may preserve function and aesthetics but can be associated with higher recurrence, whereas radical resection may provide better local control at the cost of greater morbidity.

Objective: To compare recurrence and postoperative outcomes following conservative and radical surgical management of ameloblastoma over a 20-year period.

Methods: This retrospective comparative study included 20 patients with histopathologically confirmed ameloblastoma treated between January 2006 and December 2025. Patients were divided into conservative and radical treatment groups according to the definitive surgical procedure. Demographic, clinical, radiographic, histopathological, treatment, postoperative complication, follow-up, and recurrence data were recorded. Categorical variables were analyzed using Fisher’s exact test and continuous variables using the Mann–Whitney U test. A p-value <0.05 was considered statistically significant.

Results: Nine patients (45.0%) underwent conservative treatment and 11 (55.0%) underwent radical treatment. The median tumor size was significantly smaller in the conservative group than in the radical group (4.0 cm vs. 5.8 cm; p=0.002). Overall recurrence occurred in 5 patients (25.0%). Recurrence was observed in 4 of 9 patients (44.4%) treated conservatively compared with 1 of 11 patients (9.1%) treated radically; however, this difference was not statistically significant (p=0.127). Postoperative complications occurred in 1 patient (11.1%) in the conservative group and 5 patients (45.5%) in the radical group (p=0.157).

Conclusion: Radical treatment demonstrated a lower observed recurrence rate, while conservative treatment was associated with fewer postoperative complications.