Le Fort 1 downfracture approach for the treatment of a posterior maxillary ameloblastoma

The ameloblastoma is a slow-growing insidious tumor derived from the dental lamina. It may be described as locally invasive and clinically persistent, and it has high recurrence rates if adequate treatment is not rendered. From a clinical perspective, the maxillary ameloblastoma is considered to be more aggressive than its mandibular counterpart. This is because the maxillary bone is thin and more easily penetrated, and not because of a difference in biological behavior. In the treatment of intraosseous multicystic or solid maxillary ameloblastomas, many authors stress the need for adequate access to achieve a proper surgical resection. This paper presents a case of maxillary ameloblastoma that was treated using a Le Fort 1 downfracture technique in combination with a segmental resection of the posterior part of the left maxilla. The Le Fort 1 technique provided excellent access and visibility, especially on the medial aspect of the resection. No major problems were encountered with the technique. Six months after the resection, the patient remained clinically and radiographically free of the tumor. The need for long-term follow-up is stressed.