Efficacy of piezoelectric surgery in the conservative management of unicystic ameloblastoma: a 5-year retrospective cohort study

BACKGROUND: Unicystic ameloblastoma (UAM) is a subtype of ameloblastoma characterized by less aggressive clinical behavior than its conventional counterpart. Surgical enucleation represents a conservative approach compared to more invasive treatment options; however, the risk of recurrence may be significant. The aim of this study was to evaluate the efficacy of the conservative treatment of UAM associated to a piezoelectric debridement. The main outcome was to evaluate the recurrence rate of UAM over a 5-year follow-up period. METHODS: A retrospective cohort study was conducted on patients diagnosed with UAM who underwent enucleation and residual cavity debridement with a piezoelectric surgery device. Clinical and radiological follow-ups were conducted at 6-month intervals over a 5-year period. RESULTS: Twelve patients (7 female and 5 men) met the inclusion criteria and completed the 5-year follow-up. Lesions predominantly affected the mandible (10 cases), with the posterior region being the most common site. Recurrence occurred in 2 out of 12 patients and was limited to the mural variant of UAM. Both recurrent cases occurred in the posterior mandible and involved the largest lesion sizes observed in this study. CONCLUSIONS: The conservative approach of UAM combining enucleation and piezoelectric bone debridement provided a minimally invasive and effective solution for the management of this pathology, representing a viable alternative to surgical resection.