**4. Contemporary treatment options**

Current management concept of ameloblastoma is still controversial. To date, standard treatment is radical resection with a wide bone margin. However, various treatment methods have been recommended with respect to many factors, such as type and clinical presentation of tumor [5]. Regardless of the type, the management of ameloblastoma is either surgical or non-surgical. Surgical approach can be furtherly divided into radical and conservative surgery. These approaches often intertwine, and conservative methods such as decompression are valuable in preoperative reduction of tumor volume [24]. Non-surgical methods include radiotherapy and/ or chemotherapy. Recent advances in signaling pathways and genetic understanding related to pathogenesis of ameloblastoma resulted with the development of molecular targeted therapies as a valuable treatment option in management of the disease [3, 25]. Details on the contemporary surgical approach and aforementioned treatment methods will be provided in the following subchapters.

## **4.1 Diagnostic protocol**

Standard diagnostic protocol of ameloblastoma is by no means different from other odontogenic tumors [26]. Thorough clinical examination combined with adequate radiological imaging and histopathological analysis are mandatory to successful diagnosis and further management. A variety of radiological procedures are available to provide surgeon with precise structural expanse of ameloblastoma. Different methods are often combined, starting with orthopantomogram as a usual starting

**Figure 3.** *Preoperative CBCT image of ameloblastoma found on the right side of the mandible.*

point. Three-dimensional analysis is further performed by conventional computed tomography (CT), cone-beam computed tomography (CBCT) or magnetic resonance imaging (MRI). Taking into consideration potential malignancy of ameloblastoma, positron emission tomography combined with CT (PET/CT) can be used for diagnosing distant metastasis [3]. CBCT is considered as a standard three-dimensional imaging modality prior to further therapeutic procedures (**Figure 3**). Nevertheless, it is worth pointing out that MRI provides superior soft-tissue contrast, which makes it a useful imaging modality for diagnosing tumors with soft-tissue components [27]. This is especially applicable for depicting the extension of ameloblastoma to adjacent anatomical structures. Finally, definitive diagnosis cannot be made by clinical and/or radiological findings alone, thus it is imperative to obtain a biopsy for histopathological analysis.
