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PubMed2001

Amyloid-like fibrils from an 18-residue peptide analogue of a part of the central domain of the B-family of silkmoth chorion proteins.

Chorion is the major component of silkmoth eggshell. More than 95% of its dry mass consists of the A and B families of low molecular weight structural proteins, which have remarkable mechanical and chemical properties, and protect the oocyte and the developing embryo from the environment. We present data from negative staining, Congo red binding, X-ray diffraction, Fourier transform-Raman, attenuated total reflectance infrared spectroscopy and modelling studies of a synthetic peptide analogue of a part of the central domain of the B family of silkmoth chorion proteins, indicating that this peptide folds and self-assembles, forming amyloid-like fibrils. These results support further our proposal, based on experimental data from a synthetic peptide analogue of the central domain of the A family of chorion proteins, that silkmoth chorion is a natural, protective amyloid [Iconomidou et al., FEBS Lett. 479 (2000) 141-145].

Amyloid↗
PubMed2002

An ovarian follicular epithelium protein of the silkworm (Bombyx mori) that associates with the vitelline membrane and contributes to the structural integrity of the follicle.

We have cloned and functionally characterized a novel protein, BmVMP30, which is synthesized by the cells of the follicular epithelium of the ovarian follicles of the domesticated silkworm Bombyx mori, secreted from them and associated with the vitelline membrane. BmVMP30 is a 30 kDa protein that bears limited structural features reminiscent of other insect vitelline membrane proteins. Although BmVMP30 does not share pronounced similarities or signature motifs with other reported proteins, its temporal and spatial expression and its behavior throughout oogenesis suggest that it is a novel member of the insect vitelline membrane protein family. The protein is expressed exclusively in the cells of the follicular epithelium during stages -15 to -1 of vitellogenesis, secreted from them and, ultimately, localized at the junction between the oocyte and the eggshell, where the vitelline membrane is located. Treatment of follicles with an antisense oligonucleotide that encompasses the translation initiation codon results in the production of an N-terminally truncated protein and disruption of the integrity of the follicular epithelium. Antisense oligonucleotide treatment, however, has no effect on the implementation of the developmental program that directs the autonomous progression of ovarian follicles through the last stages of vitellogenesis and choriogenesis.

Animals↗
PubMed2002

Progesterone and progesterone receptors in reptiles.

The role of progesterone (P) has been most extensively studied in the female reproductive tissues (ovary, reproductive tract, mammary gland) and in the brain, in which it is an important regulator and modulator in conjunction with estradiol (E). In nonmammalian vertebrate species, less work has been done on P metabolites involved in ovulation. In addition, P induces the expression of egg-white proteins, decreases myometrial contractility, and facilitates processing of eggs, formation of eggshell, and deposition of egg-white proteins. Actions of P may be synergistic with, or antagonist to, the actions of E, depending on hormone ratios, timing of exposure, and physiological state. These effects of P are mediated through progesterone receptor isoform A (PRA), a general transcription inhibitor of P target genes, and isoform B (PRB), a specific transcriptional stimulator of some reproductive tract genes. In this review, we focus on P action and PR expression in the liver and reproductive tissues of several reptilian species, especially Chelonia, since most of the data obtained are from this group. We also present novel data showing the expression of PR in nonreproductive tissues (such as kidney, spleen, gastrointestinal tract) in the painted turtle, Chrysemys picta.

Animals↗
PubMed1999

Separation of proteins and peptides by capillary electrophoresis in acid buffers containing high concentrations of surfactants.

Separations of proteins at acid pH in the presence of a high concentration of surfactant [sodium laurylsulfate (SDS), 50 mmol/l] was investigated. The purpose of using high concentrations of SDS as background electrolyte modifier was threefold: First, the surfactant exerts a washing effect upon the capillary wall thus preventing binding of analytes and possible clogging of the capillary. Second, it was revealed that even under very acid conditions (below pH 3) the surfactant is capable of forming associates with protein analytes which still bear considerable negative charge and can be separated on this basis. Third, the system can be applied not only for protein mixtures sufficiently soluble in neutral to alkaline media (leukocyte lysates, standard proteins), but it can be used also with proteins, that are under such conditions virtually insoluble and their solubilization is possible in acid buffers only (eggshell proteins or collagen CNBr fragments). The result was that adsorption to the capillary wall was minimized and the analytes were separated as negatively charged associates with high efficiency. With collagen fragments partition was possible on the affinity differences of the peptides to the surfactant micelles and inner wall of the capillary. Theoretical plate counts approaching 100,000 were easily achieved even with proteins which under the more conventional operation conditions exhibit considerable sticking to the capillary wall. The other feature of this system is that the associates move very rapidly to the anode. Owing to the low pH, endoosmotic flow is negligible, and therefore the system has to be operated at reversed polarity.

Buffers↗
PubMed1999

Anopheles albitarsis eggs: ultrastructural analysis of chorion layers after permeabilization.

Construction of transgenic Anopheles mosquitoes refractory to Plasmodium requires knowledge of mosquito developmental biology. In order to study Anopheles embryology the removal or, alternatively, the permeabilization of the melanized and sclerotized egg chorion were attempted. The protocol classically used for chorion removal of Drosophila eggs was applied, with partial efficacy, to Anopheles albitarsis, a neotropical malaria vector. Each step was monitored by scanning electron microscopy and the results suggest differences in chorion composition between the two taxa. As an alternative to chorion removal, mosquito eggs were permeabilized with benserazide, an inhibitor of Dopa Decarboxylase, one of the enzymes needed for mosquito eggshell sclerotization. Embryo morphology and viability were not affected by this treatment. Permeabilization of the egg chorion allowed the ultrastructural observation of an internal homogeneous endochorion and an external compound exochorion, the latter consisting of a basal lamellar layer and protruding tubercles.

Journal Article↗
PubMedDate not supplied

Effects of in ovo exposure to 2,3,7,8-TCDD on F1 generation adult chickens (Gallus gallus).

White Leghorn chickens (Gallus gallus) were used as surrogate species for the resident wild turkeys found on the Times Beach, Missouri, Superfund site. Parental chickens were injected with concentrations of 2,3,7,8-TCDD which modeled soil concentrations before (200 ppb) and after remediation (1ppb)[1]. Offspring were followed through development to assess alterations in reproductive maturity through the use of a four-way breeding study. F1 adult females exposed to a maternal dose of 8.6 ng/day began egg production approximately two weeks later than did F1 control adult females. By week eight, however, egg production between groups was equivalent. No differences were observed in eggshell gland estrogen or progesterone receptor levels.

Animals↗
PubMed1999

Modulation of endocrine pathways by 4,4'-DDE in the deer mouse Peromyscus maniculatus.

4,4'-DDT and 4,4'-DDE are widespread environmental contaminants that cause eggshell thinning in birds, altered sex ratios in the American alligator, and changes in the anal-genital distance in rodents. These contaminants are known to cause some of their toxicity by altering steroid receptor-mediated mechanisms. However, chemical-specific alterations in the expression of hormone-metabolizing enzymes may also be a mechanism for endocrine disruption, by altering the half-life of hormones in critical tissues. Previously, we showed that 4,4'-DDE causes a dose-dependent increase in ethoxyresorufin-O-deethylase (EROD) activity, but not pentoxyresorufin-O-dealkylase (PROD) activity, in the deer mouse. In this study, we demonstrated that 4,4'-DDE elicited a corresponding increase in CYP1A protein expression but not CYP2B using Western blotting and immunoprecipitation. 4,4'-DDE-mediated changes in phase II conjugating enzymes; UDP-glucuronosyltransferase (UGT) and phenolsulfotransferase (ST), were also investigated for the first time. Prepubescent female deer mice were dosed with 4,4'-DDE by gavage on days 1 and 2, then euthanized on day 4. As anticipated, dose-dependent increases in hepatic EROD and MROD activities, but not PROD or BROD, were observed. UGT activity was monitored by incubating liver microsomes and 14C-UDP-GA with potential substrates and measuring incorporation of radioactivity into TLC-resolved glucuronides. Dose-dependent increases in conjugation were observed with p-nitrophenol (a general UGT substrate) but not testosterone. Interestingly, a biphasic dose-response curve was observed for ST activity, with a peak at the 3 mg/kg dose. Dose-dependent increases in CYP1A1 and UGT-specific immunoreactive proteins were observed, suggesting de novo synthesis as a consequence of 4,4'-DDE exposure. We also measured Phase I and II enzymes in deer mouse platelets. Preliminary results indicate that the 4,4'-DDE-induced changes in liver Phase I and II enzyme activity were similar, but not identical, to those found in platelets. These results indicate that environmentally-relevant levels of 4,4'-DDE modulate the activity and expression of CYP1A1 and phase II enzymes in the deer mouse and that certain changes may be measured non-lethally.

Animals↗
PubMed1999

Induction of hepatic estrogen receptor in juvenile Atlantic salmon in vivo by the environmental estrogen, 4-nonylphenol.

Alkylphenol ethoxylate degradation products such as nonylphenol and octylphenol are shown to have estrogenic effects. Nonylphenol induces synthesis of vitellogenin (a precursor of egg yolk proteins) and zona radiata proteins (eggshell proteins) in juvenile and/or male fish. Little is known about the molecular mechanisms of estrogenicity of environmental chemicals such as nonylphenol. To study the mechanisms of estrogenic effects of 4-nonylphenol (NP), we examined its in vivo effects on the expression of the estrogen receptor (ER), vitellogenin (Vtg) and zona radiata protein (Zrp) genes in juvenile Atlantic salmon liver. We show that the ER mRNA synthesis is induced by NP in a dose-dependent manner in juvenile Atlantic salmon liver. The induction of the ER mRNA synthesis is followed by the induction of Zrp and Vtg mRNA synthesis. The ER transcripts reach peak levels earlier than the Zrp and Vtg mRNA and proteins, which is in agreement with the physiological effects of estradiol during zonagenesis and vitellogenesis. Various studies have also shown that NP competitively inhibits the binding of 17 beta-estradiol (E2) to ER. Our results further suggest that NP directly mimics E2 in inducing the ER, Zrp and Vtg genes in salmon liver.

Animals↗
PubMed1999

Fish model for assessing the in vivo estrogenic potency of the mycotoxin zearalenone and its metabolites.

The in vivo estrogenic potency of zearalenone (ZEA), a mycotoxin produced by different strains of Fusarium fungi, and its metabolites (alpha- and beta-zearalenol), have been studied in fish. Estrogenicity was evaluated using an in vitro competitive receptor binding assay and in vivo induction of vitellogenesis and zonagenesis, two estrogen receptor (ER)-mediated responses that are integral aspects of fish oogenesis. The ER binding affinities of alpha-zearalenol and ZEA in rainbow trout (Oncorhynchus mykiss) were approximately 1/150 and 1/300 to that of estradiol, respectively. Juvenile salmon (Salmo salar) were exposed to a single intraperitoneal injection of ZEA, alpha-zearalenol and beta-zearalenol (each at 1 and 10 mg/kg) and compared to fish injected with estradiol-17 beta (E2; 5 mg/kg) and controls. Using indirect enzyme-linked immunosorbent assay (ELISA) with homologous antibodies, a dose-dependent induction of vitellogenin (Vtg) and eggshell zona radiata proteins (Zr-proteins) were observed 7 days after exposure to ZEA and alpha-zearalenol. beta-Zearalenol did not elevate plasma Vtg levels, but a non-significant elevation of plasma Zr-proteins levels was observed at the highest dose (10 mg/kg). Generally, alpha-zearalenol and ZEA possess estrogenic potencies that are approximately 50% compared to that of E2, and their order of estrogenic potency (in both in vitro receptor competitive binding and in vivo induction of Vtg and Zr-proteins levels) is: alpha-zearalenol > ZEA > beta-zearalenol. Our results show that blood plasma analysis of Vtg and Zr-proteins levels provides a suitable in vivo fish model for assessing the estrogenic potencies of ZEA and its metabolites.

Animals↗
PubMed2001

Bonding of contemporary glass ionomer cements to dentin.

OBJECTIVE: The objective of this study was to investigate the microtensile bond strength (microTBS) of contemporary glass ionomer cements (GIC) to sound coronal dentin. METHODS: Three specimen teeth were prepared for each material tested: Fuji IX GP (GC), ChemFlex (Dentsply) and Ketac-Molar Aplicap (ESPE). GIC buildups were made according to the manufacturers' instructions. After being stored at 37 degrees C, 100% humidity for 24h, the teeth were vertically sectioned into 1x1mm beams for microTBS evaluation. Representative fractured beams were prepared for scanning (SEM) and transmission electron microscopic (TEM) examination. RESULTS: Results of the microTBS test were: Fuji IX GP (12.4+/-8.6MPa), ChemFlex (15.0+/-9.3MPa) and Ketac-Molar Aplicap (11.4+/-7.7MPa). One-way ANOVA and a multiple comparison test showed that ChemFlex had a statistically higher microTBS (p<0.05). SEM fractographic analysis showed that the predominant failure modes were interfacial and mixed failures. The GIC side of the fractured beams revealed dehydration cracks, a high level of porosity, and voids with an eggshell-like crust. TEM analysis of the demineralized dentin sides of the fractured beams revealed the presence of an intermediate layer along the GIC-dentin interface. This zone was present on the fractured dentin surface in the case of interfacial failure, and beneath GIC remnants in specimens that exhibited a mixed failure mode. SIGNIFICANCE: The findings suggest that the bonding of GIC to dentin is not weak and that the microTBS values probably represent the weak yield strengths of GICs under tension.

Acid Etching, Dental↗
PubMed1998

Laser-Raman and FT-IR spectroscopic studies of peptide-analogues of silkmoth chorion protein segments.

Silkmoth chorion, the proteinaceous major component of the eggshell, with extraordinary mechanical and physiological properties, consists of a complex set of proteins, which have a tripartite structure: a central, evolutionarily conserved, domain and two more variable 'arms'. Peptide-analogues of silkmoth chorion protein central domain segments have been synthesized. Laser-Raman and infrared spectroscopic studies suggest the preponderance of antiparallel beta-pleated sheet structure for these peptides, both in solution and in the solid state.

Amino Acid Sequence↗
PubMed2002

Effects of 4-nonylphenol on gene expression of pituitary hormones in juvenile Atlantic salmon (Salmo salar).

Alkylphenols such as 4-nonylphenol (NP) are one of the wide variety of environmental chemicals reported to have estrogenic effects in both in vitro and in vivo studies. Induction of eggshell zona radiata proteins (Zrp) and vitellogenin (Vtg) mRNA and protein synthesis in the liver are widely used biomarkers for xenoestrogen exposure in fish. However, little work has been done to characterize the molecular effects of xenoestrogens on other potential target organs such as the pituitary. To evaluate pituitary effects and develop new potential biomarkers for xenoestrogens, the influences of NP and 17beta-estradiol (E2) on the mRNA levels of pituitary gonadotropic hormone (GTH) beta subunits [leutinizing hormone beta (LH beta or GTH II beta) and follicle stimulating hormone beta (FSH beta or GTH I beta)], prolactin (PRL), growth hormone (GH) and the pituitary specific transcription factor (Pit-1) were investigated in individual male and female juvenile Atlantic salmon (Salmo salar), 3 days after a single intraperitoneal (i.p.) injection. In one experiment, fish were injected with NP (125 mg/kg body weight (BW)) or E2 (5 mg/kg BW) and a semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) method was used to analyze LH beta and FSH beta mRNA levels. In the second experiment, fish were injected with three doses of NP (10, 50, 125 mg/kg BW) or a single dose of E2 (5 mg/kg BW) and Northern blot analysis was used to quantify LH beta, FSH beta, PRL, GH and Pit-1 mRNAs. Both NP (50 and 125 mg/kg BW) and E2 significantly induced LH beta mRNA levels (P<0.01), but only in females. The highest dose of NP (125 mg/kg BW) significantly induced Pit-1 mRNA in males (P<0.01). NP did not have significant effects on any of the other pituitary transcripts. NP induced LH beta mRNA synthesis in females by up to 6-fold and the changes appeared to correlate with the increases in hepatic Vtg and Zrp mRNA levels. The results show that LH beta mRNA assay in female juvenile salmonids may be used as a marker for pituitary effects of xenoestrogens. The data also suggest that NP may have the potential to perturb the regulation of LH beta gene expression by mimicking E2.

Actins↗
PubMed2000

Effects of xenoestrogen treatment on zona radiata protein and vitellogenin expression in Atlantic salmon (Salmo salar).

Zonagenesis (zona radiata protein synthesis) and vitellogenesis (yolk protein synthesis) are two reproductive responses that are integral aspects of fish oogenesis. This study examines the responses of eggshell zona radiata proteins (Zrp) and vitellogenin (Vtg) to five environmental pollutants; 4-nonylphenol (NP) and o,p'-DDT [both at 25 mg/kg], lindane (gamma-HCH) [10 mg/kg], a technical PCB mixture (Aroclor 1254; A1254) and bisphenol A (BPA) [both at 5 mg/kg] in juvenile Atlantic salmon (Salmo salar). Fish were given intraperitoneal injections of o,p'-DDT, gamma-HCH, A1254 or BPA; singly, in combination with NP, and as a cocktail of all five chemicals, and later compared to NP-treated and untreated fish. In a separate experiment, fish were exposed to BPA in a dose-response manner (1, 5, 25 and 125 mg/kg fish). Based on previous studies, blood and liver samples were collected 2 weeks after injection. Zrp and Vtg levels were analyzed in plasma using immunoblotting and enzyme-linked immunosorbent assay. Liver cytochrome P4501A was analyzed by 7-ethoxyresorufin O-deethylase (EROD) activity. NP caused pronounced elevations in plasma Zrp and Vtg levels. In comparison, when NP was given in combination with gamma-HCH, Vtg levels was significantly reduced, compared to NP treatment alone. Using o,p'-DDT, A1254 and BPA, significant elevations of plasma Zrp and Vtg were seen when chemicals were given in combination with NP, but not when administered by themselves. An apparent dose-response induction of Vtg and Zrp levels were observed in BPA treated juvenile salmon. In immunoblots, one component of molecular weight approximating the Zrp-beta was detected when either o,p'-DDT, gamma-HCH, A1254 or BPA were given singly. A1254 significantly induced hepatic EROD activity when administered alone. However, when given as a mixture with all the other xenobiotics, reduction of EROD activity was observed. The data suggest a pattern of xenobiotics action which may complicate assessment of their reproductive effects. Zrp (the beta monomer) was more responsive to the xenoestrogens than Vtg, and provides a sensitive means of detecting exposure to environmental estrogens.

Journal Article↗
PubMed2000

Identification and functional characterization of a member of the PUR-alpha family from Schistosoma mansoni.

Schistosoma mansoni p14 gene encodes an eggshell precursor that is expressed only in vitelline cells of mature female worms in response to a male stimulus. The upstream region of the p14 gene contains several potential cis-acting regulatory sequences. We used the upstream region of the p14 gene as bait in a yeast-one-hybrid screen of a S. mansoni cDNA library to identify interacting proteins. We report the identification and characterization of a cDNA (S. mansoni PUR-alpha (SmPUR-alpha)) encoding a protein homologous to single-stranded DNA transcription activator PUR-alpha, that binds to the p14 upstream region and activates transcription of the HIS3 reporter gene in yeast. SmPUR-alpha has a predicted molecular mass of 30 kDa and shares an overall homology of 63% with mammalian PUR-alpha. The DNA binding domain of SmPUR-alpha is highly conserved. We show by gel shift assays that GST-SmPUR-alpha binds to oligonucleotides comprising the p14 upstream region. SmPUR-alpha binds preferentially to single-stranded DNA and also binds RNA. Unlike the mammalian homologue, SmPUR-alpha exhibits little specificity for the PUR element GGn, but shows strong preference for a sequence containing alternating pyrimidines. Our data support that SmPUR-alpha is a single-copy gene and through reverse transcriptase-polymerase chain reaction and in situ hybridization, we show that SmPUR-alpha is constitutively transcribed in many cell types and thus likely plays a role as a general transcription activator in schistosomes.

Amino Acid Sequence↗
PubMed1999

Gender-specific gene expression in Brugia malayi.

Brugia malayi is a mosquito-borne filarial nematode that causes lymphatic filariasis and elephantiasis in humans. The purpose of this study was to identify and characterize genes that are expressed differentially in male and female B. malayi in hopes of gaining new insight into the reproductive biology of the parasite. Two approaches were used. A 5' differential display PCR (splice leader differential display PCR, SL DD-PCR) was performed by PCR with splice leader and random primers on cDNA templates, and electronic subtraction was performed on expressed sequence tag (EST) cluster databases developed by the Filarial Genome Project (FGP). Gender-specific expression of candidate clones was confirmed by RT-PCR for six of 22 (27%) clones identified by DD and in seven of 15 (47%) clones identified by electronic subtraction. One clone was identified by both methods. Several female-specific clones had homology to known nematode genes that encode a fatty acid binding protein, a high mobility group protein, an eggshell protein, a glutamate-gated ion channel, and a collagen. However, most of the clones have no significant homology to known genes or proteins in computer databases. This project has confirmed the value of SL DD-PCR and electronic subtraction for analysis of gene expression in filariae. These two complimentary techniques may be generally applicable to the study of gender-specific (and by analogy stage specific) gene expression in other nematodes.

Animals↗
PubMedDate not supplied

Quantitative analysis of microdebriders used in endoscopic sinus surgery.

PURPOSE: To develop a standardized in vitro model for evaluating efficacy of the microdebriders and to assess whether differences in efficacy exist among available microdebriders. Microdebriders combine suction of tissue with amputation by a hollow rotating cutter. Several models are available, and they are increasingly popular in endoscopic sinus surgery. MATERIALS AND METHODS: Seven microdebriders were tested by using a standardized soft tissue model (standard fresh raw oysters excluding muscle) and a firm tissue model (standard fresh raw oyster muscle). Efficacy was measured in grams of tissue aspirated per minute. Models to simulate lamina papyracea (eggshell) and dura (egg sac) were also tested with each microdebrider. RESULTS: Statistically significant differences in soft tissue aspiration were found between most microdebriders ranging from the Xomed (Jacksonville, FL) Straight Shot/4.0-mm blade (147 g/min); the ESSential Shaver (Smith & Nephew, Memphis, TN)/4.0-mm blade (99 g/min), the Linvatec (Largo, FL)/4.2-mm blade and Dyonics (Burscheid, Germany)/3.5-mm blade and Wizard Plus/4.0-mm blade (range 43 to 46 g/min), followed by the Hummer II (Stryker, Santa Clara, CA) 4.0-mm blade (22.5 g/min), and finally the Xomed Wizard Plus/3.5-mm blade at 16 g/min. The Xomed Straight Shot/4.0 blade was statistically superior to all other microdebriders in efficiency of aspiration in the firm tissue model. All microdebriders were able to abrade a "bony" spicule and intact "dura," whereas none could abrade intact "bone." CONCLUSIONS: Significant differences exist among the various microdebriders in this standardized model of efficiency of aspiration. Additional clinical factors including cost, safety, ease of use, and adaptability should also be considered in the choice of a microdebrider.

Analysis of Variance↗
PubMed1997

Chlorinated hydrocarbons in the tissues of South Polar Skuas (Catharacta maccormicki) and Adélie Penguins (Pygoscelis adeliea) from Ross Sea, Antarctica.

High rates of egg infertility and embryo death in a colony of South Polar Skuas breeding in the Antarctic were similar to those in polluted North Atlantic populations of the Great Skua. Such loss could not be linked to factors such as organochlorine pollutants, as levels of DDE and PCBs in the contents of skua eggs from the population were only a small fraction of those in polluted skua populations from the Northern Hemisphere. Average eggshell thickness for skuas nesting on Ross Island has shown no significant change since the introduction of DDT. Concentrations of DDE and PCBs in South Polar Skuas were 13 and 22 times higher, respectively, than those in the eggs of sympatric Adélie Penguins, and this probably reflects the greater exposure of skuas to pollution when they migrate north of the Antarctic Convergence in winter. Residues in liver tissue showed a similar trend, and a higher rate of mixed function oxidase induction in skua liver compared to that of penguins is consistent with the trends seen in pollutant levels. The same PCB congener predominated in both skua and penguin samples. Comparisons with historical residue data suggest that global levels of DDT residues are declining.

Journal Article↗
PubMed1999

Management of mandibular ameloblastoma: the clinical basis for a treatment algorithm.

PURPOSE: This article discusses the management of intraosseous mandibular ameloblastomas as the basis for a treatment algorithm. PATIENTS AND METHODS: The records of 26 consecutive patients referred for management of mandibular ameloblastoma were reviewed. Demographic data, location, number and types of prior surgical treatment, radiographic findings, number of recurrences, and reconstructive methods used were analyzed. RESULTS: All patients treated with curettage alone developed recurrence (n = 11). No patients treated with either curettage or resection plus liquid nitrogen cryotherapy developed a recurrence (n = 9). Patients whose radiographs showed large tumors with eggshell-thin bony margins, and who underwent segmental resection with excision of the involved soft tissue also had no recurrences (n = 8). In addition, 2 patients were referred with soft tissue recurrence necessitating resection. Both of these patients underwent multiple resective procedures, including neck dissections and skull base resections. All patients were reconstructed with either primary or secondary bone grafting. Only 3 patients went on to have complete dental reconstruction that included osseointegrated implants. CONCLUSIONS: Curettage of ameloblastoma results in unacceptable recurrence rates. Lesions contained within the mandible are adequately treated by curettage or marginal resection combined with cryotherapy. Segmental resection of the mandible with involved soft tissue, including periosteum, produces acceptable results when extraosseous spread has occurred. The first operation affords the best chance for cure. When tumor recurs in soft tissue, extensive surgery is necessary to salvage the patient. Few patients in this series went on to full reconstruction that included osseointegrated implants.

Adolescent↗