## 3 Discussion
One consideration for conservative treatment in pediatric ameloblastoma is its histologic features. Plexiform type is considered to be the most common variant of conventional ameloblastoma in children. This variant is less aggressive than the follicular variant. Pediatric plexiform ameloblastoma remains in the primitive stage of tumor differentiation, whereas the follicular type is thought to undergo squamous differentiation. Furthermore, pediatric conventional ameloblastoma grows rapidly but does not differentiate into the follicular type in the remodeled bone of younger patients. In adult patients, the follicular is the most common variant, and the tumor which persists in the bone for long time, has a potential to progress to squamous metaplasia. In [PERSON]'s study which included five cases of pediatric plexiform ameloblastoma and 1 pediatric follicular ameloblastoma with the longest follow-up period of 11 years 10 months, satisfactory results were obtained with no signs of recurrence [15]. Based on this consideration, we performed conservative decompression and copious warm saline irrigation treatment with long-term clinical and radiographic follow-up. Decompression has a plethora of benefits, including bone formation, oral tissue preservation, pulp vitality maintenance, prevention of tooth extraction, important anatomic structure preservation, and a low risk of recurrence [16]. [PERSON] emphasized the cavity irrigation through the tube using normal saline as an integral part of decompression treatment for odontogenic cysts to facilitate the lavage of the cyst [17]. [PERSON] et al., also reported successful outcome on calcifying epithelial odontogenic tumor treatment using decompression with a saline tube irrigation followed by enucleation [18]. According to the meta-analysis study on efficacy of continuous saline bladder irrigation following bladder tumor resection by [PERSON] et al., continuous saline irrigation after transurethral resection of bladder tumors can prevent the recurrence by washing away the floating cancer cells and prevent the adhesion of the cancer cells [19]. In another meta-analysis study on association of irrigation and local recurrence of anterior resection for rectal cancer by [PERSON] et al., the rectal washout using normal saline alone can reduce the rectal cancer local recurrence risk by 63%. The explanation for this is that the exfoliated malignant cells can be washed out through mechanical cleansing by saline since saline does not have cytocidal or tumoricidal effect. However, the saline washout is volume dependent and should be used copiously [20]. Furthermore, copious irrigation can keep the wound cavity clean and prevent infection, especially in aerodigestive tract [21,22]. Using this conservative treatment modality, the deciduous teeth and IAN can be preserved and the risk of recurrence as well as infection can be decreased. The IAN is a sensory nerve, that carries not only sensory information, but also neuropeptides that are important in maintaining bone homeostasis. In an animal experimental study by [PERSON] et al., the transection of IAN caused changes in bone's inorganic components including decrease in calcium, iron, and strontium, and increase in zinc. In a balanced condition, these inorganic components are essential for bone turnover and mineralization [23,24]. Moreover, [PERSON] found that IAN neurootomy affected mandibular growth in rat, with significant lower height and length of the mandible in neurotomized group than the control group [25]. As essential as IAN, deciduous teeth play an important role in development of facial muscles movement, eating skills, and speech abilities of children [26]. Deciduous teeth also guide eruption of permanent teeth and stimulate growth of the jaw [27]. In the absences of deciduous teeth during primary dentition period, food and nutrient intake as well as mastication activity are impaired. As a result, development and growth of the child will be compromised.