Controversy has been documented regarding margins for ameloblastoma resection and conservative treatment. In general, it is now widely accepted that ∼1 cm margins are appropriate for solid/multicystic ameloblastoma.4Is there a role for enucleation in the management of ameloblastoma?.,5The ameloblastoma: primary, curative surgical management. It is known that lesion can extend up to 8 mm beyond the radiographic margin of the ameloblastoma as it spreads through cancellous bone, which further justifies this margin.6Pu JJ Choi WS Yu P et al.Do predetermined surgical margins compromise oncological safety in computer-assisted head and neck reconstruction?. Recurrence in the setting of curettage has been reported between 50 and 90% for solid/multicystic ameloblastoma, and recurrence generally manifests between 2 and 5 years after definitive therapy. It is possible, however, for lesions to recur up to 20 years after resection.2Neville BW Damm DD Allen CM Bouquot JE Oral and Maxillofacial Pathology.,4Is there a role for enucleation in the management of ameloblastoma?. Initially, enucleation and curettage was touted as conservative therapy for unicystic ameloblastoma with recurrence rates between 10 and 20% for true unicystic ameloblastomas. However, recurrence rates have also been documented at more than 60% following this therapy; in these incidences, an incisional biopsy identified the lesion as unicystic but surgical pathology at the time of definitive treatment showed mural invasion.2Neville BW Damm DD Allen CM Bouquot JE Oral and Maxillofacial Pathology.,4Is there a role for enucleation in the management of ameloblastoma?. For large unicystic ameloblastoma, resecting with 1 cm margin may produce a significant continuity defect. Clinicians may elect to undergo a period of decompression followed by marginal resection with adjunctive therapies. Justification for 1 cm margins in the setting of an incisional biopsy-proven unicystic ameloblastoma is that the lesion in its entirety is not examined microscopically; only retrospective evaluation of these lesions is performed once enucleation is completed.2Neville BW Damm DD Allen CM Bouquot JE Oral and Maxillofacial Pathology. Reports of maxillary ameloblastoma have shown the potentially aggressive nature of these neoplasms; the maxilla lacks the thick confining cortical bone that is present in the mandible. Thus, it has been advocated that all resectable maxillary ameloblastomas be treated with resection; ameloblastoma in the midface and maxilla can extend to the skull base or intracranially making certain lesions unresectable. In this case, clinicians may decide to utilize proton therapy.5The ameloblastoma: primary, curative surgical management. It has also been recommended that resection margins include 1 unaffected tissue plane.4Is there a role for enucleation in the management of ameloblastoma?. For instance, if a tumor is noted to penetrate through the mandibular cortex, resection should include periosteum at that site. In contrast, peripheral ameloblastoma appears to respond to local excision with lower recurrence rates than multicystic/solid or unicystic ameloblastoma.