BackgroundIn developing countries, many diagnosed cases of ameloblastoma (AB) have a significant delay in receiving treatment because of patient factors and healthcare facility constraints.ObjectivesThe radiologic progression of ABs with delayed treatment was analysed using panoramic radiographs and cone-beam computed tomography imaging.MethodHistopathologically confirmed cases of AB with follow-up radiographs indicating no treatment were retrospectively reviewed over a study period of 10 years. Fifty-seven cases with 57 initial and 107 follow-up radiographs were included. Each follow-up radiograph was analysed for changes in borders, locularity, effects on surrounding structures and lesion size.ResultsThere was a general increase in poorly-demarcated lesions, with seven cases transforming from an initial unilocular to a multilocular appearance. At follow-up, there was an increase in cortical thinning and cortical destruction. Ameloblastomas presented with a three-fold increase in average size from the initial to follow-up visits. Regression analysis showed a statistically significant relationship between lesion duration and length (p= 0.001). A statistically significant relationship existed between duration and overall lesion dimensions when only the first and last observations per patient were used (p= 0.044).ConclusionConsidering the aggressive nature and unlimited growth potential, ABs with delayed treatment may show extensive growth, complicating their eventual management.ContributionThis study aimed to raise awareness of the importance of the timeous management of patients with AB by highlighting the detrimental effects of delayed treatment.