The Use of Enucleation and Chemical Cauterization (Carnoy's) in the Management of Odontogenic Keratocyst of the Jaws (original) (raw)
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Reclassification and treatment of odontogenic keratocysts: A cohort study
Brazilian oral research, 2017
The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrenc...
Egyptian Dental Journal
Background: odontogenic keratocyst is classified as a developmental cyst derived from enamel organ or from dental lamina. Treatment of odontogenic keratocysts of the jaws remains controversial. Aim of study: was to report the outcome of a conservative treatment protocol in the form of enucleation with open packing for surgical treatment of parakeratinized odontogenic keratocysts. Methods: after clinical and radiographic examination, fine needle aspiration was obtained from lesions and submitted for histopathological examination. Then the patients were treated by enucleation and open packing. This conservative treatment protocol was selected to decrease the morbidity rate in young aged patients. The follow-up duration of the cases was 2 years. All the cases were monitored continuously with clinical evaluations and radiographically through Orthopantomographs (OPG) and Cone beam computed tomography (CBCT). Results: Clinical evaluation showed healing improvement of the surgical site with no signs of infection. Radiographic examination showed newly formed bony trabeculation at surgical site. Conclusions: This conservative treatment protocol for odontogenic keratocysts based on enucleation with open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.
Conservative Treatment Protocol of Odontogenic Keratocyst: A Preliminary Study
Journal of Oral and Maxillofacial Surgery, 2006
Purpose: The objective of this study was to report our experience with the treatment of 30 odontogenic keratocyst (OKC) patients with a conservative treatment protocol based on decompression with reference to the recurrence rate. Patients and Methods: Twenty-eight patients (19 females, 9 males) with 30 OKCs attended the OMS Department of the Piracicaba Dental School of Campinas State University between 1995 and 2003. Age range was 13 to 69 years (mean, 30 years of age). Initial biopsy was carried out in all patients and the OKCs were diagnosed after histological examination by the Oral Pathology Department. The cases were treated according to the treatment employed in this department, consisting mainly of decompression and curettage of the remaining lesion. The average follow-up for the 28 cases was 24.89 months (Ϯ9.74). Results: The majority of the lesions (16 patients, 53.3%) occurred in the angle of the mandible and mandibular ramus. The most common histological pattern of OKC was parakeratinized (66.6%) and 13 of 28 patients presented impacted teeth associated with the lesion. The mean time for decompression was 9.27 months. Recurrence occurred in 4 patients (14.3%) with 4 OKCs. These patients were treated initially with decompression and curettage (2 cases), or with decompression only (2 cases). All the cases were monitored continuously with panoramic radiographies and clinical evaluations. Conclusions: The treatment protocol for OKC based on decompression offers a conservative and effective option with low morbidity and similar recurrence rates to those reported in the literature. The systematic and long-term post-surgical follow-up is considered to be a key element for successful results.
Contemporary approach to odontogenic keratocyst: a review of the literature and case report
Journal of Dental Health, Oral Disorders & Therapy, 2020
The aim of this study was to evaluate the efficacy of the Odontogenic Keratocyst treatment through enucleation and cryotherapy with liquid nitrogen in a lesion that had previously been biopsied and also to compare the microscopic characteristic of the enucleated lesion to the biopsy microscopy. Enucleation was performed in a 27-year-old female patient with previously diagnosis by initial biopsy. The lesion extended from left mandibular body region to the ramus ipsilateral. The use of this technique proved to be an effective treatment. It is believed that the initial biopsies allowed a decrease in the size of the lesion and increase the thickness of the fibrous capsule, which prevent the rupture of the keratocyst capsule.
Odontogenic Keratocyst- a Review on Various Treatment Modalities
International Journal of Biology, Pharmacy and Allied Sciences, 2020
However In 2017, the new WHO classification of Head and Neck pathology reclassified OKC into cyst category. Epidemiologically OKC accounts for approx. 7.8 % of all cyst of the jaw and incidence vary from 4-16.5%. It occurs at all ages with peak incidence in 2nd and 4th decade of life. it predominantly occurs in white population with male :female ratio of 1.6:1. Location wise it is most commonly seen twice in mandible as compared to maxilla. In mandible it occurs usually in angle-ascending ramus region (69-83%). Mandibular cyst crosess the mid line and maxillary cyst may involve sinus and nasal floor, premaxilla and maxillary third molar region. OKC may arise from temporomandibular joint also.
The purpose of this study was to determine the Recurrence rate of odontogenic keratocysts (OKC), and association of recurrence with various surgical modalities. It was cohort analytical study. Eighty-two odontogenic keratocysts cases treated at Oral and Maxillofacial department Armed Forces Institute of Dentistry, Rawalpindi farmed the study subject, and were followed for a period of 9 years from 2004 to 2013. Recurrence of OKCs were evaluated from 1-9 years after surgical treatment by clinical and ra-diographic means and correlated with various treatment modalities. The most frequent site affected by OKCs was the posterior mandible including body, angle and ramus. Patients were followed for recurrence. 16 patients were lost to follow up and this journal was 14 cases of recurrence out of 66 were treated with varying modalities (21.2%). Patients treated conservatively with marsupialization or enucleation alone demonstrated higher recurrence rates (100% and 50% respectively). Odontogenic keratocyst is an aggressive cyst associated with high recurrence. Surgeons should decide on various modalities as per requirement of the case. Although resection carries least risk of recurrence, it should be limited to recurrent and aggressive OKCs. The outcomes of enucleation combined with peripheral ostectomy and chemical cauterization is reasonably acceptable.
The Odontogenic Keratocyst ; Evolution of Treatment Modalities and Recurrence Rates
2020
The odontogenic keratocyst (OKC) is considered one of the more aggressive cysts due to its high recurrence rate, expressed histopathologically by a delicate, friable wall containing small satellite cysts which is often difficult to enucleate from the bone in toto. First described by Philipsen in 1956, this particular entity has evoked much discussion and debate in terms of the treatment options and recurrence rates, in literature. Numerous surgical modalities have been practiced including decompression, marsupialization, enucleation with or without adjunct (such as Carnoy’s solution or cryotherapy) and resection. Having been classified as a cyst of odontogenic origin for over five decades, the designation changed from a cyst to an odontogenic tumour in 2005, and reversed back to a cyst in 2017. Approximately 11 % of all cysts of the maxillofacial region are comprised of odontogenic keratocysts and it is located most commonly in the mandibular posterior region. This paper aims to rev...
A review of odontogenic keratocysts and the behavior of recurrences
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2006
Objective. The purpose of this study is to report experiences of odontogenic keratocysts (OKCs) and analyze information regarding recurrences to better understand the nature of recurrences.
Journal of Oral and Maxillofacial Surgery, 2007
We discuss the outcome of 2 well-established and widely accepted methods used for the treatment of odontogenic keratocyst (OKC), enucleation with peripheral ostectomy or resection and decompression followed by enucleation and peripheral ostectomy. Patients and Methods: A retrospective chart review of all cases of OKC treated in the University of Maryland's Department of Oral and Maxillofacial Surgery between 1994 and 2004 was undertaken. A total of 31 patients with OKCs was identified. Three of these patients diagnosed with basal cell nevus syndrome and multiple OKCs and 6 patients who did not have adequate follow-up were excluded from this study; thus, 22 patients were evaluated. Of these 22 patients, 11 were treated with resection or enucleation with peripheral ostectomy (group I) and 11 were treated with decompression followed by enucleation when indicated (group II). Results: A total of 22 patients with biopsy-proven OKC ranging in age from 18 to 90 years were separated into 2 treatment arms. Group I comprised 6 females and 5 males, age 18 to 71 years, with 6 OKCs located in the mandible and 5 in the maxilla. Group II comprised 6 females and 5 males, age 24 to 90 years, with 10 OKCs in the mandible and 1 in the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. The last follow-up revealed no recurrences in group I and 2 recurrences in group II. Both patients with recurrence in group II had undergone enucleation of the same lesion in the past, and both cysts recurred within 2 years after initial treatment. Conclusions: Our study results concur with the literature regarding recurrence rates of OKC. The aggressive nature of some OKCs necessitates equally aggressive treatment, whereas long-term follow up even for nonsyndromic patients with single lesions is of paramount importance. Age of the patient and the site and histological characteristics of the treated lesions were not significantly associated with the incidence of recurrence.