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Kim P, Seo B, Hussaini H, Rich AM, De Silva H. Epidemiology of odontogenic tumours and selected cysts diagnosed at a single New Zealand oral pathology centre- A 15-year retrospective study. Oral Maxillofac Surg 2024; 28:1595-1603. [PMID: 39210202 DOI: 10.1007/s10006-024-01290-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023. METHODS Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS. RESULTS Of the 34,225 biopsies over the 15-year period, 1.8% were identified as OTs, COC and OKCs and accounted for 47%, 1.5% and 51.5% respectively. The most prevalent OT types were odontoma (43.7%), ameloblastoma (27%) and cemento-ossifying fibroma (7.5%). Malignant OT, ameloblastic carcinoma, constituted 1.4% of OT. The average age at diagnosis for OKC, COC and OT patients were 48.2 ± 20.9, 33.7 ± 23.3 and 28.9 ± 19.3 years. Overall, male and mandibular site predilections were observed. Recurrence of OKC and ameloblastoma occurred in 15.2% and 13.7% of patients. The time for recurrence for OKC and Ameloblastoma were 61.7 ± 56.5 months and 122 ± 152 months respectively. CONCLUSION The demographic features and range of OT, COC and OKC in New Zealand align with those of other western countries. The study also confirms need for long term follow up for patient with OKC and ameloblastoma.
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Affiliation(s)
- Paul Kim
- Oral and Maxillofacial Surgery Registrar, Dunedin Hospital, Dunedin, New Zealand.
| | - Benedict Seo
- Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Haizal Hussaini
- Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Alison M Rich
- Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Harsha De Silva
- Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand
- , Sydney, Australia
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Gonçalves TODF, Rangel RMR, Marañón-Vásquez GA, Soares-Silva L, Agostini M, Abrahão AC, Romañach MJ, Maia LC. Management and recurrence of the odontogenic keratocyst: an overview of systematic reviews. Oral Maxillofac Surg 2024; 28:1457-1478. [PMID: 38954313 DOI: 10.1007/s10006-024-01277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
MATERIALS AND METHODS An extensive literature search among six eletronic databases and Grey Literature was used to identify systematic reviews (S) that could respond if: in individuals diagnosed with OKC (P), is there any influence of the treatment method (I/C) on the recurrence rate of the lesion (O)? After evaluating all titles and abstracts and then applying the eligibility criteria, the included studies were read in full, and data were extracted based on a standardized sheet ordered in the PICO sequence. The assessment of the quality of the systematic reviews included, was determined by AMSTAR2, and final synthesis were descriptively made based on the results and quality of the systematic reviews. RESULTS From a total of 19 included systematic reviews, it was observed that the most used treatment for OKC was enucleation, followed by enucleation with adjuvant techniques and marsupialization. The mean percentage of recurrence was 16,2%, and the highest OKC recurrence rate was 43.2% after simple enucleation. The use of adjuvant techniques promoted reductions in OKC recurrence rates. The overall methodological quality of systematic reviews was critically low, and this parameter demonstrate the need for more studies to facilitate the choose of the treatment. CONCLUSION Despite being the most used treatment, simple enucleation is related to the highest rate of recurrence, except when performed after marsupialization/decompression. In addition, the use of adjuvant techniques has a strong impact on reducing the likelihood of recurrence. However, these findings are not conclusive because of the critically low quality of the systematic reviews.
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Affiliation(s)
- Thayanne Oliveira de Freitas Gonçalves
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), R. Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Renata Matuck Roque Rangel
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Larissa Soares-Silva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), R. Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), R. Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), R. Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Bera RN, Tandon S, Tiwari P, Mishra M. Recurrence and Prognosticators of Recurrence in Odontogenic Keratocyst of the Jaws. J Maxillofac Oral Surg 2024; 23:1304-1315. [PMID: 39376753 PMCID: PMC11455759 DOI: 10.1007/s12663-022-01846-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction The incidence of recurrence of OKC varied from 2.5 to 62%. Studies have linked recurrence to treatment methods and also clinical and pathological features. The aim of this study was to evaluate the 5-year recurrence and the factors associated with recurrence in odontogenic keratocysts of the jaws. Methods A retrospective review of records was done from the Institute's Medical Records Directory from 2010 to 2021. The following data were obtained of the lesion; age at presentation, gender, site, subsite, radiographic presentation (locularity), radiographic borders, presence or absence of satellite cysts, inflammatory infiltrate, and treatment rendered presence or absence of cortical perforation and soft-tissue extension and presence or absence of recurrence. Kaplan Meir estimator was used to evaluate recurrence rate and log rank test was used to compare the survival amongst groups. Cox regression analysis was used to evaluate the odds ratio to find out the possible factors influencing risk of recurrence. A p value of < 0.05 was considered statistically significant at 95% confidence interval. Results In our study cohort, 27.2% of patients had recurrence. Posterior maxillary lesions, multilocular lesions, lesions with scalloped borders, presence of soft-tissue extension and cortical perforation, presence of satellite cysts and inflammatory infiltrate and enucleation with peripheral ostectomy were significantly associated with recurrence. However, soft-tissue extension, cortical perforation, multilocular lesions and presence of satellite cysts were independent risk factors. Conclusion There is still debate on the best treatment modality for the management of OKCs. More studies are required to quantify the results.
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Affiliation(s)
- Rathindra Nath Bera
- Department of Oral and Maxillofacial Surgery, Dental College Rajendra Institute of Medical Sciences Ranchi, Ranchi, India
| | - Sapna Tandon
- Department of Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences and Hospital Lucknow, Lucknow, India
| | - Preeti Tiwari
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences Institute of Medical Sciences, Banaras Hindu University Varanasi, Varanasi, India
| | - Madan Mishra
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences Lucknow, Lucknow, India
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Colnot N, Savoldelli C, Afota F, Latreche S, Lupi L, Lerhe B, Fricain M. Treatment of benign maxillomandibular osteolytic lesions larger than 4 cm: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101933. [PMID: 38823480 DOI: 10.1016/j.jormas.2024.101933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE This systematic review aimed to assess the different treatments of benign maxillo-mandibular radiolucent bone lesions over 4 cm to propose a management algorithm. STUDY DESIGN A literature search was conducted using MEDLINE/PubMed, Scopus, Google Scholar, Virtual Health Library databases, and gray literature. Randomized or non-randomized clinical trials and case series with 10 or more patients with a minimum follow up of 1 year, published in French or English until August 2023, were included. The risk of bias was assessed for all papers included. RESULTS Of 1433 records identified, 22 were included in this review, reporting data from 1364 lesions. Ameloblastoma was the most common lesion (51.22%) and mandible was the most common site (81.21%). Initial conservative treatment was prevalent (71.04%). Recurrence was higher after conservative (13.8%) than after radical treatments (6.5%). Multilocularity, cortical perforation, dental element preservation were linked to a higher recurrence risk. CONCLUSION This study has shown importance of understanding specific characteristics and recurrence risk in benign maxillomandibular osteolytic lesions. Multidisciplinary team approval, personalized approach based on lesion type and patient are crucial. The presence of at least one risk factor could lead to therapeutic decision. Despite limitations, the study informed lesion management and provided precise recommendations.
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Affiliation(s)
- Nathan Colnot
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France.
| | - Charles Savoldelli
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France
| | - Franck Afota
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France
| | - Sarah Latreche
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France
| | - Laurence Lupi
- Department of Oral Surgery, Oral and Dental Medicine Institute, University of Côte d'Azur, Nice 06300, France
| | - Barbara Lerhe
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France; Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, University of Côte d'Azur, Nice 06200, France
| | - Margaux Fricain
- Department of Oral and Maxillo Facial Surgery, Head and Neck Institute, University of Côte d'Azur, Nice 06100, France
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Kumar M, Tripathi A, Singh G, Singh A, Gupta A, Kasrija R. The Role of Adjunctive Chemical Solutions in the Treatment of Odontogenic Keratocysts: A Scoping Review. Cureus 2023; 15:e41822. [PMID: 37575715 PMCID: PMC10423004 DOI: 10.7759/cureus.41822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Odontogenic keratocysts (OKC) are aggressive cysts with a high recurrence potential. Treating them with surgical enucleation procedures alone is associated with high recurrence rates; therefore, additional or supportive treatment approaches, such as peripheral osteotomy, cryotherapy, and chemical solutions, are warranted. The objective of the present review was to evaluate the existing literature on the efficacy of chemical approaches, such as Carnoy's solution (CS), in preventing recurrence after the enucleation of OKC. An electronic search was conducted on PubMed, Scopus, and Google Scholar databases to find articles published from January 2010 to December 2022 by using the Medical Subject Headings (MeSH) terms "Odontogenic Keratocyst" "Carnoy's Solution," "Treatment," and "Enucleation." Articles published in the English language were selected for the study. The PICOS criteria (population: patients with non-syndromic OKC with histopathological diagnosis and a minimum follow-up of six months; intervention and comparison: enucleation followed by adjunctive chemical therapy and standard procedure; outcome: recurrence rates; study design: retrospective and prospective studies, randomized controlled trials, and case series involving at least 10 cases of OKC) were employed. Studies involving syndromic (nevoid basal cell carcinoma) cases were excluded from the search. Seventeen studies fulfilled the inclusion criteria and the majority of them were retrospective studies, with a few case series. OKC was found more frequently in the mandible, with a recurrence rate of 11%, when treated with CS following enucleation after four years of follow-up. Modified Carnoy's solution (MC) was used in two studies. The mean follow-up period was 44 months. Based on our findings, adjuvant therapy using a chemical approach following enucleation is a more effective and beneficial modality for the treatment of OKC.
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Affiliation(s)
- Munish Kumar
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College & Research Institute, Sunam, IND
| | - Arpit Tripathi
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College & Research Institute, Sunam, IND
| | - Gagandeep Singh
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College & Research Institute, Sunam, IND
| | - Amrinder Singh
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College & Research Institute, Sunam, IND
| | - Ankush Gupta
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College & Research Institute, Sunam, IND
| | - Rishabh Kasrija
- Department of Oral and Maxillofacial Surgery, JSS Dental College, Mysuru, IND
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Ochoa Moreira JA, Reinoso Quezada SJ, Molina-Barahona M. [Techniques for the treatment of keratocyst, review of the literature and case report]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e159. [PMID: 38288449 PMCID: PMC10809971 DOI: 10.21142/2523-2754-1102-2023-159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/28/2023] [Indexed: 01/31/2024] Open
Abstract
The odontogenic keratocystic tumor (OKT) or also currently known as odontogenic keratocyst (OK) is a benign pathology derived from the remains of the dental lamina characteristic for possessing variable amounts of desquamated keratin. It usually rises as solitary or with the presence of satellite cysts, the appearance of these satellite cysts is frequently related to the possible recurrence of OK, according to the literature, this recurrence can vary between 0 - 50%. As for the treatment stage of (OKT), it can be mentioned that at present there is a well-defined histological and clinical criterion, which facilitates its recognition and therefore its treatment. According to the literature, there are several treatment procedures that can be classified into non-conservative or radical treatments and conservative treatments accompanied by adjuvant methods. Within the non-conservative or radical treatments, we find en bloc resection, which is the most aggressive way to treat a keratocyst; however, it is the most effective way to avoid recurrence. Within the conservative treatments, marsupialization, decompression, and enucleation with or without adjuvant therapy are described. It is paramount to know how to recognize the different types of treatment for (OKT) since this will be conditioned by multiple factors, such as the location of nearby bone structures and the size of the lesion considering the possible involvement of dental structures. The objective is to seek the lowest-risk treatment possible, which avoids recurrence and finally puts an end to this pathology.
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Affiliation(s)
- Jorge Andrés Ochoa Moreira
- Universidad Católica de Cuenca. Cuenca, Ecuador. , , Universidad Católica de Cuenca Universidad Católica de Cuenca Cuenca Ecuador
| | - Santiago José Reinoso Quezada
- Universidad Católica de Cuenca. Cuenca, Ecuador. , , Universidad Católica de Cuenca Universidad Católica de Cuenca Cuenca Ecuador
| | - Magdalena Molina-Barahona
- Universidad Católica de Cuenca. Cuenca, Ecuador. , , Universidad Católica de Cuenca Universidad Católica de Cuenca Cuenca Ecuador
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Khalifa GA, Alkharboush SA. Volumetric changes in the size of odontogenic keratocysts after decompression followed by enucleation, peripheral ostectomy, and Carnoy's solution: A retrospective study. J Craniomaxillofac Surg 2023; 51:143-150. [PMID: 37045614 DOI: 10.1016/j.jcms.2023.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 02/01/2023] [Accepted: 04/02/2023] [Indexed: 04/08/2023] Open
Abstract
The study aimed to retrospectively analyze the reduction pattern of odontogenic keratocysts (OKCs) after decompression, followed by enucleation (EN), peripheral ostectomy (PO), and Carnoy's solution (CS) to establish the appropriate time for inserting implants, along with assessing the long-term success of conservative treatment with adjunctive therapy. The predictable variables were the reduction pattern and the study's treatment option. The outcome variable was the volumetric changes in the size of bony defects. These changes were determined using a percentage difference and a reduction rate. They were recorded after decompression and one, three, six, twelve, and eighteen months after EN. P-values of .05 were considered significant. The study included 66 patients with 71 OKCs. Males, younger ages, and mandibular OKCs significantly predominated. The decompression significantly changed the initial volume from 135.40 ± 1.2 cm3 to 101.55 ± 0.1 cm3 with 28.6 percentage difference and 25% reduction rate. At the end of the first and third months after EN, the reduction pattern is 50.0%-75.5% of the initial volume, with no significant prediction for the direction of the reduction pattern. After 18 months, all bony defects disappeared, with no recurrences for the next 18 years. In conclusion, the reduction pattern is 75.5% of its initial volume at the end of the third month after OKC management. Therefore, within the limitations of the study, its treatment approach seems to be an option amongst other protocols that includes a view to early implant based dental rehabilitation.
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Affiliation(s)
- Ghada Amin Khalifa
- Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Qassim University, Saudi Arabia; Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.
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Modified Carnoy's Versus Carnoy's Solution in the Management of Odontogenic Keratocysts-A Single Center Experience. J Clin Med 2023; 12:jcm12031133. [PMID: 36769783 PMCID: PMC9917467 DOI: 10.3390/jcm12031133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
To date, few studies have been conducted to test the effectiveness of Carnoy's (CS) versus modified Carnoy's (MC) solution for preventing the recurrence of odontogenic keratocysts, which are potentially aggressive lesions. To evaluate the efficacy of MC application, we conducted a retrospective cohort study over an 18-year period, from October 2004 to October 2022, in 122 patients treated surgically with adjunctive chemical cautery, with either CS (n = 73; median age: 30 years) or MC (n = 49; median age: 42 years), by a single surgeon. The primary outcome variables were observed recurrence and interval to recurrence. Independent variables were demographics, location, clinical presentation at baseline, adjacent tooth extraction, and bone grafting. Males predominated in both groups. No statistically significant differences were observed between the two arms in terms of recurrences in particular months, with six patients (8.2%) in the CS arm and 5 (10.2%) in the MC arm. Of the 11 recurrences, 10 were observed within the first 2 years post-surgery, with only one occurring in the 7th year of follow-up. Thus, when used as adjunctive therapy, the application of MC has an efficiency comparable to that of CS for lowering the recurrence rate of odontogenic keratocysts.
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De Feudis F, Girotto R, Balercia A, Togni L, Rubini C, Balercia P. Management of the odontogenic keratocysts from diagnoses to treatment: an algorithm derived from the comparison of a single institution experience and literature review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Al-Moraissi EA, Kaur A, Gomez RS, Ellis E. Effectiveness of different treatments for odontogenic keratocyst: a network meta-analysis. Int J Oral Maxillofac Surg 2022; 52:32-43. [PMID: 36150944 DOI: 10.1016/j.ijom.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
Abstract
Odontogenic keratocysts (OKC) are benign but aggressive lesions. As there is a lack of well randomized clinical studies assessing the effectiveness of the different treatment options for OKC, a network meta-analysis (NMA) was performed to identify the best treatment option with the lowest recurrence rate. An electronic search was performed following the PRISMA guidelines to identify all clinical studies comparing treatment options against enucleation alone. The outcome variable was recurrence. The predictor variables were treatments. The eight included treatments were: enucleation with peripheral ostectomy/curettage (E + PO/curettage); enucleation with cryotherapy (E + CRYO); enucleation with/without PO followed by modified Carnoy's solution (E ± PO+MCS); enucleation with PO and with topical 5-fluorouracil (E + PO+5FU); enucleation with/without PO followed by original Carnoy's solution (E ± PO+CS); marsupialization alone (MARS); marsupialization followed by secondary enucleation with/without PO (MARS+2°E ± PO); and resection. The odds ratio was used to estimate the recurrence rate. A frequentist NMA was performed using Stata software. A total of 2989 patients in 40 studies were included. Both direct pairwise meta-analysis and NMA showed that E + 5FU+PO was significantly superior to E ± PO+MCS. However, no statistically significant difference was found between E ± PO+CS vs E + 5FU+PO, E ± PO+MCS, and resection, respectively (all very low quality evidence). The three most effective treatments in reducing the recurrence rate were E + PO+ 5FU (98.1%; very low quality evidence), resection (83.5%; very low quality evidence), and E ± PO+CS (63.8%; moderate quality evidence). The findings from this study suggest that CS remains the most effective fixative agent after enucleation and PO until proven otherwise. Additionally, 5FU appears to be an effective method with promising results that needs further research. Finally, the efficacy of MCS remains controversial; further in vivo and in vitro studies are required to determine new protocols. As this NMA included retrospective studies, the results should be interpreted with great caution (level of evidence: type III).
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - A Kaur
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - E Ellis
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Xiong X, Li C, Guo L, Wu Y, Wang Y, Song X. Effect of Intracapsular Pressure on Decompression Effectiveness. Int Dent J 2022; 72:839-846. [DOI: 10.1016/j.identj.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/01/2022] Open
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Kumar Singh A, Khanal N, Chaulagain R, Bhujel N, Singh RP. How effective is 5-Fluorouracil as an adjuvant in the management of odontogenic keratocyst? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 2022; 60:746-754. [DOI: 10.1016/j.bjoms.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
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Tooth Loss after Jaw Curettage Surgery: Associated Factors and Potential Benefit of Splint Application. DISEASE MARKERS 2022; 2022:7750229. [PMID: 35126790 PMCID: PMC8816549 DOI: 10.1155/2022/7750229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
Background This retrospective study is aimed at (I) assessment of tooth loss and related parameters after jaw curettage of benign lesions and (II) assessment of the outcome of jaw curettage supported by splint insertion after at least six months of follow-up. Material and Methods. For (I), patients who had jaw curettage surgery in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University (Guangzhou, China) from July 2015 to June 2019 were included. For part (II), consecutive patients who came to the department from July to December 2019 that were additionally treated with dental splinting were involved in this study. Based on the patient records, age, gender, initial tooth mobility, follow-up outcome, and potential tooth loss (intra- or postoperatively) were recorded. Based on available radiographs, alveolar crest bone loss and root surface area supported by bone (RSA) were determined. Results (I) 128 patients with 305 teeth were included, of which 40 teeth were lost (success rate 86.9%), without statistical difference in gender, age, or tooth type (P > 0.05). Tooth mobility, RSA, and the presence of alveolar crest bone defects were associated to tooth loss (P < 0.001). (II) 17 patients with a medium follow-up period of 11 months (range 9 to 13 months) were enrolled. All lesion-involving teeth supported by splint treatment at risks of loss were preserved, showing an effective tooth retention rate in 17/17 cases (74/74 teeth, success rate: 100%). Conclusions Tooth mobility and bone loss (lesion-related and/or periodontal) are potential risk predictors for tooth loss in the first year after jaw curettage surgery. Dental splints could be recommendable for teeth involved by jaw benign lesions with little bone support.
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Sarfi D, Bouya M, Ben Yahya I. Conservative management of a large Odontogenic Keratocyst: A case report. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Cavarra F, Boffano P, Brucoli M, Ruslin M, Forouzanfar T, Ridwan-Pramana A, Rodríguez-Santamarta T, de Vicente JC, Starch-Jensen T, Pechalova P, Pavlov N, Doykova I, Gospodinov D, Konstantinovic VS, Jovanović M, Barrabé A, Louvrier A, Meyer C, Tamme T, Andrianov A, Dovšak T, Birk A, Rocchetti V. Imaging of odontogenic keratocysts: a pictorial review. Minerva Dent Oral Sci 2021; 71:48-52. [PMID: 34636215 DOI: 10.23736/s2724-6329.21.04582-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The aim of the present article was to review and depict the main radiological features of odontogenic keratocysts, thus helping the differential diagnoses from other odontogenic cysts and neoplasms. METHODS A review of articles published between January 2000 and October 2020 using Medline and the MeSH Term "odontogenic keratocyst" in combination with the following terms 'imaging,' 'radiology,' 'panoramic radiograph,' and 'computed tomography,' was performed. RESULTS Radiographically, OKCs are well-defined unilocular or multilocular radiolucencies bounded by corticated margins. Most lesions are unilocular; instead, multilocular OKCs represent about the 30% of cases, mainly involving the posterior mandible. When, particularly in large lesions, OKCs display a multilocular presentation with adjacent satellite cysts (daughter cysts) a "soap-bubble appearance" can be recognized. CONCLUSIONS Panoramic radiograph and CT still play an important role in the diagnosis and treatment planning of OKCs. Unfortunately, it may not be easy to differentiate OKCs from other odontogenic lesions, especially when they are small and unilocular. Histopathological findings are still necessary to obtain a definitive diagnosis.
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Affiliation(s)
| | - Paolo Boffano
- Division of Dentistry, Vercelli Hospital, Vercelli, Italy -
| | - Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital Maggiore della Carità, University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Angela Ridwan-Pramana
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Petia Pechalova
- Department of Oral surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Nikolai Pavlov
- Clinic of Maxillofacial surgery, University Hospital St. George, Plovdiv, Bulgaria
| | - Iva Doykova
- Department of Maxillofacial surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Dimitar Gospodinov
- Department of Oral surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | - Milan Jovanović
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Aude Barrabé
- Department of Oral and Maxillofacial Surgery, Hospital Dentistry Unit, University Hospital of Besançon, Besançon, France
| | - Aurélien Louvrier
- Department of Oral and Maxillofacial Surgery, Hospital Dentistry Unit, University Hospital of Besançon, Besançon, France.,University of Franche-Comté, INSERM, EFS BFC, UMR 1098 Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
| | - Christophe Meyer
- Department of Oral and Maxillofacial Surgery, Hospital Dentistry Unit, University Hospital of Besançon, Besançon, France.,University of Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, Besançon, France
| | - Tiia Tamme
- Department of Stomatology, University of Tartu, Tartu, Estonia
| | | | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
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Boffano P, Cavarra F, Agnone AM, Brucoli M, Ruslin M, Forouzanfar T, Ridwan-Pramana A, Rodríguez-Santamarta T, de Vicente JC, Starch-Jensen T, Pechalova P, Pavlov N, Doykova I, Gospodinov D, Konstantinovic VS, Jovanović M, Barrabé A, Louvrier A, Meyer C, Tamme T, Andrianov A, Dovšak T, Birk A, Masu L, Rocchetti V. The epidemiology and management of odontogenic keratocysts (OKCs): A European multicenter study. J Craniomaxillofac Surg 2021; 50:1-6. [PMID: 34625371 DOI: 10.1016/j.jcms.2021.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of the present study was to assess the epidemiology including demographic variables, diagnostic features, and the management of odontogenic keratocyst (OKCs) at several European departments of maxillofacial and oral surgery. This study is based on a systematic computer-assisted database that allowed the recording of data from treated OKCs. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, site, size, radiographic features, treatment of OKCs, length of hospital stay, complications, recurrence, management and complications of eventual recurrence. A total of 405 patients, 249 male and 156 female, with 415 OKCs (407 sporadic and 8 syndromic lesions) were included in the study: 320 lesions were found in the mandible, whereas 95 were found in the maxilla. In the mandible, the most frequently involved subsite was the angle, whereas in the maxilla it was the molar region. The most frequently performed treatment option was enucleation plus curettage/peripheral ostectomy in 204 OKCs (recurrence rate, 9%). Decompression without residual cystectomy (recurrence rate, 66%), marsupialization with residual enucleation with the use of Carnoy's solution (recurrence rate, 50%), decompression with residual cystectomy (recurrence rate, 43%), and simple enucleation (recurrence rate, 24%) were the treatment options with the highest recurrence rates. An appropriate management of odontogenic keratocysts should be individualized, taking into consideration clinical and radiological findings, as well as patients' age and comorbidities.
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Affiliation(s)
- Paolo Boffano
- Division of Dentistry, Vercelli Hospital, Vercelli, Italy.
| | | | | | - Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore Della Carità", University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Angela Ridwan-Pramana
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Petia Pechalova
- Department of Oral Surgery, Medical University of Plovdiv, Bulgaria
| | - Nikolai Pavlov
- Clinic of Maxillofacial Surgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Iva Doykova
- Department of Maxillofacial Surgery, Medical University of Plovdiv, Bulgaria
| | | | | | - Milan Jovanović
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Aude Barrabé
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon - France
| | - Aurélien Louvrier
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon - France; University of Franche-Comté, INSERM, EFS BFC, UMR 1098 Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon - France
| | - Christophe Meyer
- Department of Oral and Maxillofacial Surgery - Hospital Dentistry Unit, University Hospital of Besançon - France; University of Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, F-25000 Besançon - France
| | - Tiia Tamme
- Department of Stomatology, University of Tartu, Estonia
| | | | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - Lavinia Masu
- Division of Pathology, Vercelli Hospital, Vercelli, Italy
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Umer F, Javed F. Decompression strategy for critical-sized lesions: A case series and literature review. AUST ENDOD J 2021; 47:731-740. [PMID: 34145932 DOI: 10.1111/aej.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/23/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Critical-sized lesions are defined as the smallest sized intraosseous wound in a particular bone that will not heal spontaneously during the lifetime of that animal. These critical-sized entities pose a unique challenge in endodontics, where these lesions are most likely cystic, with dimensions extending over 10 mm. This paper describes a structured methodology to treat such cases whilst also highlighting inconsistencies and variability between practitioners regarding management of critical-sized lesions. The case series demonstrates that non-surgical root canal therapy followed by surgical decompression may be the treatment of choice for such pathosis. A 16 gauge nasogastric tube was used as a decompression device and sutured to surrounding mucosa. Healing was evaluated using both two- and three-dimensional radiographs. Decompression of critical-sized lesions would appear to be a reliable, conservative and an altogether complete procedure that may not warrant second-stage surgery.
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Affiliation(s)
- Fahad Umer
- Operative Dentistry, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Faizan Javed
- Operative Dentistry, Department of Surgery, Aga Khan University, Karachi, Pakistan
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18
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Leite-Lima F, Bastos VC, Vitório JG, Duarte-Andrade FF, Pereira TDSF, Martins-Chaves RR, Cruz AF, de Lacerda JCT, Lebron YAR, Moreira VR, Santos LVDS, Lange LC, de Macedo AN, Diniz MG, Gomes CC, de Castro WH, Canuto GAB, Gomez RS. Unveiling metabolic changes in marsupialized odontogenic keratocyst: A pilot study. Oral Dis 2021; 28:2219-2229. [PMID: 33978981 DOI: 10.1111/odi.13913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/08/2021] [Accepted: 05/05/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to assess which metabolic pathways would be implicated in the phenotypic changes of the epithelial lining of odontogenic keratocyst after marsupialization, comparing pre- and post-marsupialized lesions with adjacent oral mucosa. MATERIALS AND METHODS Eighteen formalin-fixed and paraffin-embedded tissues from six subjects were divided into three paired groups: odontogenic keratocyst pre- (n = 6) and post-marsupialization (n = 6), and adjacent oral mucosa (n = 6). The metabolic pathways found in these groups were obtained by high-performance liquid chromatography-mass spectrometry-based untargeted metabolomics performed. RESULTS Through putative metabolite annotation followed by pathway enrichment and predictive analysis with automated algorithms (Mummichog and Gene Set Enrichment Analysis), we found differences in many cellular processes that may be involved in inflammation, oxidative stress response, keratinocyte-basal membrane attachment, differentiation, and proliferation functions, all relevant to odontogenic keratocyst pathobiology and the phenotype acquired after marsupialization. CONCLUSION Our study was able to identify several metabolic pathways potentially involved in the metaplastic changes induced by marsupialization of odontogenic keratocysts. An improved comprehension of this process could pave the way for the development of targeted therapies.
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Affiliation(s)
- Flávia Leite-Lima
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Victor Coutinho Bastos
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Jéssica Gardone Vitório
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Filipe Fideles Duarte-Andrade
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Thaís Dos Santos Fontes Pereira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Roberta Rayra Martins-Chaves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Aline Fernanda Cruz
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Júlio César Tanos de Lacerda
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Yuri Abner Rocha Lebron
- Department of Sanitation and Environmental Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Victor Rezende Moreira
- Department of Sanitation and Environmental Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Lucilaine Valéria de Souza Santos
- Department of Sanitation and Environmental Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Liséte Celina Lange
- Department of Sanitation and Environmental Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Adriana Nori de Macedo
- Department of Chemistry, Exact Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marina Gonçalves Diniz
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Wagner Henriques de Castro
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Gisele André Baptista Canuto
- Department of Analytical Chemistry, Institute of Chemistry, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Berretta LM, Melo G, Mello FW, Lizio G, Rivero ERC. Effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions: a systematic review. Br J Oral Maxillofac Surg 2021; 59:E17-E42. [PMID: 34749963 DOI: 10.1016/j.bjoms.2021.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/12/2021] [Indexed: 11/26/2022]
Abstract
In this study, we aimed to systematically review and critically appraise the available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines were followed and the study protocol was registered at the 'International Prospective Register of Systematic Reviews' (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science. Searches were complemented with three grey literature sources: Google Scholar, ProQuest, and Open Grey. Any reduction measures, compared with preoperative status or other procedures, were considered. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thirty-one studies were included, of which five were judged with low, 24 with moderate, and two with high risk of bias. Considering surgical approach, 20 studies assessed the decompression and 11 the marsupialisation technique. Most studies considered these techniques as preliminary treatments, followed by enucleation. From 1088 lesions found, most were odontogenic keratocysts (33.8%), followed by unicystic ameloblastomas (21.0%), dentigerous cysts (20.6%), and radicular cysts (8.4%). Large lesions and younger individuals frequently presented more favourable responses to treatment and anatomical location was not associated with lesion reduction overall. The intervention duration generally ranged between one to two years. In conclusion, marsupialisation and decompression were mostly considered as preliminary treatments, followed by enucleation. Lesion reduction was generally considered insufficient for these techniques to be used as definitive therapies, although benefits concerning the diminished invasiveness of the secondary surgery were often proposed.
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Affiliation(s)
- L M Berretta
- Dental School, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Melo
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - F W Mello
- Postgraduate Programme in Dentistry, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
| | - G Lizio
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna - Bologna, Italy.
| | - E R C Rivero
- Department of Pathology, Health Sciences Centre, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil.
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Muret M, Malthiéry E, Casenave T, Costes-Martineau V, Torres JH. Decompression: a first-intention treatment for “large” non-syndromic odontogenic keratocysts. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2020063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Though odontogenic keratocysts (OKCs) are benign lesions, they have a high recurrence rate. Because of their aggressive behavior, they have been classified as tumors by the WHO until 2017. Main differential diagnoses are amelobastoma and dentigerous cyst. Anatomopathological examination can reach a final diagnosis. Several treatments have been proposed: curettage, resection, enucleation (alone or together with peripheral ostectomy) and decompression. Decompression aims to decrease the volume of the lesion of “large” OKCs, in order to prevent surgery-related fractures and to preserve the surrounding important anatomical structures such as the inferior alveolar nerve. It could lead to a complete regression. If not, secondary enucleation can be performed in better conditions: a reduced volume to remove, a thicker epithelium to detach, a lower risk to damage neighboring anatomic structures and a lower recurrence rate. Long-term follow-up however remains necessary. Nowadays, minimally invasive surgery prevails. And since OKC was returned into the odontogenic cysts group in the WHO classification, decompression should be considered as the first intention treatment. The purpose of this paper is to provide an update about OKC features and biological mechanisms, to review the different treatment options and to provide a step-by-step protocol for decompression.
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21
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Non-neoplastic jaw cysts: a 30-year epidemiological study of 2150 cases in the Italian population. Br J Oral Maxillofac Surg 2021; 59:168-173. [DOI: 10.1016/j.bjoms.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022]
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Laino L, Russo D, Cicciù M, D'Amico C, Fiorillo L, Cervino G. Surgical conservative approach of odontogenic keratocyst tumor of the jaws. Minerva Dent Oral Sci 2021; 70:26-31. [PMID: 33094933 DOI: 10.23736/s2724-6329.20.04422-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Odontogenic keratocyst (OKC) can be classified as an oral lesion representing the third most common cyst of the jaws characterized by a high rate of recurrence. OKC was accepted as a neoplastic lesion in the 2005 WHO classification and it was called keratocystic odontogenic tumor (KCOT). However, in the 2017 classification of odontogenic tumors, OKC was moved back into the cyst category. This study aimed to evaluate clinically, radiographically and through the histological examination, the healing of a patient with OKC who underwent surgery with a marsupialization approach. METHODS A 83-year-old female patient, presented deformation of the right hemi-mandibular region and paresthesia of the right hemi-labium. During intraoral examination it was possible to detect an eggshell crackle on palpation of the anterior edentulous mandible; moreover, the patient reported a growth of the lesion over time that prevented her from using the removable prosthesis. At the OPT it was possible to appreciate a unilocular area that extended from the parasymphyseal region to the right hemi-mandible. The CT scan showed massive erosion that only partially spared the lower cortex and involvement of the mental foramen. RESULTS Checks following surgery show healing also confirmed by instrumental check-ups. CONCLUSIONS Surely this study offers a valid alternative to more invasive and debilitating surgical treatments.
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Affiliation(s)
- Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Diana Russo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy -
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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23
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Consolo U, Setti G, Tognacci S, Cavatorta C, Cassi D, Bellini P. Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enucleation. Med Oral Patol Oral Cir Bucal 2020; 25:e827-e833. [PMID: 33037805 PMCID: PMC7648911 DOI: 10.4317/medoral.23898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/03/2020] [Indexed: 01/18/2023] Open
Abstract
Background The purpose of this study was to evaluate whether marsupialization treatment induces changes in the histology of odontogenic keratocyst epithelium and to compare our experience with the literature.
Material and Methods A retrospective revision of histological samples was performed. 5 patients with odontogenic keratocyst treated with marsupialization follow by enucleation were selected. Histologic evaluation analyzed the changes in the keratocyst epithelium after marsupialization in terms of type of keratinization, thickness of the epithelium and connective tissue, the presence of acanthosis, the presence and grade of fibrosis, the type and grade of inflammation and the presence and number of mitotic figures and daughter cysts.
Results In our case series, a variation of para-keratinized into ortho-keratinized keratocyst was found in one case, and no significant increases were observed in the epithelium and capsule thickness, or even in the level of inflammation. However, we observed an increase in fibrosis and qualitative changes in inflammation type.
Conclusions Minor and major histological changes were associated with reduction in cyst volume, which resulted in a simpler and less invasive cystic enucleation after marsupialization. Key words:Keratocyst, marsupialization, enucleation, histology, histological changes.
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Affiliation(s)
- U Consolo
- University of Modena and Reggio Emilia Modena, Italy
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24
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Titinchi F. Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods. J Korean Assoc Oral Maxillofac Surg 2020; 46:358-360. [PMID: 33122462 PMCID: PMC7609937 DOI: 10.5125/jkaoms.2020.46.5.358] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 11/07/2022] Open
Abstract
The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy’s solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent.
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Affiliation(s)
- Fadi Titinchi
- Department of Maxillo-Facial and Oral Surgery, Faculty of Dentistry and WHO Collaborating Centres, University of the Western Cape, Cape Town, South Africa
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25
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Liu YX, Qu Y, Li ZH, Wang HP. [Effect of decompression combined with curettage and autogenous bone cement implantation on large cysts of the jaw]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:464-469. [PMID: 32865370 DOI: 10.7518/hxkq.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a "three-step method" to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.
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Affiliation(s)
- Yi-Xiu Liu
- Dept. of Head and Neck Surgery, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Yang Qu
- Dept. of Stomatology, People's Hospital of Shapingba District, Chongqing 400030, China
| | - Zhen-Hua Li
- Dept. of Head and Neck Surgery, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Hong-Peng Wang
- Dept. of Head and Neck Surgery, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
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26
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de França GM, da Silva LBA, Mafra RP, da Silva WR, de Lima KC, Galvão HC. Recurrence-free survival and prognostic factors of odontogenic keratocyst: a single-center retrospective cohort. Eur Arch Otorhinolaryngol 2020; 278:1223-1231. [PMID: 32696249 DOI: 10.1007/s00405-020-06229-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the 5-year recurrence-free survival and prognostic factors of odontogenic keratocyst (OKC) from a single-center retrospective cohort in the northeastern region of Brazil. METHODS Forty cases of OKC comprised the study population. In the cohort analyzed, 18 (45%) cases were recurrent OKCs and 22 (55%) were non-recurrent OKCs. Recurrence-free survival was defined as the period from the release of the histopathological report to the occurrence of relapse or last visit to the service. RESULTS Comparison of the clinicopathological variables between primary and recurrent OKC lesions revealed no differences in the frequency of epithelial thickness, presence of satellite cysts and cystic spaces, presence of an inflammatory infiltrate, locularity, and lesion borders. The frequency of symptoms was practically the same even after recurrence. Satellite cysts were more frequent in the group of recurrent lesions (n = 9, p = 0.002) and the presence of an inflammatory infiltrate was also significantly associated with recurrent lesions (n = 15, p = 0.006). Previous decompression or marsupialization was associated with recurrence of the lesion (p = 0.010). CONCLUSIONS In conclusion, the most significant prognostic factors were previous decompression or marsupialization, as well as, morphological parameters associated with the recurrence cases were the presence of an inflammatory infiltrate and satellites cysts. The risk of recurrence is low but continues due to the particularities of epithelial proliferation in OKC.
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Affiliation(s)
- Glória Maria de França
- Department of Dentistry, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Avenue Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
| | | | - Rodrigo Porpino Mafra
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Weslay Rodrigues da Silva
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kênio Costa de Lima
- Department of Dentistry, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Hébel Cavalcanti Galvão
- Department of Dentistry, Postgraduate Program in Dental Sciences (Stomatology and Oral Pathology), Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Hauer L, Seidlová P, Merglová V, Hrusak D, Böhmová H, Posta P, Gencur J, Netolicky J. Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents. J Craniomaxillofac Surg 2020; 48:808-814. [PMID: 32593630 DOI: 10.1016/j.jcms.2020.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/15/2020] [Accepted: 05/31/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to evaluate the results of dentigerous cysts enucleation with preservation of cyst-associated teeth as a single procedure in a group of children and preadolescents. A retrospective case series of seven patients with 15 unerupted developing teeth associated with or adjacent to dentigerous cysts was conducted. Patients were treated using the uniform surgical protocol (cystectomy, preservation of cyst-associated teeth, without use of orthodontic traction, primary wound closure). The metric analysis of the cysts and unerupted teeth on CBCT and an evaluation of the state of involved teeth after the treatment was performed. The mean age of patients was 9.0 ± 2.1 years (range 5-12 years, median = 9 years). All teeth erupted spontaneously. No serious postoperative complications or recurrences of lesions were detected. The mean follow-up was 53.1 ± 15.7 months (range 25-71 months, median = 52 months). The cystectomy of dentigerous cysts with preservation of associated teeth may be considered an alternative to marsupialization in children and preadolescents.
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Affiliation(s)
- Lukas Hauer
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic.
| | - Petra Seidlová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Vlasta Merglová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Daniel Hrusak
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Hana Böhmová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Petr Posta
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jiri Gencur
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jan Netolicky
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
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Conservative management of odontogenic keratocyst with long-term 5-year follow-up: Case report and literature review. Int J Surg Case Rep 2019; 66:8-15. [PMID: 31785568 PMCID: PMC6889737 DOI: 10.1016/j.ijscr.2019.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/26/2022] Open
Abstract
The World Health Organization, in the last classification of the Head and Neck tumours defined Odontogenic Keratocyst as a cyst instead of a tumor. There are plenty of approaches in order to reduce the high recurrence of this lesion consisted in surgical, non-surgical and combined treatment. Surgical treatment is considered, for several years as the gold standard treatment, but currently a combined therapy has become as a first choice.
Introduction Odontogenic Keratocyst (OKC) is a benign lesion recently considered an odontogenic cyst in the present World Health Organization (WHO) classification of Head and Neck tumors (2017) mainly based on its clinical and histopathological features. Several studies, systematic reviews and meta-analyses have shown a multimodal approach to reducing the high recurrence rates inherently exhibited by this pathological condition after long-term periods of follow-up. Presentation of case The patient, a 67-years-old woman, was submitted to conservative surgical management of an odontogenic keratocyst. Initially this consisted of decompression and subsequent enucleation, with a long-term period of follow-up to ensure that there was no recurrence. Discussion Conservative surgical management is the first choice and might be considered the gold standard, but combined therapy such as marsupialization, application of Carnoy’s solution, enucleation of the remnant lesion and an extensive follow-up period would considerably reduce recurrence rates. Conclusion Therefore, an appropriate long-term follow-up must be done after the treatment performed in order to ensure clinical success, which in this case was described as an absence of signs of recurrent disease.
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Wang L, Ma C, Li X, Wang L, Cui C, Guo B, Qin X. Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts. Oral Dis 2019; 26:350-359. [PMID: 31725179 DOI: 10.1111/odi.13233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/17/2019] [Accepted: 11/03/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the differences between two types of decompression for treating large mandibular odontogenic cysts. MATERIALS AND METHODS This retrospective, cohort study included patients who were diagnosed for large mandibular odontogenic cysts from January 2015 to April 2018 and underwent two different types of decompression based on removal or retention of the cyst wall. The primary outcome was the percentage of the residual cyst area within 1 year after surgery. We used the propensity score matching (PSM) to balance the covariates of the two groups, and the primary outcome was analyzed by the non-inferiority test. RESULTS A total of 93 cases were included in our study. After 1 year, the wall removal group was non-inferior to the wall retaining group in terms of cyst area, cyst volume, and the difference between the HU values of the original cyst region and the normal mandible. In subgroup analysis, we found there were no differences between two groups in the percentage of patients in whom the cystic area was reduced by 90% after 1 year. CONCLUSION Our findings suggest that the wall removal group showed better results than the cyst wall retaining group in large mandibular odontogenic cysts.
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Affiliation(s)
- Lei Wang
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chunyue Ma
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xin Li
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Liang Wang
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chang Cui
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Bing Guo
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xingjun Qin
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Araújo S, Kindely Ramos De Oliveira L, Mombrini Pigatti F, Mayrink G. Queratocisto odontogênico em região anterior da maxila: relato de caso. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2019.v45.16941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: O queratocisto odontogênico é uma lesão cística intra-óssea que se origina do resto celular da lâmina dentária. Possui crescimento lento, assintomático e é comumente encontrado em radiografias de rotina. É mais prevalente no sexo masculino entre a 2ª e 3ª décadas de vida e acomete preferencialmente a mandíbula. Objetivo: relatar um caso de queratocisto em região anterior da maxila e realizar uma revisão dos tratamentos que estão disponíveis para essa lesão. Relato de caso: paciente do sexo feminino, 46 anos de idade, durante exame radiográfico de rotina, exibiu área radiolúcida unilocular com borda esclerótica definida que se estendia do dente 11 ao 24. No exame clínico não foi possível notar nenhuma expansão da cortical óssea. Foi realizada biópsia e instalado, no mesmo momento cirúrgico, dispositivo para descompressão da lesão. Após análise histopatológica e confirmação diagnóstica, a paciente foi submetida a enucleação cirúrgica. Conclusão: o paciente permanece em acompanhamento há 3 anos sem sinais clínicos ou radiográficos de recidiva da lesão.
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Dokova AF, Anamali S, Ismail R, Lindhout JA, Benavides E, Salzmann LB, Danciu TE. A pediatric patient with multiple radiolucencies impeding normal tooth eruption. J Am Dent Assoc 2019; 150:70-75. [DOI: 10.1016/j.adaj.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 11/16/2022]
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Slusarenko da Silva Y, Stoelinga PJW, Naclério-Homem MDG. Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysis. Oral Maxillofac Surg 2018; 23:1-11. [PMID: 30498866 DOI: 10.1007/s10006-018-0737-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/16/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE This study was conducted in order to determine whether marsupialization before definitive enucleation of nonsyndromic odontogenic keratocysts (OKCs) is capable of decreasing the recurrence rate more effectively than just enucleation. METHODS We searched MEDLINE, Web of Science, Scopus, and Cochrane Library, until August 5th of 2017 for original studies reporting on the treatment of OKCs with and without previous marsupialization and the related recurrence rate. All records and data were independently assessed, meta-analysis was performed, and the odds ratio of recurrence was the effect measure; P value for the summary effect of < 0.05 was considered statistically significant. RESULTS The 748 records retrieved were reduced to 6 studies to be qualitatively assessed and 5 studies were included in the meta-analysis. The overall odds ratio of 0.57 [0.25-1.28] of the pooled values pointed that marsupialization reduced the recurrence rate in comparison to just enucleation; however, the P value showed that there is no strong evidence to support this statement. CONCLUSIONS Marsupialization followed by enucleation after 12 to 18 months reduces the recurrence rate, but more studies are necessary to support this statement.
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Affiliation(s)
- Yuri Slusarenko da Silva
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil.
| | - Paul J W Stoelinga
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen, the Netherlands
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo, Av Prof. Lineu Prestes 2227 Butantã, São Paulo, 05508-000, Brazil
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