Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases

Abstract

BackgroundThe keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour.MethodsThree patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years.ResultsOut of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations.ConclusionsThis conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

Enucleation Followed by Open Packing of Iodoform Gauze in Mandibular Unicystic Ameloblastoma: A Case Report

“…Other possible regions were difference of the age of the patients and size of the lesions. Hadziabdic N et al and Yildirim G et al reported that radiographically complete bone healing was achieved in about 12 months and 16 months respectively [6] [20]. Similar result was found in our case.…”

“…A general agreement was made to eradicate these lesions completely with the help of aggressive surgical approach like resection with or without continuity defects. These surgical procedures may cause severe deformity postoperatively that adversely affects the physcosocial condition of the patient particularly in young age [6]- [9].…”

“…Iodoform is one of them because they reduces wound fluids by fibrinolytic activity, exhibits antimicrobial activity after topical application and covers denuded bone surface to reduce pain [10] [18] [19]. Recent literatures also reported that decompression or marsupialization alters the epithelial lining of KCOT into less aggressive form and some tumors were completely resolved clinically and radiographically [6] [7]. On the basis of above findings, we preferred enucleation followed by iodoform gauze dressing for this case to restore its natural forms and functions because patient was very young.…”

“…Mutilation adversely affects the physcosocial condition of the patient particularly in young patient. Therefore, our primary aim is to restore its natural forms and functions till last attempt to avoid mutilation [6]- [9]. This case report was performed to evaluate the success of conservative treatment like surgical enucleation followed by iodoform gauze dressing in luminal unicystic ameloblastoma of the mandible.…”

Importance of Different Modalities of Treatment For the Management of Keratocystic Odontogenic Tumour with Five year follow-up

“…The KCOT is one of the most aggressive odontogenic tumours due to its relatively high recurrence rate, its relatively fast growth, and its tendency to invade adjacent tissues including bones [8]. Based on its clinical behavior, Toller related OKC closer to the category of true benign epithelial tumours rather than a conventional cyst [9].…”