What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis

Al‐Moraissi, Essam Ahmed; Dahan, Ayed Ali; Alwadeai, Mohamed Salah; Oginni, Fadekemi Olufunmilayo; Al-Jamali, Jamil; Alkhutari, A.S.; Al-Tairi, Nashwan Hamid; Almaweri, Abdulrazaq Ahmed; Al-Sanabani, Jaber Saleh

doi:10.1016/j.jcms.2016.10.013

Cited by 123 publications

(140 citation statements)

References 44 publications

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“…25,26 Resection, which was already a treatment option, gained more prominence when OKC was classified as an odontogenic tumor. 19,27,28 The reclassification of OKC as an odontogenic cyst stimulates the choice of conservative treatments and reinforces the continuity of investigations on decompression and complementary treatments, which was done in this study.…”

Section: Discussionsupporting

confidence: 66%

“…Despite t he cont roversies related to t he decompression of OKCs, studies have demonstrated that such a method produces recurrences equivalent to or even lower than those of direct enucleation. 12,14,15,16,28 The recurrence after decompression (15.4%) was similar to that after direct enucleation (14.8%), with no significant difference in the RFPs and with a lower CRR (Tables 1 and 2). These results showed that decompression did not increase the risk for recurrence in the medium term.…”

mentioning

confidence: 62%

“…15,17,18,28 The sample presented here could not be evaluated for decompression without further enucleation because only one OKC did not undergo further surgery.…”

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confidence: 99%

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Reclassification and treatment of odontogenic keratocysts: A cohort study

et al. 2017

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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 recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

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Section: Discussionsupporting

confidence: 66%

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confidence: 62%

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Reclassification and treatment of odontogenic keratocysts: A cohort study

et al. 2017

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“…Because of the large expansion of the KCOT in our case, a radical surgical intervention was justified. An even more radical intervention could have reduced the likelihood of recurrence [20]; we observed recurrence after 1 year of follow-up. However, even recurrences in bone grafts were observed, which may not justify the morbidity associated with such a radical surgical intervention [15], [17].…”

Section: Discussionmentioning

confidence: 67%

Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review

Pittl

Meier

Hakl

et al. 2017

International Journal of Surgery Case Reports

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HighlightsKeratocystic odontogenic tumours (KCOTs) are rare, benign lesions of the jaw.We present a 49-year-old woman with a rare, large KCOT of the mandible.We describe a treatment method involving enucleation with Carnoy’s solution plus inserting a titanium plate.Although the patient showed recurrence once, she has not shown recurrence since 2010.Our approach was effective for the treatment of a large KCOT with tooth preservation.

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“…Clinically, primary excision of cysts is usually performed for cysts with a maximum diameter of less than 3 cm (Enislidis, Fock, Sulzbacher, & Ewers, ). There are many options for treating large odontogenic cysts, such as enucleation, decompression, marsupialization, and block resection of the mandible (Al‐Moraissi et al, ; de Castro et al, ). However, treatment of large odontogenic cysts is inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts

Wang

et al. 2020

Oral Diseases

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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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What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis

Cited by 123 publications

References 44 publications

Reclassification and treatment of odontogenic keratocysts: A cohort study

Reclassification and treatment of odontogenic keratocysts: A cohort study

Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review

Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts

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