HOME - Clinical cases - Oral surgery
 
 
03 July 2019

Odontogenic keratocysts: analysis of recurrence

Lara Figini


Odontogenic keratocyst (OKC), also known as keratoconus odontogenic tumor, is locally aggressive and frequently relapses, with most relapses occurring within 5 years of treatment. It originates from the epithelial tissue residues that participate in tooth formation (dental lamina). It can be uni- or multilocular, it has an invasive growth, and it tends to expand inside the bone tissue, inducing its reabsorption. If not diagnosed and treated it can lead to deformation of the affected bone and soft tissue, cause pain, tooth displacement, paresthesia and anesthesia due to nerve compression.
The treatment is mainly surgical, and involves the removal of the lesion, followed by a careful remote follow-up.  

MATERIALS AND METHODS
The study published by Kinard et al. investigated the overall percentage of recurrence of odontogenic keratocysts 5 years after treatment and what factors were associated with their recurrence.This multicenter retrospective cohort study considered patients for the evaluation and management of OKC previously never treated for this issue. The predictive variables have been grouped into demographic, medical, radiographic and operational categories. The primary outcome variable was represented by the recurrence time of the lesion. Data analyzes were performed using bivariate analysis and univariate or multivariate Cox proportional risk models. 

RESULTS
231 keratocysts (OKC) were analyzed. Of these, 57 (24.7%) were treated by decompression and residual cystectomy, 86 (37.2%) by enucleation without adjuvant therapy and 78 (33.8%) by enucleation with peripheral ostectomy.
44 relapses were recorded with an average recurrence time of 26.7 months.  

CONCLUSIONS
From the data emerging from this study, which must be confirmed with other similar studies, it can be concluded that, using the appropriate time-to-event survival analysis, which also takes into account the cases lost to follow-up, 5 years after treatment of keratocysts has a cure rate without recurrence of 29%. Mandibular lesions, multilocular lesions and lesions treated by decompression and residual cystectomy were found to be more associated with recurrence.


For additional informations:
How well do we manage the odontogenic keratocyst? A multicenter study

Related articles

The connective tissue graft (CTG) is considered the material of choice in treating gingival or mucosal recessions around teeth and implants. Nowadays it is...


Panoramic radiography, also known as orthopantomography (OPG), is commonly used in facial and dental pain investigations. This radiographic modality shows the...


Impacted third molars are directly or indirectly the underlying cause of numerous disorders in the mouth, jaw and facial regions like:  pericoronitis...


Maxillary sinus elevation has been shown to be a safe and effective means of creating adequate vital bone formation for implant placement in pneumatized ...


Co-authors: G. Monaco, S. Cecchini, G.A. Pelliccioni.

Late infections resulting from the surgical removal of third molars, despite having a relatively low incidence (from 0.5% to 1.8%), represent a significant ...


Read more

In orthodontics, the archform is considered to be important mainly for stability, occlusion, and esthetics. Archform tends to return toward the pretreatment ...


Authors: G. Mergoni, I. Giovannacci, G. Giunta, G. Ghidini, M. Meleti, M. Manfredi, P. Vescovi

An 11-year-old patient  was sent to out observation by her pediatrician for a maxillary gingival lesion that had arisen about 2 months earlier and...


Many dental procedures can be performed with local anesthesia. Nonetheless in certain clinical situation and especially with pediatric patients it can be...


Zirconia implants have been brought to the dental market as a viable alternative to titanium implants initially to fulfill a demand from patients for...


Is it better to try to preserve a dental element with every possible means or to place an osseointegrated implant? There is a great variability of response...


 
 

Newsletter

 
 
 
 

Most popular

 
 

Events