Management of Mandibular Odontogenic Keratocyst Through Radical Resection: Report of 35 Cases

Overview

Journal Oncol Lett

Specialty Oncology

Date 2019 Jul 11

PMID 31289548

Citations 7

Authors

Nyimi Bushabu Fidele

Liu Bing

Yanfang Sun

Tianfu Wu

Yueyu Zheng

Yifang Zhao

Affiliations

Soon will be listed here.

Abstract

The present study reported the clinical outcomes of 35 patients with mandibular odontogenic keratocysts (OKCs) following treatment by radical resection and immediate defect reconstruction. Amongst 565 patients with OKCs that were treated between April 2003 and May 2015, 35 patients underwent segmental or marginal mandibulectomy. The use of radical resection was based on clinical and/or radiographic evidence of size, cortical perforation and subsequent soft tissue involvement, and on the history of previous recurrence of the same lesion. Recurrence, justifications of the main major factor for resection, and functional and cosmetic results of the patients following mandibular reconstruction were systematically evaluated. There were 26 OKCs in the mandibular molar-ramus region, eight in the mandibular anterior-premolar region and one in the mandibular molar-ramus and anterior-molar regions. Among the 35 patients, 20 had primary OKCs and 15 had recurrent OKCs. A total of 31 patients underwent segmental mandibulectomy, of which 28 were immediately reconstructed with a vascularized flap, whereas four patients underwent marginal mandibulectomy. The functional and cosmetic outcomes of patients were evaluated as satisfactory. The length of the follow-up period ranged from 2 to 17 years following operation (average, 5.82 years). Recurrence was identified in one patient who had been treated with marginal mandibulectomy. In conclusion, the findings from the present study suggested that radical resection may be recommended for patients with OKCs and locally aggressive features. Immediate mandibular reconstruction with a vascularized flap may be a crucial part of this aggressive treatment method that may reduce OKCs-associated morbidity.

Citing Articles

Long-term follow-up of a large multilocular odontogenic keratocyst. Analysis of recurrences and the applied treatments.

Borras-Ferreres J, Albisu-Altolaguirre I, Gay-Escoda C, Mosqueda-Taylor A J Clin Exp Dent. 2024; 16(9):e1157-e1163.

PMID: 39399852 PMC: 11470458. DOI: 10.4317/jced.62032.

Management regulations for odontogenic keratocyst: a case report and review of the literature.

Grover S, Hegde S, Mascarenhas R J Med Case Rep. 2024; 18(1):152.

PMID: 38576053 PMC: 10996238. DOI: 10.1186/s13256-024-04473-8.

[Techniques for the treatment of keratocyst, review of the literature and case report].

Ochoa Moreira J, Reinoso Quezada S, Molina-Barahona M Rev Cient Odontol (Lima). 2024; 11(2):e159.

PMID: 38288449 PMC: 10809971. DOI: 10.21142/2523-2754-1102-2023-159.

Mandibular reconstruction after excision of recurrent odontogenic keratocyst using a novel mandibular distraction osteogenesis method- a case report.

Lin H, Zhong X, Zhou N, Huang X Head Face Med. 2023; 19(1):21.

PMID: 37268991 PMC: 10236778. DOI: 10.1186/s13005-023-00367-0.

Odontogenic keratocyst in the mandibular condyle base region: A case report.

Miyamoto S, Goto T, Shirakawa J, Kawano T, Murahashi M, Ide K Exp Ther Med. 2023; 25(3):141.

PMID: 36845954 PMC: 9947583. DOI: 10.3892/etm.2023.11840.

References

Blanas N, Freund B, Schwartz M, Furst I . Systematic review of the treatment and prognosis of the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90(5):553-8. DOI: 10.1067/moe.2000.110814. View

Myoung H, Hong S, Hong S, Lee J, Lim C, Choung P . Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91(3):328-33. DOI: 10.1067/moe.2001.113109. View

Stoelinga P . Long-term follow-up on keratocysts treated according to a defined protocol. Int J Oral Maxillofac Surg. 2001; 30(1):14-25. DOI: 10.1054/ijom.2000.0027. View

Hidalgo D, Pusic A . Free-flap mandibular reconstruction: a 10-year follow-up study. Plast Reconstr Surg. 2002; 110(2):438-49; discussion 450-1. DOI: 10.1097/00006534-200208000-00010. View

Zhao Y, Wang S . Treatment of odontogenic keratocysts: a follow-up of 255 Chinese patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94(2):151-6. DOI: 10.1067/moe.2001.125694. View

August M, Faquin W, Troulis M, Kaban L . Dedifferentiation of odontogenic keratocyst epithelium after cyst decompression. J Oral Maxillofac Surg. 2003; 61(6):678-83; discussion 683-4. DOI: 10.1053/joms.2003.50137. View

Anthony Pogrel M, Jordan R . Marsupialization as a definitive treatment for the odontogenic keratocyst. J Oral Maxillofac Surg. 2004; 62(6):651-5. DOI: 10.1016/j.joms.2003.08.029. View

Worrall S . Recurrent odontogenic keratocyst within the temporalis muscle. Br J Oral Maxillofac Surg. 1992; 30(1):59-62. DOI: 10.1016/0266-4356(92)90139-a. View

Lyons A, James R, Collyer J . Free vascularised iliac crest graft: an audit of 26 consecutive cases. Br J Oral Maxillofac Surg. 2005; 43(3):210-4. DOI: 10.1016/j.bjoms.2004.11.015. View

10.

Chirapathomsakul D, Sastravaha P, Jansisyanont P . A review of odontogenic keratocysts and the behavior of recurrences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 101(1):5-9. DOI: 10.1016/j.tripleo.2005.03.023. View

11.

Giuliani M, Grossi G, Lajolo C, Bisceglia M, Herb K . Conservative management of a large odontogenic keratocyst: report of a case and review of the literature. J Oral Maxillofac Surg. 2006; 64(2):308-16. DOI: 10.1016/j.joms.2005.10.013. View

12.

Boyne P, Hou D, Moretta C, Pritchard T . The multifocal nature of odontogenic keratocysts. J Calif Dent Assoc. 2006; 33(12):961-5. View

13.

Kolokythas A, Fernandes R, Pazoki A, Ord R . Odontogenic keratocyst: to decompress or not to decompress? A comparative study of decompression and enucleation versus resection/peripheral ostectomy. J Oral Maxillofac Surg. 2007; 65(4):640-4. DOI: 10.1016/j.joms.2006.06.284. View

14.

Stoelinga P . Etiology and pathogenesis of keratocysts. Oral Maxillofac Surg Clin North Am. 2007; 15(3):317-24. DOI: 10.1016/S1042-3699(03)00032-3. View

15.

Yagyuu T, Kirita T, Sasahira T, Moriwaka Y, Yamamoto K, Kuniyasu H . Recurrence of keratocystic odontogenic tumor: clinicopathological features and immunohistochemical study of the Hedgehog signaling pathway. Pathobiology. 2008; 75(3):171-6. DOI: 10.1159/000124977. View

16.

Gosau M, Draenert F, Muller S, Frerich B, Burgers R, Reichert T . Two modifications in the treatment of keratocystic odontogenic tumors (KCOT) and the use of Carnoy's solution (CS)--a retrospective study lasting between 2 and 10 years. Clin Oral Investig. 2009; 14(1):27-34. DOI: 10.1007/s00784-009-0264-6. View

17.

Pitak-Arnnop P, Chaine A, Oprean N, Dhanuthai K, Bertrand J, Bertolus C . Management of odontogenic keratocysts of the jaws: a ten-year experience with 120 consecutive lesions. J Craniomaxillofac Surg. 2009; 38(5):358-64. DOI: 10.1016/j.jcms.2009.10.006. View

18.

Amaral Mendes R, Carvalho J, van der Waal I . Characterization and management of the keratocystic odontogenic tumor in relation to its histopathological and biological features. Oral Oncol. 2010; 46(4):219-25. DOI: 10.1016/j.oraloncology.2010.01.012. View

19.

Zecha J, Amaral Mendes R, Lindeboom V, van der Waal I . Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without adjunctive therapies - A 35-year single institution experience. Oral Oncol. 2010; 46(10):740-2. DOI: 10.1016/j.oraloncology.2010.07.004. View

20.

Liu B, Cai Y, Wang S, Zhao Y . Recurrent keratocystic odontogenic tumor in the masseter muscle overlying the boney perforations: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113(4):e1-5. DOI: 10.1016/j.tripleo.2011.07.005. View