IADR Abstract Archives
OKC Recurrence Based On Treatment Modality: A Systematic Literature Review
Objectives: Evaluate efficacy of treatment for odontogenic keratocysts (OKC) based on recurrence .
Methods: Cochrane Library and PubMed/MEDLINE databases (1/1/1955 - 7/31/2019) were searched for studies investigating OKC treatments.
Search terms included odontogenic keratocyst, OKC, KCOT, enucleation (EN), decompression (DC)
Inclusion criteria:
Peer-reviewed English language articles evaluating treatments, recurrence rates, studies of immunohistochemical markers, diagnosis of OKC
Non-syndromic patients with histopathologic diagnosis
Minimum 12 months followup
Randomized controlled trials (RCT), clinical trials, cohort studies, retrospective studies, case series with at least 10 cases
Exclusion criteria:
Studies published in a language other than English
Case Reports
Case series with fewer than 10 cases
Nevoid Basal Cell Carcinoma Syndrome.
Orthokeratinized lesions.
Results: 1,138 search results were screened, yielding 8 articles (6 retrospective reviews, 1 cohort study, 1 prospective study). 520 subjects (295 male and 225 females) were included. Treatments included EN, DC, peripheral ostectomy (PO), marsupialization (MS), and resection (RS) and may have been combined with adjuvants (ADJ) such as Carnoy’s solution, 5FU, and cryotherapy. Treatment modalities were sorted into categories and recurrence rates compared: (1) aggressive v. conservative and (2) surgical v. surgical with ADJ therapies. Aggressive treatments included RS and surgical treatments combined with ADJs, while conservative treatments included DC, EN, PO, and MS. Average recurrence rates for aggressive v. conservative treatments were 14.71% and 22.14% respectively. Surgical techniques alone had an average recurrence rate of 21.43%; surgery combined with ADJs was 18.52%. A comparison of treatments including EN and PO was done. Treatments involving EN had an average recurrence rate of 23.26%, while treatments involving PO had an average recurrence rate of 16.67%.
Conclusions: Aggressive modalities yielded lower recurrence rates compared to conservative treatments. Surgery with ADJs yielded lower recurrence rates than surgery alone. Treatment with PO and EN or ADJ had lower overall recurrence rates than treatment involving EN alone or EN with ADJs. In PO, bone removal may help reduce recurrence. RCTs with consistent follow-up times are recommended to verify these results.
Methods: Cochrane Library and PubMed/MEDLINE databases (1/1/1955 - 7/31/2019) were searched for studies investigating OKC treatments.
Search terms included odontogenic keratocyst, OKC, KCOT, enucleation (EN), decompression (DC)
Inclusion criteria:
Peer-reviewed English language articles evaluating treatments, recurrence rates, studies of immunohistochemical markers, diagnosis of OKC
Non-syndromic patients with histopathologic diagnosis
Minimum 12 months followup
Randomized controlled trials (RCT), clinical trials, cohort studies, retrospective studies, case series with at least 10 cases
Exclusion criteria:
Studies published in a language other than English
Case Reports
Case series with fewer than 10 cases
Nevoid Basal Cell Carcinoma Syndrome.
Orthokeratinized lesions.
Results: 1,138 search results were screened, yielding 8 articles (6 retrospective reviews, 1 cohort study, 1 prospective study). 520 subjects (295 male and 225 females) were included. Treatments included EN, DC, peripheral ostectomy (PO), marsupialization (MS), and resection (RS) and may have been combined with adjuvants (ADJ) such as Carnoy’s solution, 5FU, and cryotherapy. Treatment modalities were sorted into categories and recurrence rates compared: (1) aggressive v. conservative and (2) surgical v. surgical with ADJ therapies. Aggressive treatments included RS and surgical treatments combined with ADJs, while conservative treatments included DC, EN, PO, and MS. Average recurrence rates for aggressive v. conservative treatments were 14.71% and 22.14% respectively. Surgical techniques alone had an average recurrence rate of 21.43%; surgery combined with ADJs was 18.52%. A comparison of treatments including EN and PO was done. Treatments involving EN had an average recurrence rate of 23.26%, while treatments involving PO had an average recurrence rate of 16.67%.
Conclusions: Aggressive modalities yielded lower recurrence rates compared to conservative treatments. Surgery with ADJs yielded lower recurrence rates than surgery alone. Treatment with PO and EN or ADJ had lower overall recurrence rates than treatment involving EN alone or EN with ADJs. In PO, bone removal may help reduce recurrence. RCTs with consistent follow-up times are recommended to verify these results.
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