Decompression for Management of Keratocystic Odontogenic Tumor in the Mandible

Abstract

Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of odontogenic origin with high recurrence rate. To date, various conservative or aggressive management strategies have been suggested as a method of treatment. Decompression is a conservative method that has been used in the treatment of large odontogenic cysts. The present paper reports a case of KCOT located in the mandible and discusses the importance of its management using conservative methods. The authors present a case of a 38-year-old patient with a KCOT located in the right mandibular angle and ascending ramus, which was treated by decompression followed by enucleation and curettage. The lesion did not recur during a follow-up period of 3 years after surgery. Preserving important structures of the bone and soft tissue decompression is a method with low morbidity. In addition, according to the literature, decompression has a success rate at least as high as the one of most aggressive treatments.

Differential expression of inducible nitric oxide synthase in keratocystic odontogenic tumors prior and subsequent to decompression

“…Furthermore, it was reported that the typical features of KCOTs are significantly altered following decompression treatment (9). In our previous study (3) we observed that subsequent to decompression, the typical presentation of KCOT was altered to one marked by hyperplastic epithelium, thickened fibrous lamina and increased inflammatory infiltration. Numerous studies have shown that biomarkers typically expressed at high levels in KCOTs, such as interleukin (IL)-1α, collagenase, Ki-67, B-cell lymphoma-2 and keratinocyte growth factors, are notably decreased following decompression (10)(11)(12) indicating the attenuation of cell proliferation, survival and local invasion.…”

“…Following decompression, the size of the lesion may decrease (2). Furthermore, a previous study (3) showed that the histological features of KCOTs markedly changed following decompression, as evidenced by the thickening of the epithelial layer and enhanced inflammation in the fibrous layer. However, the mechanisms responsible for these changes in clinical features remain to be elucidated.…”

Abordagem clínica e terapêutica sobre o Tumor Odontogênico Ceratocístico: uma revisão abrangente da literatura

“…1. 38 casos -Somente aumento de volume 17,20,21,[23][24][25][26][28][29][30]35,[39][40][41][46][47][48]52,53,56,59,63,64,67,[70][71][72]75,81,89,92 ; 2. Aumento de volume associado a:…”

“…1. 53 casos -Não reportado [10][11][12][14][15][16]18,25,27,30,33,35,36,41,46,50,51,55,56,[58][59][60][61]63,64,[66][67][68][71][72][73]75,76,79,81,[82][83][84][87][88][89]91 ; 2. 20 casos -CO 8,9,13,17,19,22,28,29,31,37,39,…”

“…A maioria dos relatos de caso referiu ocorrência da lesão em mandíbula 8,11,14,[16][17][18][19][20][22][23][24][25]27,28,31,[33][34][35][36][37][39][40][41][42][43][45][46][47][48][49][50][51]53,54,56,58,59,61,65,67,[70][71][72]75,76,[78][79][80][82][83][84][85]…”