How well do we manage the odontogenic keratocyst? A multicenter study

Kinard, Brian; Hansen, Gentry; Newman, Marshall F.; Dennis, Peter; Haeffs, Tyler H.; Perez, Sebastian D.; Hamao-Sakamoto, Aya; Steed, Martin B.; Hughes, Pamela J.; August, Meredith; Abramowicz, Shelly

doi:10.1016/j.oooo.2018.12.001

Cited by 16 publications

(9 citation statements)

References 31 publications

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“…Concerning treatment, options range from more conservative procedures such as marsupialization and enucleation of the lesion with or without peripheral osteotomy to more radical therapies such as segmental resection [12]. The location of the lesion (mandible or maxilla), the size, and evidence of cortical bone perforation must be considered for treatment choice [13]. In our study, all cases were treated with surgical enucleation.…”

Section: Discussionmentioning

confidence: 93%

Epithelial-mesenchymal markers and their correlation with clinical aspects in odontogenic keratocysts

Vendruscolo

Lessa

Ioshii

et al. 2022

RGO, Rev. Gaúch. Odontol.

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Objective: Odontogenic keratocysts have a high recurrence rate and aggressive clinical behavior. The event called epithelial-mesenchymal transition is a process in which the epithelial cell loses its epithelial characteristics and acquires properties typical of mesenchymal cells. Studies have already demonstrated that odontogenic keratocysts has expression of tumor markers, but the lack of clarification about its development mechanism and molecular composition makes the therapeutic options remain limited. The aim of this study is to evaluate the expression of epithelial-mesenchymal transition marker proteins in these lesions, correlating the expression of these proteins with clinical aspects of each case. Methods: Patients with odontogenic keratocysts diagnoses, treated by the Department of Oral and Maxillofacial Surgery of the Erasto Gaertner Hospital, Curitiba, Brazil in the period between 2016 and 2019 were evaluated by immunohistochemical analysis, to assess the expression of epithelial-mesenchymal transition markers (Vimentin, beta-catenin and E-cadherin) by qualitative analysis. Results: Eighteen patients were included, with a mean age of 43 years, and most of them were male. The mandible was more affected than the maxilla. No association between the clinical characteristics of the cysts and the immunohistochemical profile for epithelial-mesenchymal transition proteins was observed. Conclusion: The positivity of E-cadherin and negativity of vimentin demonstrates that its function is preserved. Loss of function of E-cadherin is associated with worse prognosis. The identification of the epithelial-mesenchymal transition process as a prognostic marker for odontogenic cysts and tumors could be an important tool for defining treatment.

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Section: Discussionmentioning

confidence: 93%

Epithelial-mesenchymal markers and their correlation with clinical aspects in odontogenic keratocysts

Vendruscolo

Lessa

Ioshii

et al. 2022

RGO, Rev. Gaúch. Odontol.

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“…Recurrence of OKCs is triggered by inadequate elimination of the epithelial remnants from the lining of the cyst, satellite and/or microcyst, and remnants left in the basal cell layer of the oral epithelium [2,[7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, recurrence may be dependent on the treatment modality and its success. Thus there have been numerous attempts to decrease the high recurrence rate by refining the surgical techniques [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…OKCs are managed surgically with careful complete excision due to their high recurrence rate. The thin and friable cyst lining is behind the surgical challenges of OKCs [7][8][9]. To avoid the recurrence potential of OKC, chemical solutions such as Carnoy's solution (CS) (1 g of ferric chloride (FeCl 3 ) dissolved in 6 mL of absolute alcohol, 3 mL of chloroform, 1 mL of glacial acetic acid), modified Carnoy's solution (MCS) (absolute alcohol 6 mL, chloroform 3 mL, glacial acetic acid 1 mL, ferric chloride 0.1 gm/ mL), 5-Fluorouracil (5-FU) and liquid nitrogen cryotherapy have been associated with surgical treatment [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Combined conservative treatment of a recurrent mandibular keratocyst by enucleation, diode laser, 5-Fluorouracil and dental implants: a case report with 18 years-follow up

Berbéri

Aoun

Hjeij

et al. 2021

Medicine and Pharmacy Reports

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In 2017, the World Health Organization classified the odontogenic keratocyst as a developmental odontogenic cyst. The posterior parts of the mandible, especially the angle and the ramus, are the most involved sites. Due to their high recurrence rate, keratocysts are managed surgically with careful complete excision. Additionally, chemical solutions such as Carnoy's solution, modified Carnoy's solution, and 5-Fluorouracil have been associated with surgical treatment. Diode lasers generate diverse wavelengths that have photothermal and photochemical special properties and could have some effects on the lining epithelium remnants of the cyst. In this paper, we discuss a case of mandibular recurrent odontogenic keratocyst treated with 5-Fluorouracil topical application after enucleation and diode laser application with 18 years follow-up and teeth replacement with dental implant. 5-Fluorouracil and diode laser have been found to be very effective in the treatment of keratocysts.

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“…Regarding treatment at the initial occurrence, two cases were treated conservatively by decompression and enucleation, while four cases were treated by enucleation followed by ostectomy and Carnoy's solution use. The literature indicates that decompression followed by surgical enucleation reduces the likelihood of recurrence and that decompression followed by enucleation is advantageous, especially in cases of extensive lesions, [15][16][17] with fibrous capsule thickening observed in previous decompression procedures, facilitating complete surgical lesion removal. [18][19][20] Although cross -sectional studies with retrospective analysis represent important study methods for collecting clinical data, they present some limitations.…”

Section: Discussionmentioning

confidence: 99%

Recurrence rate of odontogenic keratocysts: Clinical-radiographic characterization throughout a 48-year period

Pinheiro¹,

Cavalcante²,

Santos³

et al. 2020

j.rpemd

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The aim of the present study was to carry out a retrospective analysis and evaluate the recurrence rate of cases histopathologically diagnosed as odontogenic keratocysts in an Oral Pathology Service in Northeastern Brazil. Methods:The data of the present research were obtained from clinical files from our Service, and included information on patients' age and sex, keratocysts' anatomical location, association with teeth and radiographic aspect, type of biopsy, symptoms, type of data collected, treatment, recurrence, and possible association with Gorlin syndrome.Results: During the study period, 15,670 case records of maxillofacial lesions were obtained, of which 106 (0.67%) were histopathologically diagnosed as odontogenic keratocysts. Recurrence was observed in 13.2% of cases. Conclusions:The recurrence of odontogenic keratocysts was not associated with their anatomical location, the patient's sex, or the radiographic appearance at the time of diagnosis. Odontogenic keratocysts were identified as a non-aggressive cystic lesion, with a low rate of recurrence when treated conservatively by decompression and surgical enucleation. (Rev

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How well do we manage the odontogenic keratocyst? A multicenter study

Cited by 16 publications

References 31 publications

Epithelial-mesenchymal markers and their correlation with clinical aspects in odontogenic keratocysts

Epithelial-mesenchymal markers and their correlation with clinical aspects in odontogenic keratocysts

Combined conservative treatment of a recurrent mandibular keratocyst by enucleation, diode laser, 5-Fluorouracil and dental implants: a case report with 18 years-follow up

Recurrence rate of odontogenic keratocysts: Clinical-radiographic characterization throughout a 48-year period

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