Novel recurrence risk stratification of odontogenic keratocysts: A systematic review

Abstract

The aim of this study was to identify all clinical, radiological, histopathological, and immunohistochemical features associated with recurrence of odontogenic keratocysts (OKCs) in the literature and formulate a recurrence risk stratification based on these findings. A search was performed in PubMed/Medline, Scopus, Web of Science, Google Scholar and Cochrane databases for clinical and laboratory studies reporting on clinico‐pathological features that led to OKC recurrences for the period 2000 to 2020. Twenty‐three studies were identified and analyzed qualitatively. A total of 2064 OKCs were included of which 439 OKCs were recurrent with a mean follow‐up period of 46.7 months. Significantly associated parameters with OKC recurrence included age (variable age categories), large (>4 cm), multilocular lesions with cortical perforation, association with dentition, presence of daughter cysts, and epithelial budding. Immunohistochemical markers including high Ki67 index and AgNOR count were also implicated. A recurrence risk stratification was formulated based on these findings. Although the level of evidence from the included studies was low, there was considerable evidence that the clinico‐pathological parameters identified were linked with higher OKC recurrence. The surgeon, radiologist, and pathologist should aim to identify these features when making a diagnosis so as to determine the appropriate management regime and prevent recurrences.

Clinical and Radiologic Spectrum of Odontogenic Keratocyst: Descriptive Study

“…Parameters like gender distribution and age distribution was in the similar manner as reported in previously studies. 12,13 In our study males were predominant victims and usually were in their forties. Paradoxical to age distribution among enrolled participants in one study age ranged from 5 to 86 years 14 .…”

A recurrence odontogenic keratocyst formation of mandible with distinctive features: a case report

“…Aggressive methods include peripheral osteotomy, cryotherapy (with liquid nitrogen) and application of Carnoy’s solution 18 , 19 . Marsupialization and decompression have been shown to be effective in the management of extensive OKCs with a lower recurrence rate when compared to enucleation alone 20 , 21 . Chemical cautery with the application of Carnoy’s solution has been shown to reduce the recurrence rate; however, it has been banned in some countries due to its suspected carcinogenic effects 22 .…”

Evaluation of the relationship between the expression of AgNOR and Ki67 with the recurrence rate in central granulomatous giant cell lesions: A case‐control

“…The results indicated that the mentioned index is capable of predicting recurrence in oral SCC lesions. Also Titinchi ( 2022 ), in a systematic review article, formulated a recurrence risk stratification by Ki67 and AgNOR and other parameters such as age and size of the lesion. By investigating several studies, they stated that there is a strong relationship between expression of Ki67 and AgNOR and tendency of OKC for recurrence.…”