The presentation of recurrent odontogenic keratocysts of the mandible with an emphasis on the tooth‐bearing area: a systematic review and meta‐analysis

Abstract

Aim: To gain insight in the actual ratio of recurrent odontogenic keratocysts (OKCs) occurring in the tooth-bearing area as compared to the posterior region of the mandible in order to come up with reliable data to base upon a rational treatment policy. Material and Methods: We searched MEDLINE, Web of Science, Scopus, Cochrane Library and Google Scholar databases for studies reporting on the location of recurrent mandibular OKCs. Risk Difference with a confidence interval of 95% of having the lesion in the tooth-bearing area versus the posterior region was the effect measure. P value for the summary effect of <0.05 was considered statistically significant. Results: The 1411 records retrieved were reduced to 13 studies to be qualitative/quantitative assessed. The pooled values showed that the difference in the clinical risk of having recurrent OKCs in the posterior region of the mandible and in the tooth-bearing area of the maxilla is of 7% (CI: À0.08, 0.22; P = 0.36), the posterior region being more susceptible to develop a recurrent OKC. Conclusions: The recurrence rate of OKCs in the posterior mandible is not significantly higher than of those located in the tooth-bearing part of the mandible; however, there is no reason to follow a more aggressive treatment policy for OKCs in the tooth-bearing area. Clinical RelevanceScientific rationale for study Once patients have an estimated difference of 21% to have primary keratocysts in the posterior mandible, it is important to gain insight into the actual ratio of recurrent keratocysts of the mandible. Principal findingsThe difference in the clinical risk of having recurrent keratocysts between the posterior region and toothbearing area of the mandible is 7%. Practical implicationsThe ratio of recurrent keratocysts in the posterior mandible is not significantly higher as compared to the tooth-bearing area. Therefore, there is no reason to follow a more aggressive treatment policy for keratocysts in the tooth-bearing area.