The Use of Enucleation and Chemical Cauterization (Carnoy’s) in the Management of Odontogenic Keratocyst of the Jaws

Abstract

The purpose of this study was to evaluate the use of enucleation and chemical cauterization in the management of odontogenic keratocyst (OKC) of the jaw. This study involves the retrospective review of 32 patients (20 males and 12 females) with 34 biopsy proven odontogenic keratocysts. All patients received a combination of enucleation and chemical cauterization with every time freshly prepared Carnoy's solution (absolute alcohol 6 mL, chloroform 3 mL, glacial acetic acid 1 mL, ferric chloride 0.1 gm/mL). None of these patients were diagnosed with basal cell nevus syndrome. Four of these patients did not give the follow up and were not included in the study. A total of 30 biopsy proven OKC were resolved with this treatment method. Postoperative follow up consists of clinical and radiographic examination. Follow up time ranged from a minimum of 2 years to a maximum of 5 years. Mean follow up was of 2.8 years. Recurrence rate of 5.8% was observed. Hence, concluded that the combination of enucleation and chemical cauterization may offer patients improved therapy in the management of odontogenic keratocysts of the jaws.

Role of carnoy’s solution in the treatment of keratocystic odontogenic tumor: A systematic review

“…The main results of the included clinical studies are shown in Table 2. It should be noted that the studies performed by Zhao et al (14) and Rao and Kumar (37) did not clearly specify the presence of the parakeratotic component.…”

“…High recurrence rates have been described for this lesion (4,5,9,12,14,37) mainly depending on the treatment modality (3,7). Accordingly, a recently published study (40) quantified Cyclin D1 (CCD1) expression levels, a nuclear protein essential for cell cycle progression, in a series of keratin-producing odontogenic cysts.…”

“…These lesions are difficult to interpret and easy to be confused with other lesions (12,14). Often asymptomatic, the majority of KOT tends to appear at the mandible, frequently at the mandibular ramus and angle (3,4,9,14,37), although it can also occur in the dentate area of the jaws resembling an odontogenic cyst (12). Even, involvement with an impacted tooth has been described up to 40% of cases (4,35).…”

“…Although the lesion did not recurred it is not possible to state that the combination of this techniques yields the best results, similarly to other treatments performed in some of the included studies (5,8,12,35). The studies published by Stoelinga (12), Zhao et al (14) (both published prior to 2005) and Güler et al (4) and Rao and Kumar (37) did not specify the histologic variant of the treated odontogenic keratocysts. Thus, a risk of bias in the results could have been introduced.…”

Análise histológica dos efeitos da solução de Carnoy em defeitos monocorticais realizados na mandíbula de ratos Wistar

“…Tanto na prática como na teoria, é quase unânime que a aplique, por meio de gaze ou algodão embebido, diretamente sobre o leito ósseo após a remoção de determinada lesão. Contudo, ainda há frequente disparidade de opiniões em relação ao tempo dessa aplicação, girando em torno de 1 minuto (Rao;Kumar, 2014); 3 minutos (Williams;Connor, 1994;Blanas et al, 2000;Lee et al, 2004;Ribeiro Junior et al, 2012;Rajeshkumar et al, 2013); um pouco mais de 3 minutos (Frerich et al, 1994) e 5 minutos Bronkhorst, 1988;Saulacic et al, 2009 (Pereira et al, 2015;Dias et al, 2016 ocorreram nos casos em que a primeira cirurgia foi em região dentada e a presença das raízes dificultaram o acesso a toda lesão.…”