Abstract
Factors associated with the potential for recurrence of keratocystic odontogenic tumours (KCOT) still remain to be clearly determined and no consensus exists concerning the management of KCOT. The purpose of this study was to evaluate different clinical factors associated with KCOT and its treatment methods. A retrospective review was performed of 55 cases treated from 2001 to 2010. Of the 55 cases, 27% were associated with an impacted or semi-impacted tooth. The majority of the lesions (82%) were located in tooth-bearing areas, and the overall mandibular to maxilla ratio of tumour occurrence was 5:1. The treatment options included enucleation, marsupialisation, or peripheral ostectomy, with or without the use of Carnoy´s solution. Recurrence was found in 14 cases (25%). No significant association was seen between recurrence and age, symptomatic cases, location of the lesion, or unilocular or multilocular appearance. The recurrence rate was higher in the group with tooth involvement, more marked in cases with third molar involvement. Statistical analysis showed a significant relation between recurrence and the type of treatment, with higher rates in cases treated with enucleation associated with tooth extraction. In our series, those cases with a closer relation with dental tissues showed a higher risk of recurrence, suggesting the need for a distinct classification for peripheral variants of KCOT. Key words:Keratocystic odontogenic tumour, Odontogenic keratocyst, Odontogenic cysts, Keratocyst, Carnoy’s solution.
Highlights
An odontogenic keratocyst [OKC] is an epithelial cyst lesion commonly located in the maxilla and mandible with a significant potential for growth, expansion and local invasion
We report a retrospective study of all keratocystic odontogenic tumours (KCOT) treated over a period of 10 years at the La Paz University Hospital, Madrid, with statistical analyses of epidemiological and clinical characteristics, management and course, and discuss possible factors related to recurrence
No significant associations were found between symptomatic cases and unilocular or multilocular lesions or between asymptomatic cases and unilocular or multilocular lesions
Summary
An odontogenic keratocyst [OKC] is an epithelial cyst lesion commonly located in the maxilla and mandible with a significant potential for growth, expansion and local invasion. The first description of an OKC was by Philipsen in 1956. OKCs account for 12-14% of all odontogenic cysts of the jaws, with a predilection for the posterior region of the mandible. A fibrous capsule and a lining of keratinized squamous epithelium characterize OKCs. Recurrence has been described up to 10 years after treatment, though it is more common during the first 5-7 years. The potential risk of recurrence and the long intervals reported explain the need for long-term follow-up
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