Comparison of the Recurrence Rate in Marsupialization with and Without Peripheral Sectomy in the Treatment of Odontogenic Keratocyte Tumor in Patients Referred to Bahoner Hospital, Kerman

Abstract

Aim: Odontogenic keratocyte tumor is a developmental cyst with proliferative and invasive nature. which is often observed in the posterior region of the mandible and is commonly seen in the third decade of life. The highest age of prevalence is in the 3rd to 6th decades and the male to female ratio is 2 to 1. Normally, if there is no infection, it is not manifested and it is discovered accidentally in rayograph, but if the size increases, it manifests as an extension in the form of pain, swelling and infection in the dental and bone area if the tooth is hidden. In radiographs, it appears as a radiolucent lesion with distinct ionic or multilocular boundaries and sometimes with a scallop border in the dental area or even extending to the ascending ramus and condylar area. Research shows that the origin of this cyst is the remaining odontogenic epithelium of Ceres in the alveolar region. And it can be syndromic (Gorlin syndrome) or non-syndromic. This cyst has a thin epithelium and has multiple daughter cysts, which causes the risk of recurrence due to incomplete removal of the lesion. Enucleation, marsupialization, Carney’s solution and resection are treatment methods. What is investigated in this project is the comparison of the prevalence of the two therapeutic methods of marsupialization alone and the combination of marsupialization and peripheral sect my in patients with odontogenic keratocytes regardless of whether they are syndromic or sporadic. Method and Materials: In this study, which is conducted on 10 patients referred to Behoney Hospital in Kerman. First, the patient is selected with clinical examinations and then with the preparation of panoramic radiographs. If there is visible swelling, aspiration is performed with a 10-cc syringe, and then the patient is operated on for a biopsy to definitively diagnose the odontogenic keratocyte of the tumor. In this study, there is no difference between the age and sex of the patient, and whether KOT is syndromic or sporadic; Both are included in the review. The patient is subjected to marsupialization, then the patient undergoes follow-up and periodic x-rays are used to ensure that the lesion shrinks. In the lesions where there is involvement of the surrounding bone in the form of a saucerization, after the lesion is reduced, the patients are treated with peripheral sect my or removal of the bone around the lesion in the form of a curt shape, and in small lesions, the treatment is completed with marsupialization. arrives. Then the patients are followed up and the recovery process and the rate of recurrence are checked by preparing periodical x-rays. Results: In this study, out of ten patients, 4 patients (40%) had recurrence, and among these 4 patients, 3 patients (75%) were in the first group who were treated with marsupialization. The follow-up of the patients was one year, and after the preparation of OPG, the reduction of cyst dimensions was compared to the size before the operation. The criterion for the recurrence of keratocyte odontogenic lesion is the increase in the size of the lesion according to the qualitative scale and the comparison of the graph prepared before and after marsupialization. Out of 4 patients with recurrence, one case in the second group (25%) is treated with marsupialization and peripheral sitcom, a ten-year-old boy has multiple jaw cysts in the front of the mandible, behind the maxilla on both sides, and behind the mandible on both sides. The maxillary sinus is left. According to the obtained results, the treatment of marsupialization with peripheral sect my has more effectiveness and the results had a significant difference. p value=0.043 Conclusion: According to the obtained results, the treatment of marsupialization with peripheral sitcom has more effectiveness and less recurrence.