Recurrence rate of the odontogenic keratocysts patient cohort in a UK regional maxillofacial surgery unit

Abstract

AbstractBackgroundDespite the benign nature of odontogenic keratocyst (OKC), the reported recurrence rates range from 3% to 60% depending on the treatment modality. Surgical enucleation alone is often insufficient to prevent recurrence, thus adjunctive therapies have been adopted. The aim of this study was to determine the recurrence rate of OKC, both sporadic and those associated with naevoid basal cell carcinoma syndrome based on the treatment modality.Materials and MethodsTwo hundred patients diagnosed and treated between 2012 and 2021 for OKC were identified, from which 72 were excluded because of inadequate clinicopathological data. Forty‐four (34.3%) patients were cases of syndromic and 84 (65.5%) sporadic OKC.ResultsThe most common surgical procedure was enucleation alone (45%) followed by enucleation and removal of the associated tooth (28.1%). Carnoy's solution was the most used adjunctive method (14.7%). The overall recurrence rate of sporadic OKC in our study was 18.7% which was in line with the 16.6% reported by Al‐Moraissi et al. in their systematic review.ConclusionsSyndromic cases were statistically significantly more likely to recur at the same site of the surgery than sporadic cases (p < 0.05) with a recurrence rate of 52% (23 out of 44). Overall, adjunctive treatments to enucleation alone are associated with a lower recurrence rate but no one method eliminates recurrence.Practical ImplicationsIncisional biopsy and diagnosis of OKC can better tailor definitive treatment. Syndromic OKC is associated with a higher recurrence rate, and adjunctive treatments to enucleation alone help in reducing recurrence rate.