The Use of Carnoy’s Solution and Its Modifications for Reducing the Number of Recurrences after Surgical Removal of Keratocystic Odontogenic Tumors and Ameloblastomas: A Systematic Review

Abstract

The paper is a systematic review of using the pharmaceutical substance, Carnoy’s solution, to reduce the number of recurrences of such tumors as keratocystic odontogenic tumor and ameloblastoma. These are benign yet aggressive jaw tumors with a high percentage of recurrences (up to 60–80%). Surgical treatment of the above-described lesions can be performed using: (1) marsupialization (recurrence rate up to 24.8%); (2) enucleation with or without adjunct therapy; therapy may include cryotherapy with liquid nitrogen (recurrence rate up to 23.1%), peripheral ostectomy (recurrence rate up to 20%), and bone cavity treatment with Carnoy’s solution (recurrence rate up to 6.6%); (3) marginal/segmental resection of the jaw (recurrence rate up to 2.5%). Despite the low percentage of recurrences when using marginal/segmental resection, this method requires a longer and more expensive anesthetic and surgical intervention as well as longer postoperative and rehabilitation periods. With the use of Carnoy’s solution, it became possible to reduce the risks of recurrence of keratocystic odontogenic tumors and ameloblastomas from 60–80 to 6.6‒11.5%. Worldwide today, not only Carnoy’s solution recommended by Cutler and Zollinger in 1933 is applied but also its modifications that are not inferior to the original substance in terms of removal efficiency of the remaining cystic cells. The safety of the use of the solution near the vessels and nerves is confirmed by works of a number of authors. It is concluded that, despite the large number of surgical treatments of both keratocystic odontogenic tumors and ameloblastomas, enucleation with the use of Carnoy’s solution is the optimal method of choice for these diseases.