Long-term follow-up on keratocysts treated according to a defined protocol

Area of Science:

• Oral and Maxillofacial Surgery
• Pathology
• Oncology

Background:

• Odontogenic keratocysts (OKCs) are known for their high recurrence rates and potential for aggressive behavior.
• Accurate diagnosis and effective treatment protocols are essential for managing OKCs and preventing complications.

Purpose of the Study:

• To evaluate the clinical presentation, treatment outcomes, and recurrence patterns of odontogenic keratocysts.
• To assess the efficacy of a defined surgical protocol involving Carnoy's solution compared to simple enucleation.

Main Methods:

• Prospective study of 82 odontogenic keratocysts in 80 patients over 25 years.
• Correlation of clinical and radiographic data to understand presentation and complications.
• Comparison of treatment outcomes between simple enucleation and a protocol involving mucosal excision, enucleation, and Carnoy's solution.

Main Results:

• Recurrence rate was significantly lower (3/82) in the group treated with the defined protocol versus simple enucleation (6/82).
• Most recurrences occurred within 5 years, but late recurrences were observed even after 25 years.
• The defined protocol provided a more accurate diagnosis prior to surgery in 60% of cases.

Conclusions:

• The suggested treatment protocol and follow-up schedule are effective in managing odontogenic keratocysts.
• Long-term follow-up is critical for detecting late recurrences of odontogenic keratocysts.
• This approach offers a safe method for managing a lesion with a propensity for recurrence and potentially life-threatening outcomes.