Surgical treatments for nonsyndromic odontogenic keratocysts

Data sourcesPubMed/MEDLINE, Science Direct, Web of Science, Scopus and the Cochrane Library were searched until October 2017.Study selectionClinical trials, controlled trials, retrospective studies and case series containing at least ten cases with a minimum follow-up of ten years of patients treated with marsupialisation or decompression with or without enucleation, and enucleation alone evaluating the recurrence rates.Data extraction and synthesisTwo reviewers independently assessed for eligibility and extracted data. The level of agreement between reviewers was calculated. The quality of the included studies was assessed using the Methodological Index of Nonrandomised Studies (MINORS) scoring system and the Newcastle Ottawa Quality Assessment Scale (NOS).Data were combined in meta-analysis using a fixed effect model of the calculated odds ratio with 95% CI for each comparison.ResultsTwenty-nine studies were included in the review. Of those 25 were characterised as retrospective studies, one cohort and three case series. Of the 1321 cases 99 were marsupialisation; 45 received marsupialisation followed by enucleation; 27 were treated by decompression; 101 received decompression followed by enucleation and 1049 cases were treated by enucleation alone.The recurrence rate for decompression followed by enucleation was 11.9% (95% CI 5.6 to 18.2%), marsupialisation followed by enucleation 17% (95% CI 6.6 to 28.9%), enucleation 20.8% (95% CI 18.3 to 23.2% ), decompression alone 18.5% (95% CI 8.2 to 28.9%) and marsupialisation 18.2% (95% CI 10.6 to 25.8%).ConclusionsThe authors concluded that there is a significant superiority for OKC treatment when decompression is used before enucleation OR 0.48 (95% CI 0.22 to 1.08).