How well do we manage the odontogenic keratocyst? A multicenter study

Area of Science:

• Oral and Maxillofacial Surgery
• Oncology
• Surgical Pathology

Background:

• Odontogenic keratocysts (OKCs) are cystic jaw lesions known for their high recurrence rates.
• Understanding factors influencing OKC recurrence is crucial for effective patient management and treatment planning.

Purpose of the Study:

• To determine the 5-year disease-free rate following treatment for odontogenic keratocysts (OKCs).
• To identify demographic, medical, radiographic, and operative factors associated with OKC disease recurrence.

Main Methods:

• A multicenter retrospective cohort study analyzed 231 previously untreated odontogenic keratocysts (OKCs).
• Predictor variables included patient demographics, medical history, radiographic features, and surgical techniques.
• Time to lesion recurrence was the primary outcome, analyzed using bivariate and Cox proportional hazards models.

Main Results:

• A total of 231 OKCs were analyzed, with 44 recurrences (19%) observed.
• The median time to recurrence was 26.7 months.
• Treatment modalities included decompression with residual cystectomy (24.7%), enucleation without adjuvant therapy (37.2%), and enucleation with peripheral ostectomy (33.8%).

Conclusions:

• The estimated 5-year disease-free rate for odontogenic keratocysts (OKCs) was 29%.
• Factors significantly associated with increased recurrence risk included mandibular location, multilocular lesion characteristics, and treatment with decompression and residual cystectomy.