Reclassification and treatment of odontogenic keratocysts: A cohort study

Abstract

The odontogenic keratocyst (OKC) is a recurrent cyst that has beenrecently reclassified from an odontogenic tumor to an odontogenic cyst.The aim of the present study was to investigate its treatment and addressissues related to its association with nevoid basal cell carcinoma syndrome(NBCCS). Lesions from the cohort of patients included in the present studyconsisted of 40 OKCs, of which 27 lesions were treated by enucleation(GE) and 13 underwent decompression (GD). Complementary treatmentoccurred in 38 (95%) lesions, of which 10 underwent isolated peripheralostectomy (GO) and 28 underwent peripheral ostectomy combined withCarnoy’s solution (GC). Thirteen lesions were associated with NBCCS(GS), while the others (n=27) were non-syndromic lesions (GnS). Therecurrence-free periods (RFP) in the sample groups were compared usingthe Kaplan-Meier function and log-rank test at a significance level of 5%(p < 0.05) and were used to calculate the cumulative risk of recurrence(CRR) in each postoperative year. During the follow-up period, whichhad a mean of 43.5 months (range: 12–102 months), six (15%) recurrenceswere diagnosed. There was no significant difference among the RFP forthe compared groups (p > 0.05) or increased CRR for the decompression(15.4%) over five years. Application of Carnoy’s solution did not increasethe efficacy of the peripheral ostectomy, but was related to a CRR of 0%for the syndromic lesions over five years. Therefore, 1) decompression didnot increase the recurrence risk; 2) peripheral ostectomy demonstrated asimilar efficacy as the combination with Carnoy’s solution; 3) the associationof NBCCS did not seem to significantly influence OKC recurrence; and 4)syndromic lesions seem to behave in the same manner as non-syndromiclesions when submitted to complementary treatments