Conservative management of an extensive odontogenic keratocyst in the anterior region of a pediatric patient’s jaw
Keywords:Odontogenic keratocysts; Marsupialization; Conservative treatment.
Odontogenic keratocysts (OKCs) are now considered benign cysts of odontogenic origin that are characterized by an aggressive behavior with a relatively high recurrence rate, particularly when OKCs are associated with syndromes. Its histological appearance is characteristic with the presence of an epithelial lining parakeratinized showing a corrugated surface, together with a number of architectural features of the epithelium as a thickness of six to eight layers and the presence of columns, palisade basal cell. Radiographically, the lesion is often unilocular radiolucent surrounded by margins smooth or jagged edges with sclerotic. OKCs are more frequently in the third decade of life. This article reports a case of a young patient with exuberant OKC on unusual anterior mandibular site underwent treatment that involved a 48-month period of decompression, followed by enucleation of the residual cyst. Preserving important structures of the bone and soft tissue decompression is a method with low morbidity. In addition, according to the literature, decompression has a success rate at least as high as the one of most aggressive treatments.
Al-Moraissi, E. A., Dahan, A. A., Alwadeai, M. S., et al. (2017). What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis. J Craniomaxillofac Surg, 45:131-44.
Al-Moraissi, E. A., Pogrel, M. A., & Ellis, E. (2016). Does the Excision of Overlying Oral Mucosa Reduce the Recurrence Rate in the Treatment of the Keratocystic Odontogenic Tumor? A Systematic Review and Meta-Analysis. Journal of Oral and Maxillofacial Surgery, 74:1974-82.
Antonoglou, G. N., Sandor, G. K., Koidou, V. P., et al. (2014). Non-syndromic and syndromic keratocystic odontogenic tumors: systematic review and meta-analysis of recurrences. J Craniomaxillofac Surg, 42:e364-71.
Bhargava, D., Deshpande, A., & Pogrel, M. A. (2012). Keratocystic odontogenic tumour (KCOT)--a cyst to a tumour. Oral Maxillofac Surg, 16:163-70.
Bilodeau, E. A., & Collins, B. M. (2017). Odontogenic Cysts and Neoplasms. Surgical Pathology Clinics, 10:177-222.
Blanas, N., Freund, B., Schwartz, M., et al. (2000). Systematic review of the treatment and prognosis of the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 90:553-8.
Buchbender, M., Neukam, F. W., Lutz, R., et al. (2018). Treatment of enucleated odontogenic jaw cysts: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol, 125:399-406.
Chrcanovic, B. R., & Gomez, R. S. (2016). Peripheral calcifying cystic odontogenic tumour and peripheral dentinogenic ghost cell tumour: an updated systematic review of 117 cases reported in the literature. Acta Odontologica Scandinavica, 74:591-7.
Cunha, J. F., Gomes, C. C., de Mesquita, R. A., et al. (2016). Clinicopathologic features associated with recurrence of the odontogenic keratocyst: a cohort retrospective analysis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 121:629-35.
da Silva, L. P., Serpa, M. S., Tenório, J. R., et al. (2016) Retrospective study of 289 odontogenic tumors in a Brazilian population. . Med Oral Patol Oral Cirurg Bucal, 21:271-5.
Dammer, R., Niederdellmann, H., Dammer, P., et al. (1997). Conservative or radical treatment of keratocysts: a retrospective review. Br J Oral Maxillofac Surg, 35:46-8.
de Castro, M. S., Caixeta, C. A., de Carli, M. L., et al. (2018). Conservative surgical treatments for nonsyndromic odontogenic keratocysts: a systematic review and meta-analysis. Clin Oral Investig, 22:2089-101.
de Souza, L. B., Gordón-Núñez, M. A., Nonaka, C. F., et al. (2010). Odontogenic cysts: demographic profile in a Brazilian population over a 38-year period. Med Oral Patol Oral Cir Bucal, 15:e583-90.
Estrela, C. (2018). Scientific Methodology: Science, Teaching, Research. Editora Artes Médicas.
Guo, Y. Y., Zhang, J. Y., Li, X. F., et al. (2013). PTCH1 gene mutations in Keratocystic odontogenic tumors: a study of 43 Chinese patients and a systematic review. PLoS One, 8:e77305.
Johnson, N. R., Batstone, M. D., & Savage, N. W. (2013). Management and recurrence of keratocystic odontogenic tumor: a systematic review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 116:e271-e6.
Khosravi, N., Razavi, S. M., Kowkabi, M., et al. (2013). Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010). Dent Res J (Isfahan), 10:162-7.
Kshirsagar, R. A., Bhende, R. C., Raut, P. H., et al. (2019). Odontogenic Keratocyst: Developing a Protocol for Surgical Intervention. Ann Maxillofac Surg, 9:152-7.
Marker, P., Brondum, N., Clausen, P. P., et al. (1996). Treatment of a large odontogenic keratocyst by decompression and later cystectomy. Oral Surg Oral Med Oral Pathol, 82:122-31.
Naruse, T., Yamashita, K., Yanamoto, S., et al. (2017). Histopathological and immunohistochemical study in keratocystic odontogenic tumors: Predictive factors of recurrence. Oncol Lett, 13:3487-93.
Nayak, M. T., Singh, A., Singhvi, A., et al. (2013). Odontogenic keratocyst: What is in the name? J Nat Sci Biol Med, 4:282-5.
Pogrel, M. A. (2015). The keratocystic odontogenic tumour (KCOT)--an odyssey. Int J Oral Maxillofac Surg, 44:1565-8.
Polak, K., Jedrusik-Pawlowska, M., Drozdzowska, B., et al. (2019). Odontogenic keratocyst of the mandible: A case report and literature review. Dent Med Probl, 56:433-6.
Sansare, K., Raghav, M., Mupparapu, M., et al. (2013). Keratocystic odontogenic tumor: systematic review with analysis of 72 additional cases from Mumbai, India. Oral Surg Oral Med Oral Pathol Oral Radiol, 115:128-39.
Sharif, F., Oliver, R., Sweet, C., et al. (2010). Interventions for the treatment of keratocystic odontogenic tumours (KCOT, odontogenic keratocysts (OKC)). Cochrane Database Syst Rev, CD008464.
Sharif, F. N., Oliver, R., Sweet, C., et al. (2015). Interventions for the treatment of keratocystic odontogenic tumours. Cochrane Database Syst Rev, 2015:CD008464.
Slusarenko da Silva, Y., Stoelinga, P. J. W., & Naclerio-Homem, M. D. G. (2019). Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysis. Oral Maxillofac Surg, 23:1-11.
Speight, P. M., & Takata, T. (2017). New tumour entities in the 4th edition of the World Health Organization Classification of Head and Neck tumours: odontogenic and maxillofacial bone tumours. Virchows Archiv, 472:331-9.
Stoelinga, P. J. W. (2019). Keratocystic odontogenic tumour (KCOT) has again been renamed odontogenic keratocyst (OKC). International Journal of Oral and Maxillofacial Surgery, 48:415-6.
Tabrizi, R., Hosseini Kordkheili, M. R., Jafarian, M., et al. (2019). Decompression or Marsupialization; Which Conservative Treatment is Associated with Low Recurrence Rate in Keratocystic Odontogenic Tumors? A Systematic Review. J Dent (Shiraz), 20:145-51.
Wright, J. M., Odell, E. W., Speight, P. M., et al. (2014). Odontogenic tumors, WHO 2005: where do we go from here? Head Neck Pathol, 8:373-82.
Yildirim, G., Ataoglu, H., Kalayci, A., et al. (2010). Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases. J Oral Maxillofac Res, 1:e7.
How to Cite
Copyright (c) 2021 Filipe Nobre Chaves; Jefferson Douglas Lima Fernandes; Samuel Rocha França; Denise Hélen Imaculada Pereira Oliveira; Marcelo Bonifácio da Silva Sampieri; Francisco Samuel Rodrigues Carvalho; Fábio Wildson Gurgel Costa; Karuza Maria Alves Pereira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.