Clinical indications for radical resection of odontogenic keratocyst: A systematic review.

Autor:	Bushabu FN; Department of Oral and Maxilla-Facial Surgery, Oral Maxillofacial Head and Neck Oncology Service, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo, Head and Director of the National Center Laboratory of Oral Biomedicine, Ministry of Research Innovation and Technology, Democratic Republic of the Congo., Titinchi F; Department of Maxillo-Facial and Oral Surgery, Faculty of Dentistry and WHO Collaborating Centre, University of the Western Cape, Cape Town, South Africa., Bing L; Department of Oral Maxillofacial Head and Neck Oncology Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, P.R. China., Davda L; University of Portsmouth Dental Academy, Faculty of Science and Health, University of Portsmouth, PO1 2QG, Portsmouth, United Kingdom.
Jazyk:	angličtina
Zdroj:	National journal of maxillofacial surgery [Natl J Maxillofac Surg] 2023 May-Aug; Vol. 14 (2), pp. 177-184. Date of Electronic Publication: 2023 Jul 13.
DOI:	10.4103/njms.njms_90_22
Abstrakt:	The aim of this study was to identify clinico pathological indications for radical resection of odontogenic keratocysts (OKCs) in the literature and formulate clinical guidelines for the management of OKCs based on these findings. A systematic review of the literature was undertaken in September 2021 in PubMed/Medline, Scopus, Web of Science, Google Scholar, and Cochrane databases. The following MeSH Keywords terms were used in the search strategies: (odontogenic keratocyst) OR (keratocystic odontogenic tumor) OR (primordial cyst) AND (treatment) OR (Radical resection) OR (Resection of OKC) OR (Treatment methods). Eligibility criteria included publications of clinical studies on histologically confirmed OKCs which underwent radical resection. Studies with less than 5 OKCs, experimental studies, epidemiological studies, studies that included orthokeratinized odontogenic cyst, and review papers were excluded. Ten studies on OKCs reporting on segmental or marginal resections were identified and analyzed qualitatively. Of the total of 221 OKCs that underwent radical resection, 67 OKCs were primary, 30 were recurrent, and the remaining were unclear whether they were primary or recurrent. Segmental mandibulectomy was performed in 131 OKCs, marginal mandibulectomy in 87 OKCs, and 3 OKCs were treated by partial maxillectomy. The main indications for radical resection were multilocular appearance, large OKCs (> 5 cm), multiple recurrent OKCs with or without cortical perforation, and malignant transformation. In conclusion, radical resection has its place in the management of OKC. It is indicated when there is an aggressive lesion with bony perforation, involvement of the pterygoid musculature or skull base, and malignant transformation. The surgeon should aim to identify these features to manage OKC appropriately and to prevent multiple recurrences. Clinical guidelines for the management of OKCs are proposed. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 National Journal of Maxillofacial Surgery.)
Databáze:	MEDLINE
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