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Odontogenic keratocyst (OKC) is a common developmental odontogenic cyst in clinic patients. Odontogenic cysts are often treated by enucleation, curettage, marsupialization and decompression. With apparent advantages, marsupialization and decompression are often the preferred option for adolescents with large jaw cysts. This article aimed to report a case of large OKC involving the left mandibular second molar and third molar in a 13-year-old adolescent. Decompression was performed to preserve the second molar and inferior alveolar nerve, and the third molar was extracted. After ten months of follow-up, cyst volume decreased significantly, and the impacted second molar erupted spontaneously through the bony window. Subsequently, the residual cyst was removed by enucleation. After 18 months, the second molar erupted to the occlusal plane and played a normal function. No evidence of recurrence was found during the entire follow-up period., Competing Interests: The authors declare no conflict of interests., (©2024 The Author(s). Published by MRE Press.)

Objectives: Optimal time to enucleation following marsupialization of large odontogenic mandibular cysts is undefined. We aim to assess volume reduction throughout follow-up, to indicate optimal time to enucleation. Secondary objectives include the identification of factors influencing cyst reduction., Study Design: We retrospectively enrolled 15 patients with mandibular cysts of different histological types treated with marsupialization at our center between 2018 and 2022. Cyst volume was assessed with cone-beam computed tomography (CBCT) and a semi-automatic segmentation algorithm, at baseline and between 6 and 8 months post marsupialization., Results: The overall mean cyst volume reduction percent (VR%) was 57.7 % or 0.2 % per day. VR% at 8 months was significantly higher than those assessed at 6 and 7 months (67.1% vs 47.1 %, p = 0.003). Time to CBCT was the only independent variable influencing cyst VR%., Conclusion: Our study proves that the optimal time to enucleation for mandibular cyst is 8 months, independent of histological cyst type, patient age, baseline cyst volume and the number of pre-operative residual bone walls., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Objectives: To document the case of a patient who underwent several endodontic treatments due to a glandular odontogenic cyst misdiagnosed as an inflammatory periapical lesion., Background: Glandular odontogenic cysts behave more aggressively, while others have an indolent course. There is limited information on this cyst in the gerodontologic literature., Materials and Methods: A 76-year-old male patient presented with an asymptomatic expansive lesion in the anterior mandible resistant to several endodontic treatments. Cone-beam computed tomography revealed a multilocular osteolytic lesion measuring 6.0 × 4.0 cm, with cortical bone perforation., Results: Histopathological analysis of a biopsy specimen was consistent with glandular odontogenic cyst. The patient underwent marginal mandibulectomy with preservation of the base of the mandible., Conclusion: A strict diagnostic process is important to avoid unwanted consequences, particularly in the geriatric population., (© 2024 Gerodontology Association and John Wiley & Sons Ltd.)

The study aimed to retrospectively analyze the reduction pattern of odontogenic keratocysts (OKCs) after decompression, followed by enucleation (EN), peripheral ostectomy (PO), and Carnoy's solution (CS) to establish the appropriate time for inserting implants, along with assessing the long-term success of conservative treatment with adjunctive therapy. The predictable variables were the reduction pattern and the study's treatment option. The outcome variable was the volumetric changes in the size of bony defects. These changes were determined using a percentage difference and a reduction rate. They were recorded after decompression and one, three, six, twelve, and eighteen months after EN. P-values of .05 were considered significant. The study included 66 patients with 71 OKCs. Males, younger ages, and mandibular OKCs significantly predominated. The decompression significantly changed the initial volume from 135.40 ± 1.2 cm 3 to 101.55 ± 0.1 cm 3 with 28.6 percentage difference and 25% reduction rate. At the end of the first and third months after EN, the reduction pattern is 50.0%-75.5% of the initial volume, with no significant prediction for the direction of the reduction pattern. After 18 months, all bony defects disappeared, with no recurrences for the next 18 years. In conclusion, the reduction pattern is 75.5% of its initial volume at the end of the third month after OKC management. Therefore, within the limitations of the study, its treatment approach seems to be an option amongst other protocols that includes a view to early implant based dental rehabilitation., Competing Interests: Declaration of competing interest The authors declared that the study has no personal relationship with any people or organization that inappropriately affect the work., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Mandibular buccal bifurcation cyst is a rare inflammatory odontogenic cyst. We reported two cases who complained of painful swelling of extraoral soft tissue. Intraoral examination revealed the partially erupted mandibular first molar. Cone beam computed tomography showed a well-defined cystic lesion surrounding the first molar. Histopathologic images showed the cyst wall was infiltrated by a large number of plasma cells, neutrophils and eosinophils, and lined with a thin layer of non-keratinized stratified squamous epithelium. Finally, the two patients were diagnosed as mandibular buccal bifurcation cyst and treated with cyst enucleation and curettage.

Objective: To evaluate the differences between two types of decompression for treating large mandibular odontogenic cysts., Materials and Methods: This retrospective, cohort study included patients who were diagnosed for large mandibular odontogenic cysts from January 2015 to April 2018 and underwent two different types of decompression based on removal or retention of the cyst wall. The primary outcome was the percentage of the residual cyst area within 1 year after surgery. We used the propensity score matching (PSM) to balance the covariates of the two groups, and the primary outcome was analyzed by the non-inferiority test., Results: A total of 93 cases were included in our study. After 1 year, the wall removal group was non-inferior to the wall retaining group in terms of cyst area, cyst volume, and the difference between the HU values of the original cyst region and the normal mandible. In subgroup analysis, we found there were no differences between two groups in the percentage of patients in whom the cystic area was reduced by 90% after 1 year., Conclusion: Our findings suggest that the wall removal group showed better results than the cyst wall retaining group in large mandibular odontogenic cysts., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.)

Background/objective: In this retrospective study, we aimed to investigate a new 3D evaluation method for evaluating bone regeneration after cystectomy of odontogenic cysts., Methods: The study included 26 patients who underwent cystectomies between 2012 and 2017 and had received either fillings or non-fillings with autologous iliac crest. Bony regeneration was analyzed using 3D imaging software and comparing identical regions of interest (ROIs) that were determined by exact overlays of the postoperative cone beam computer tomography (CBCT) or computer tomography (CT) images. Outcome measures, including volume changes according to the defect size and configuration, patient age, the entity and distribution of the cysts, were collected., Results: Twenty-six patients (5 women and 21 men) had 30 defects, including nine keratocysts, seven radicular cysts and 14 dentigerous cysts. A total of 73% of the defects were in the mandible. The mean 3D follow-up time was 12 months. According to the 3D evaluation of bony regeneration, the defect size and configuration showed no significant differences between the groups (filled or non-filled with 15 defects per group)., Conclusions: By establishing a standardized 3D method for evaluating bone regeneration, healing can be better monitored and evaluated.

Introduction: The odontogenic keratocyst (OKC), previously known as keratocystic odontogenic tumor has been the most disputable pathologies of the maxillofacial region. Patients with OKC are often asymptomatic but may present with pain, swelling, or discharge. Despite the aggressive nature, previous literature as early as 1970s reported the fact that parakeratinized OKC can be treated by means of marsupialization alone., Patients Concerns: The patient had reported with a complaint of pain and swelling in relation with a tooth in mandibular right quadrant., Diagnosis: This case report discusses features of a rare, extensive, panmandibular OKC that is only second of its kind mentioned in the literature., Intervention: As a usual treatment protocol, marsupialization was attempted first. Immunohistochemical analysis revealed reduced expression of Ki-67 and B cell lymphoma 2 (bcl-2) markers after marsupialization from 2 separate sites. However, due to incomplete resolution in the lower right anterior region, an aggressive approach was taken by curetting it out surgically along with associated teeth and cortical plate followed by application of Carnoy's solution., Outcome: Postsurgery uneventful healing of the lesion was noted on regular follow-up visits with complete resolution at 40 months. The case has been followed for 10 years with no sign of relapse and reoccurrence., Conclusions: Based on the expression of markers it can thus be concluded that Ki-67 and bcl-2 are site specific and bear strong relationship with the recurrence of OKCs.

Purpose: This study was conducted in order to determine whether marsupialization before definitive enucleation of nonsyndromic odontogenic keratocysts (OKCs) is capable of decreasing the recurrence rate more effectively than just enucleation., Methods: We searched MEDLINE, Web of Science, Scopus, and Cochrane Library, until August 5th of 2017 for original studies reporting on the treatment of OKCs with and without previous marsupialization and the related recurrence rate. All records and data were independently assessed, meta-analysis was performed, and the odds ratio of recurrence was the effect measure; P value for the summary effect of < 0.05 was considered statistically significant., Results: The 748 records retrieved were reduced to 6 studies to be qualitatively assessed and 5 studies were included in the meta-analysis. The overall odds ratio of 0.57 [0.25-1.28] of the pooled values pointed that marsupialization reduced the recurrence rate in comparison to just enucleation; however, the P value showed that there is no strong evidence to support this statement., Conclusions: Marsupialization followed by enucleation after 12 to 18 months reduces the recurrence rate, but more studies are necessary to support this statement.

This case report describes an interesting use of virtual surgical planning to fabricate tooth-borne cutting guides to assist in localization and enucleation of multiple recurrent odontogenic keratocysts close to the inferior alveolar nerve. The 3-dimensional models generated and cutting guides increased the accuracy and precision of the procedure and decreased surgical time and potential patient morbidity., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Alveolar bone cyst enucleation can give rise to critical-size defects whose healing may be incomplete due to the loss of periosteum or bone walls and there is a paucity of studies investigating the use of immediate bone grafts. The aim of this study was to compare spontaneous healing versus a deproteinized bovine bone graft., Methods: In this prospective randomized clinical pilot study, twenty patients requiring the removal of a cyst ≥20 mm in maximum diameter were randomly assigned to one of two groups: deproteinized bovine bone grafting (test) or spontaneous healing (control). Computed tomographies were obtained preoperatively and 12 months after surgery and the radiolucent volumes were compared. Residual radiological morphology and clinical outcomes at 7 days and 1, 6 and 12 months after surgery were also assessed., Results: The median percentage reduction in the volume of the defect was 98% in the test group and 73% in the control group (P=0.001) with an evidence of soft tissue invagination in the latter. There were no differences in the clinical parameters between the two groups., Conclusions: Within the limitations of this pilot study, the healing of critical-size alveolar bone defects is incomplete at 1 year observation and the use of deproteinized bovine bone graft did not influence the clinical outcomes.

Keratocysts, also known as keratocystic odontogenic tumors (KCOT), make up 7% of all odontogenic cysts and develop asymptomatically in most cases. Enucleation is the benchmark treatment. However, there are surgical alternatives. Marsupialization and decompression are necessary in some cases, mainly when the KCOT is large, thus causing an increased risk of bone fracture, or if it has engulfed important elements such as the inferior alveolar nerve or teeth, consequently causing alveolar bone growth failure. The authors describe the case of a nine-year-old child treated for a large keratocyst situated in sector 4 (lower right jaw), impacting both premolars and the canine (45, 44 and 43). Surgical decompression associated with orthodontic multiband treatment were delivered to pull, and then place the three teeth in occlusion on the dental arch. With seven years hindsight since the first surgical procedure and three years since finishing orthodontic treatment, the cooperation between orthodontists and surgeons can be considered a success, from both the functional and esthetic points of view., (Copyright © 2017 CEO. Published by Elsevier Masson SAS. All rights reserved.)

The gingival cyst of the adult is a relatively rare, benign odontogenic cyst that maintains an insidious growth rate. This article describes a case of a diminutive fibrotic overgrowth arising on the labial interproximal gingiva between the mandibular right canine and first premolar in a 68-year-old woman. Within 1 year, the lesion had increased in size and appeared vesicular. The morphologic changes warranted surgical excision and histopathologic review. The lesion was diagnosed as a gingival cyst. At a 4.5-month recall appointment, there was no evidence of recurrence. Early lesional detection can potentially mitigate mucogingival defects and improve clinical outcomes.

Purpose: Among the different surgical treatments for keratocystic odontogenic tumors (KOTs), there is no single method associated with a zero recurrence rate (RR). Thus, this study aimed to seek the best surgical treatment with the least RR using a weighted event rated meta-analysis., Materials and Methods: To address our study purpose, a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline was performed. An extensive search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was conducted to identify all relevant articles published without language restrictions from inception to August 2016. Relevant articles were selected based on the following inclusion criteria: prospective, retrospective, and case series studies that assessed various treatments in non-syndromic KOTs in which RRs were included. The predictor variable was treatment groups, namely: enucleation alone, enucleation with peripheral ostectomy, enucleation with Carnoy's solution application, enucleation with cryotherapy, marsupialization alone, decompression followed by residual cystectomy, and resection. The outcome variable was RR. A weighted RR using a random effect model (because of variation in follow-up time) with a 95% confidence interval (CI) was performed. Data analysis was performed using a comprehensive meta-analysis software., Results: A total of 2287 KOTs in 35 studies were included in this analysis. The weighted RR for various treatment techniques was as follows: enucleation alone (23.1%), enucleation with curettage (17.4%), enucleation and Carnoy's solution (11.5%), enucleation plus liquid nitrogen cryotherapy (14.5%), marsupialization alone (32.3%), decompression followed by residual cystectomy (14.6%), and resection (8.4%). The pooled weighted overall RR of KOTs for all different treatments was 16.6%., Conclusion: Radical resection remains the certain option for obtaining the lowest recurrence with KOTs. However, low recurrence accompanies enucleation with application of Carnoy's solution or cryotherapy as the first-line treatment for primary KOTs. Marsupialization (where indicated) must be followed by secondary cystectomy to minimize recurrence. We believe that to achieve the least possible morbidity, resections should be reserved for multiple recurrent lesions and possibly syndromic cases., (Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Botryoid cyst, a rare type of odontogenic cyst, is usually considered a multilocular variant of lateral periodontal cyst. It was first described in 1973, and up to the present less than a hundred cases have been reported in the literature. Botryoid cysts are characterized by a multilocular histologic finding and a higher risk of recurrence than lateral periodontal cysts. In this article, we present a case of botryoid cyst from our clinical practice, accompanied by literature review of previous cases reported in the literature so far. Study results showed that botryoid cysts mostly affected population in their fifties, with a slight female (53.5%) predominance over males (46.5%). The mandible was the most frequently affected region, accounting for 70 (83.3%) cases. Maxilla was only sporadically affected accounting for 14 (16.7%) cases. Radiographic appearance of botryoid cysts can be multilocular or unilocular. It is concluded that the recurrence rate is relatively high (30.1%), therefore long term follow up is needed.

The author presents an innovative device to decompress odontogenic cystic lesions of the jawbones. Its use and characteristics are described.

Purpose: The primary approach to treating large cystic lesions is controversial. The aims of the present study were to assess the effects of decompression before enucleation for the treatment of large cystic lesions and to compare the rate of decrease of keratocystic odontogenic tumor, ameloblastoma, and dentigerous cyst at specific times (preoperatively and at 6 months)., Patients and Methods: The study included 40 patients (mean age, 31.22 ± 8.78 yr) with large mandibular lesions (>3 cm). Decompression was used to release intraluminal pressure and decrease the volume of the lesion. Three-dimensional computed tomography was applied to all patients at the diagnosis stage and at 6 months after decompression. Volumetric analysis was performed using software designed for 3-dimensional measurement of volumes. Other variables, such as age, gender, and rate of decrease, were recorded., Results: There were important differences in rates of decrease between preoperative and 6-month lesion volumes. Statistical analyses showed no significant differences among groups for age, gender, and histologic lesion type (P > .05)., Conclusion: Decompression of large cystic lesions could be useful for surgical interventions without complications., (Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Controversy remains in understanding both the development and treatment for the odontogenic keratocyst (OKC). With recent changes in nomenclature recognizing the odontogenic keratocyst as a benign tumor, the debate over the proper course of treatment to limit recurrence and morbidity will continue. This study presents two cases where conservative treatment failed to prevent recurrence and each patient underwent resection of aggressive, multicystic OKCs to provide the best chance for definitive care without recurrence and limited morbidity.

Keratocystic odontogenic tumors (KCOTs) are known for unique and varied behavior, high recurrence rates, and distinctive histopathologic findings. Differential diagnosis and management of KCOTs may be challenging because other jaw lesions may present similar characteristics. Careful interpretation of cone beam computed tomograms and magnetic resonance images has great significance for precise assessment of KCOTs and their relationships to adjacent anatomic structures as well as for treatment planning. This case report describes a KCOT that developed in the left angle and mandibular ramus in association with a semierupted third molar.

Background: The keratocystic odontogenic tumours (KCOTs) account for between about 2% and 11% of all jaw cysts and can occur at any age. They are more common in males than females with a male:female ratio of approximately 2:1. Although they are benign, KCOTs are locally very aggressive and have a tendency to recur after treatment. Reported recurrence rates range from 3% to 60%. The traditional method for the treatment of most KCOTs is surgical enucleation. However, due to the lining of the cyst being delicate and the fact that they frequently recur, this method alone is not sufficient. Adjunctive surgical treatment has been proposed in addition to the surgical enucleation, such as removal of the peripheral bone (ostectomy) or resection of the cyst with surrounding bone (en-bloc) resection. Other adjunctive treatments proposed are: cryotherapy (freezing) with liquid nitrogen and the use of the fixative Carnoy's solution placed in the cyst cavity after enucleation; both of which attempt to address residual tissue to prevent recurrence., Objectives: To assess the available evidence comparing the effectiveness of interventions for the treatment of KCOTs., Search Methods: We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 17 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 2), MEDLINE via Ovid (1946 to 17 March 2015) and EMBASE via Ovid (1980 to 17 March 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases., Selection Criteria: Randomised controlled trials comparing one modality of intervention with another with or without adjunctive treatment for the treatment of KCOTs. Adults, over the age of 18 with a validated diagnosis of solitary KCOTs arising in the jaw bones of the maxilla or mandible. Patients with known Gorlin syndrome were to be excluded., Data Collection and Analysis: Review authors screened trials for inclusion. Full papers were obtained for relevant and potentially relevant trials. If data had been extracted, it would have been synthesised using the fixed-effect model, if substantial clinical diversity were identified between studies we planned to use the random-effects model with studies grouped by action provided there were four or more studies included in the meta-analysis, and we would have explored the heterogeneity between the included studies., Main Results: No randomised controlled trials that met the inclusion criteria were identified., Authors' Conclusions: There are no published randomised controlled trials relevant to this review question, therefore no conclusions could be reached about the effectiveness or otherwise of the interventions considered in this review. There is a need for well designed and conducted randomised controlled trials to evaluate treatments for KCOTs.

A glandular odontogenic cyst (GOC) is a developmental cyst that is a clinically rare and histopathologically unusual type of odontogenic cyst. GOCs are now relatively well-known entities; their importance relates to the fact that they exhibit a propensity for recurrence rates from 21% to 55%, similar to odontogenic keratocysts, and may be confused microscopically with central mucoepidermoid carcinoma. Furthermore, some microscopic features of GOCs may also be found in dentigerous, botryoid, radicular and surgical ciliated cysts. The present case report aims to describe a typical case of GOC, throwing light on its epidemiology and origin, as well as on its clinical, radiographic and microscopic features, which may be helpful for diagnosis in problematic cases, long-term follow-up and to determine the most appropriate treatment., (2015 BMJ Publishing Group Ltd.)

Objective: The treatment of large mandibular cystic lesions (diameter > 35 mm) is controversial. Few studies determine the inferior alveolar nerve function after decompression which is one of the major options for treating such lesions. We aim to investigate the recovery of inferior alveolar nerve function after decompression., Methods: Twenty-two patients with large mandibular cystic lesions, diagnosed as keratocystic odontogenic tumor, ameloblastoma, or dentigerous cyst, were included. Inferior alveolar nerve function was observed by monitoring the pulp vitality of involved teeth (n = 64) with electric pulp test before decompression and 1, 3, 6, 9, 12, and 24 months after decompression, respectively., Results: The pulp vitality of the involved teeth was significantly decreased before decompression. Recovery of pulp vitality could be observed after decompression, indicating the recovery of inferior alveolar nerve function. A majority (96.9%) of the vital pulp was preserved in the involved teeth after decompression., Conclusions: Recovery of inferior alveolar nerve function was remarkable in patients with large mandibular cystic lesions after decompression, indicated by the recovery of pulp vitality of involved teeth. When decompression is preferred, conservative therapy rather than root canal therapy is recommended for the teeth with root tip exposed in the cystic lesions and without pulposis., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Glandular odontogenic cyst is a newly determined jaw entity with aggressive behavior and a high rate of recurrence. There is histopathologic resemblance to other lesions of the jaw such as intraosseous mucoepidermoid carcinoma. Although enucleation and curettage are not the treatment of choice for this cystic lesion, they comprise the most common method. On the other hand, filling the defect is a controversial matter, especially in lesions with large size. We introduce 4 cases of GOC, of which 2 are cases of recurrence. We applied bone material substitutes in 3 of these cases with success., (Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: In the treatment of cancer in the head and neck region, computer-assisted surgery can be used to estimate location and extent by segmentation of the tumor. This article presents a new tool (Smartbrush), which allows for faster automated segmentation of the tumor., Methods: This new method was compared with other well-known techniques of segmentation. Thirty-eight patients with keratocystic odontogenic tumors were included in this study. The tumors were segmented using manual segmentation, threshold-based segmentation and segmentation using Smartbrush. All three methods were compared concerning usability, time expenditure and accuracy., Results: The results suggest that segmentation using Smartbrush is significantly faster with comparable accuracy., Conclusions: After a period of adjustment to the program, one can comfortably get reliable results that, compared with other methods, are not as dependent on the user's experience. Smartbrush segmentation is a reliable and fast method of segmentation in tumor surgery., (Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Purpose: To evaluate the efficiency of decompression in treating odontogenic cystic lesions of the jaws in children., Materials and Methods: All consecutive odontogenic cysts occurring in children and treated by decompression from 1994 to 2009 at 1 maxillofacial center were included in the present study. Clinical data included age, gender, jaw, histopathologic diagnosis, and decompression time. Radiologic data from panoramic radiographs before and after decompression included tooth involvement, locularity, location, involvement of adjacent vital anatomic structures, and cyst area., Results: Thirty-two odontogenic cystic lesions from 26 children (14 boys [53.8%] and 12 girls [46.2%]) treated with decompression were included. The average age at the time of presentation was 11.6 ± 3.3 years (range, 7 to 18 yr). The mandible was involved in 13 cases (40.6%) and the maxilla in 19 (59.4%). All cysts were unilocular at presentation. Twenty-seven cysts (84.4%) showed tooth involvement. The diagnoses consisted of dentigerous cysts (20 [62.5%]), keratocysts (9 [28.1%]), and radicular cysts (3 [9.4%]). The mean decompression period was 7.45 ± 2.6 months (2 to 14 months). The mean standard lesion area index changed from 12.7 ± 0.9 mm(2) (3.6 to 44 mm(2)) before compression to 2.3 ± 4.3 mm(2) (0 to 22.3 mm(2)) after decompression. The mean percentage of reduction (POR) was 82 ± 16% (49 to 100%). The POR was ranked as good in 22 lesions (69%), moderate in 9 lesions (28%), and poor in 1 lesion (3%). Surgery was performed for 15 lesions (47%)., Conclusion: Decompression results in good regeneration potential of the bone in the developing craniofacial skeleton of children. Children might benefit from a less invasive surgical protocol., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Glandular odontogenic cyst (GOC) is a rare odontogenic cyst derived from the odontogenic epithelium. GOC shows unpredictable and potentially aggressive behavior. Although enucleation and curettage are applied in most cases, the recurrence rate remains relatively high. Because a standard care procedure for GOC has not been established, we propose a new treatment procedure for GOC. In this case report, we describe a 62-year-old Japanese woman who suffered from GOC arising at the anterior region of her mandible and who was treated using the dredging method. She underwent enucleation and curettage twice using the dredging method with preservation of the teeth, which were involved with the lesion, but the lesion recurred 2 years later. In addition to enucleation and curettage, apicoectomy of the teeth was performed with a third dredging method procedure, and prognosis has been good with no recurrence for 18 months since the last treatment.

Purpose: Odontogenic keratocysts (OKCs) have high recurrence potential. The aim of the study is to evaluate the correlation of radiographic features and treatments with the frequency of recurrence in OKCs in the mandible., Materials and Methods: This is a cohort retrospective study. The size of the lesions was measured on orthopantomography. Radiographic features (unilocular or multilocular), location, treatment type (enucleation or marsupialization), follow-up time, age, and sex were variable factors. Subjects were studied in 2 groups: a recurrence group and a nonrecurrence group. The radiographic size was considered to be a predictive factor, and the frequency of recurrence was an outcome of the study. An independent t-test and chi-squared test were used to compare variables between recurrence and nonrecurrence groups. Cox regression was applied to the time effect evaluation of the lesion's size and recurrence. A receiver operating characteristic test was used to find a cutoff point for recurrence in the size of radiographic views., Results: Ninety-one subjects were studied. Radiographic features and sizes were different between the 2 groups. The frequency of recurrent lesions was significantly different in various sites of the mandible. Cox regression demonstrated a positive effect of follow-up time on the risk of recurrence. In a 1-year increase in the follow-up time, the recurrence rate increased 1.07 times. An analysis of the data showed a positive relationship between radiographic size and recurrence rate. A 1-cm increase in the lesion's size increased the recurrence rate 1.67 times. A receiver operating characteristic test demonstrated 5.25 cm as a cutoff point in radiographic size; the radiographic size sensitivity was 88.5% (69.8%-97.4%), and specificity was 93.8% (85%-98.3%) for recurrence lesions. Lesions that were 5.25 cm or more on radiographic views had a significant relationship with recurrence rate (P < 0.05). The positive predictive value was 85.2% (65.4%-95.1%), and the negative predictive value was 95.3% (86%-98.8%)., Conclusions: The radiographic size may be a predictive factor for the frequency of recurrence lesions in OKCs. Primary multilocular lesions had a greater probability for recurrence than unilocular lesions.

Purpose: The purpose of this study was to report the histopathologic findings after postdecompression definitive treatment of odontogenic cystlike lesions and determine whether the diagnosis was consistent with the pretreatment diagnosis, thereby answering the clinical question: does decompression change the histologic diagnosis?, Materials and Methods: The authors implemented a retrospective cohort study from a sample of patients diagnosed with a benign odontogenic cystlike lesion and who underwent decompression followed by definitive surgery as part of their treatment. The predictor variable was treatment by decompression and the dependent variable was change in histologic diagnosis. Age, gender, and lesion location were included as variables. The χ(2) test was used for statistical analysis of the categorical data and P values less than .05 were considered statistically significant., Results: Twenty-five cysts and cystlike lesions in 25 patients were treated with decompression followed by enucleation and curettage. The mean age was 34 years (range, 13 to 80 yr) and 56% (14) were male patients. Lesions were located in the mandible in 76% (19 of 25) of patients. Postdecompression histologic examination at the time of definitive surgical treatment was consistent with the preoperative biopsy diagnosis in 91% (10 of 11) of keratocystic odontogenic tumors, 67% (2 of 3) of glandular odontogenic cysts, 75% (3 of 4) of dentigerous cysts, and 100% (7 of 7) of cystic ameloblastomas., Conclusions: The histologic diagnosis at time of definitive treatment by enucleation and curettage is consistent with the predecompression diagnosis. Therefore, all lesions should be definitively treated after decompression based on the initial lesion diagnosis, with all patients placed on appropriate follow-up protocols., (Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. All rights reserved.)

Disturbances of tooth development may result in anomalies which appear in the form of swelling of the overlying mucosa of the erupting deciduous or permanent teeth, mostly in children. Eruption cyst (EC), a benign cyst is one such lesion associated with erupting teeth. ECs usually present as solitary swellings on the alveolar ridge mucosa, whereas multiple ECs presenting simultaneously or in short intervals are unusual. Here, we present a rare case of four large bilateral ECs presenting with swellings and pain in the posterior region of each quadrant in the mouth. The treatment included surgical excision under general anaesthesia and exposure of the unerupted primary teeth.

Botryoid odontogenic cysts (BOC) are considered to be rare polycystic variants of lateral periodontal cysts characterized by a multilocular growth pattern. The most frequent location of BOC is the mandible, predominantly the premolar-canine area, followed by the anterior region of the maxilla. The cyst shows a slight female predilection. This case report of a BOC demonstrates a treatment with initial fenestration and decompression of the cyst in order to prevent damage to adjacent structures such as the inferior alveolar nerve. The present case report emphasizes the importance of accurate clinical, radiographic, and histologic diagnostic procedures of unspecific radiolucent lesions in the jaws to establish a firm diagnosis and avoid inappropriate treatment strategies.

Purpose: To answer the clinical question: Among patients treated for odontogenic keratocysts (OKCs), what is the overall 5-year disease-free rate and what factors are associated with disease recurrence?, Materials and Methods: The investigators implemented a retrospective cohort study and enrolled a sample composed of patients presenting for the evaluation and management of previously untreated OKCs. The predictor variables were grouped into demographic, medical, radiographic, and operative categories. The primary outcome variable was time to lesion recurrence. Data analyses were performed using univariate and bivariate or multivariate Cox proportional hazards models., Results: The study sample was composed of 31 patients (31 OKCs) with a mean age of 41.0 years. Of the 31 OKCs treated, 19 (61.3%) were treated with decompression with or without residual cystectomy and 12 (38.7%) were treated with enucleation with or without adjunctive therapy. There were 8 recurrences in 8 patients, with a median time to recurrence of 17.8 months (interquartile range, 13.4 to 26.4 months). The 5-year disease-free estimate was 51.2% (95% confidence interval, 37.2%-65.2%). Multiloculated lesions were 33.6 times more likely to recur than unilocular lesions., Conclusion: This may be the first study looking at disease recurrence after treatment of OKCs using appropriate statistical analyses for a time-dependent outcome (disease recurrence). The risk for recurrent disease is higher in this report than in many other studies and raises the issue that other reports may have underestimated the risk for recurrent disease owing to inappropriate statistical methods for assessing time-dependent outcomes., (Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without extraction of the adjacent tooth was performed. Lesion samples were sent for histopathological analysis. The histopathological analysis revealed a thin, non keratinised stratified squamous epithelium resembling reduced enamel epithelium. Epithelial plaques were also seen. A clinicopathological correlation incorporating the surgical, radiographical and gold standard histopathological findings was obtained to suggest the final diagnosis of the bilateral lateral periodontal cyst.

Clinical, histological and immunohystochemical studies of keratocystic tumors were performed showing differences in proliferative activity and MMP-9 expression scores in orthokeratinized and parakeratinised cysts. These histological features are associated with clinical course and may be used as markers for recurrence probability.

Introduction: Odontogenic keratocyst (OKC) is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy's solution, peripheral ostectomy with or without Carnoy's solution, and jaw resection have been discussed in the literature with variable rates of recurrence., Case Report: We presented a 52-year-old male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 x 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy's solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention., Conclusion: Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy's solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS). Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful results.

The odontogenic keratocyst (OKC) is distinctive among jaw cysts given its tendency toward recurrence and aggressive clinical behavior. This paper presents a well-documented case of OKC and a review of the diagnostic features, treatment modalities and new evidence supporting the reclassification and renaming of this unique pathologic process.

An odontogenic keratocyst is a unique cyst because of its locally aggressive behavior, high recurrence rate, and characteristic histologic appearance. In this article we present the case of a 22-year-old male patient with a large odontogenic keratocyst and describe his treatment with immediate dental implants.

Background and Purpose: The odontogenic keratocyst (OKC) is an unusual cyst with a high recurrence rate. The most common site for OKCs is by far the mandible. The best treatment of OKC remains controversial. Recurrence rates ranging anywhere from less than 10% to more than 60% have been reported. The aim of our study was to evaluate marsupialization as a treatment option for OKC., Methods: We managed 13 patients (8 male, 5 female) between the ages of 16 and 31 years (mean, 22.4 y) with biopsy-proven OKC. Radiographically, the patients' cyst sizes were between 25 and 90 mm. Treatment consisted of marsupialization. We followed up with patients for a total duration of at least 60 months, and posttreatment visits were carried out at 6-month intervals., Results: We documented cured or reduced cyst size with radiography. The odontogenic keratocyst resolved completely in 10 patients, and the cyst walls shrank in 3 patients. The latter patients required a second operation to remove the associated impacted teeth. A histologic evaluation of 3 lesions showed metaplasia. Any case of recurring cysts was not seen during the entire follow-up period., Conclusions: Marsupialization is an effective and conservative treatment option for OKC. Nevertheless, future studies should conduct even longer follow-up periods to evaluate any recurrence of lesions.

Background: The glandular odontogenic cyst is a rare jawbone cyst that is considered to be an independent entity, although its histopathological characteristics may lead to an incorrect diagnosis as a low-grade mucoepidermoid carcinoma. The treatment of glandular odontogenic cysts is controversial., Case Report: We present two high-risk cases treated with conservative approaches, one by enucleation and curettage and the other by marsupialisation. This report also presents a review of the clinical and pathological aspects of glandular odontogenic cysts, and considers their development. No evidence of disease was observed after 3 years of follow-up in the two cases presented., Conclusions: When possible, treatment plans for these lesions should be customised for each case, taking into account the data available in the literature and patient preferences. For high-risk cases, that are treated with conservative approaches, such as the two cases presented here, strict and regular controls and rigorous radiological follow-up evaluations are mandatory., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

The glandular odontogenic cyst (GOC) is a rare odontogenic cyst. Although none of the clinical or radiographic features of GOC are unique or pathognomonic, the lesion has a potentially aggressive behavior. Treatment of GOC includes curettage and enucleation or excision and cryotherapy; however marginal resection is usually considered a more reliable approach due to the low incidence of recurrence. In this article, we present a case with GOC which recurred five years after the initial surgical treatment.

Decompression is a conservative treatment that has frequently been used in the treatment of large odontogenic cysts. Techniques described in the recent literature have involved only fixation of a stent to soft tissue. In the present investigators' experiences, this technique has a high failure rate because of the dislodgement of the stent, due to tearing of the sutures over the course of a long-span treatment period. This report describes the use of a molded plastic stent that is fixated to bone and soft tissue, allowing access for daily irrigation during the long-span treatment period., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Odontogenic keratocyst (OKC) is a unique cyst because of its locally aggressive behaviour, high recurrence rate and characteristic histological appearance. A radical surgical approach is commonly advocated with morbid and disfiguring results. This approach also presents several reconstructive obstacles especially in anterior mandible. In this case report the authors present a 25-year-old male patient with a large OKC and treatment with decompression followed by enucleation, and chemical cauterisation. This approach though demanding prolonged treatment time and postoperative follow-up decreases the morbidity to a great extent in a young individual. At the same time, it allows an opportunity for the maxillofacial surgeon to preserve the natural dentition, maintain function and safeguard cosmesis. In our case, the authors effectively achieved all the aforementioned objectives. At the same time a radical option of treatment is still left in the armoury if required at a later date.

Objective: To evaluate the effect of fenestration and suction drainage in the treatment of large odontogenic mandibular cystic lesions., Methods: From 2005 to 2009, 24 cases of large odontogenic mandibular cystic lesions were treated with fenestration and suction drainage. The clinical symptoms and radiographical findings were evaluated before the operation and at 1 month and 6 months after suction drainage., Results: Follow-up for 1-3 years showed that all the cystic lesions disappeared without recurrence, and the clinical symptoms were resolved., Conclusion: Fenestration and suction drainage can reduce the cystic size and rapidly correct the deformity to serve as a useful modality for primary management of large odontogenic mandibular cystic lesions.

The glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin with unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency towards recurrence. GOC can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma. This paper reports a case of GOC in a 56-year-old male and reviews the main criteria for accurate diagnosis. The diagnosis of GOC can be extremely difficult due to the rarity of the cyst and lack of clear diagnostic criteria., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)