open access

https://hdl.handle.net/2115/86838

Application of "Dredging Method" for the patients with odontogenic keratocyst.

英語

Conservative treatment

2022-09-15

Hokkaido association for dental science

Hokkaido journal of dental science

43

63-69

When conservative treatment such as enucleation is applied, odontogenic keratocyst (OKC) is a well-known jaw lesion with a high recurrence rate. Other treatment modalities aimed at preventing recurrence have been used for managing OKCs. In our institute, an alternative conservative approach, known as the dredging method, is applied in OKC treatment. This paper describes and reports the characteristics and outcomes of conservative treatments involving the dredging method and enucleation in the management of patients with OKC. Seventy-four patients with OKC or keratocystic odontogenic tumor (KCOT) presented to Oral and Maxillofacial Surgery at Hokkaido University Hospital between 1983 and 2017. They were treated and followed for more than 12 months. The patients’ median age was 40 years (range 7‒72 years) and the median longitudinal diameter of the lesion was 30 mm (range 7‒128 mm). A total of 14 cysts (18.9%) were multilocular, as determined via radiographic evaluation. The surgical intervention consisted of enucleation alone in 17 cases (22.3%), deflation followed by enucleation in seven cases (9.5 %), and the dredging method in 50 cases. Statistical significance associated with the size ( P = 0.01) and locularity ( P = 0.02) of the lesions was found between the cases treated with enucleation versus the dredging method. The median duration of follow-up was 40 months (range 12 to 405 months). Recurrence occurred in 9 of 74 cases (12.2%), including 2 of 17 cases (11.8%) treated with enucleation and 7 of 57 cases (12.3 %) treated wit h the dredging method. The recurrence period ranged from 12 to 131 months. All recurrence cases were managed by enucleation. There was no correlation between recurrence and patient sex or age, lesion size or locularity, the presence of a daughter cyst, or surgical approach. These results suggest that the dredging method is a s uccessful conservative treatment option for large, multilocular OKCs. Long-term regular follow-up is essential to identify and manage recurrent cases.

学術雑誌論文

Version of Record

0914-7063

AN00229778