Odontogenic myxoma: An updated analysis of 1,692 cases reported in the literature

Objective. To integrate the available data published on odontogenic myxoma (OM) into a comprehensive analysis of its clinical/radiologic features.Methods. Electronic search undertaken in January/2018, looking for publications reporting cases of OM.Results. 377 publications included. We identified 1692 lesions and 695 were used for analysis of recurrence. There is predominance of OMs in females and in mandibles. OMs usually present with bone expansion, asymptomatic cortical perforation, multilocular. Lesion location (maxilla/mandible), bone expansion, cortical bone perforation, locular radiological appearance, tooth resorption, odontogenic epithelial rests or angular septa are not associated with recurrence. While curettage (31.3%) showed the highest recurrence rate, marginal resection (1.3%) and segmental resection (3.1%) showed the lowest values. Enucleation + peripheral osteotomy (6.7%) showed better results than enucleation (13.1%) or enucleation + curettage (12.7%). In comparison to unilocular lesions, multilocular ones were significantly more prevalent in mandibles, more often presented expansion and cortical bone perforation, had larger mean size, and were more often treated by segmental resection.Conclusion. Conservative surgical procedures are associated with higher probability of recurrence of OM. Taking into consideration the recurrence rate and morbidity associated with different surgical treatments, tumor enucleation followed by peripheral osteotomy should be considered as the first therapeutic choice

Gingival cyst of the adult, lateral periodontal cyst, and botryoid odontogenic cyst : an updated systematic review

Objective. To integrate the available data published on gingival cyst of the adult (GCA), lateral periodontal cyst (LPC) and botryoid odontogenic cyst (BOC) into a comprehensive analysis of their clinical/radiologic features.Methods. An electronic search was undertaken in July/2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis.Results. 146 publications (157 GCAs, 213 LPCs, 96 BOCs) were included. GCA and LPC presented highest prevalence in the sixth/fifth decades; BOC in the sixth/seventh decades. LPCs were larger lesions than GCAs and GCAs appeared at an older age than LPC. There was no statistically significant difference between them for other factors (location, symptoms, recurrence, follow-up time). In comparison to LPC, BOC lesions were larger, appeared more often in mandible and in older subjects, had more often a multilocular appearance, and presented a higher recurrence rate. Recurrence rates: GCA (3.2%), LPC (2.4%), BOC (21.7%). No factor seems to influence the recurrence rate of GCA or LPC. Multilocular radiological appearance seems to affect the recurrence rate of BOCs.Conclusions. Conservative surgical approaches seem to be enough for GCA/LPC. BOC presents a more aggressive behavior than GCA/LPC. Therefore, treatment of this lesion might involve some kind of adjunctive therapy after enucleation