Keratocystic odontogenic tumor: A retrospective study of 64 cases

Aim: The purpose of this retrospective study was to evaluate the clinicopathological features of 64 patients with keratocystic odontogenic tumor (KCOT). Materials and Methods: The patients ranged in age at the time of diagnosis from 8 to 74 years (mean: 38.20 ;plusmn; 16.71). Postoperative follow-up period was 3-8 years (mean time 4.76 ;plusmn; 1.10). This research was carried out on panoramic radiographs and histopathological samples. Data such as gender, age, treatment methods, location of the tumor, presence of impacted teeth and its histological features were subjected to descriptive statistical analyses with the statistical software program. Results: Of the 64 analyzed cases of KCOT, 68.8% of them were men and 31.2% were females (male-to-fem ale ratio was 2.2:1 ). It was observed that KCOT peaked in the third an d fifth decade of life (23.4%-20.3%). The incidence of KCOT was higher in the mandible than in the maxilla (76.6%-23.4%). There was recurrence in nine out of 64 subjects (14.1%) in the follow -up period. The recurrence was more often found in posterior mandible. It is noteworthy that in 9 recurren t subjects , 7 lesions were parakeratotic and 4 lesions were associated with daughter cysts. Conclusion: Although there are several studies about KCOT in the literature, the choice of treatment modalities remains controversial. In recurrent subjects, more aggressive therapy approach es should be considered. Periodic controls and aggressive treatment approach es may be effective in the prevention of recurrences.Amaç: Bu retrospektif çalışma da, keratokistik odontojenik tümör (KOT) tanısı konmuş 64 hastanın klinikopatolojik özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Hastaların yaş aralığı 8 ile 74 yaş aralığında değişiklik gösteriyordu (ortalama: 38.20±16.71). Postoperatif takip süresi 3 ile 8 yıl arasındaydı (ortalama: 4.76±1.10). Çalışmada panoromik radyografiler ve histopatolojik örnekler değerlendirildi. Cinsiyet, yaş, tedavi yöntemleri, tümörün lokalizasyonu, gömülü diş varlığı ve tümörün histolojik özellikleri gibi veriler istatistiksel yazılım programı yardımı ile tanımlayıcı istatistiksel analizlere tabi tutuldu. Bulgular: 64 KOT vakası incelendiğinde olguların%68.8’ini erkekler % 31.2‘sini ise kadınlar oluşturuyordu (kadın/erkek oranı 1:2.2). KOT’un hayatın üçüncü ve beşinci on yılı içinde pik yaptığı bulundu (%23.4-%20.3). KOT insidansı mandibulada maksillaya oranla daha yüksekti (% 76.6 -% 23.4). Takip sürecinde 64 vakanın 9 tanesinin (%14. 1) nüks ettiği tespit edildi. Nüks vakalarının büyük çoğunluğu posterior mandibulada tespit edildi. Dikkat çekici şekilde 9 nüks vakasının 7’si parakeratotik tipte olup 4 tanesi daughter kist ile ilkişkiliydi. Sonu ç: Literatürde KOT ile ilgili birçok çalışma olmasına rağmen tedavi stratejilerinin seçimi halan tartışmalıdır. Rekürrens gösteren vakalarda daha agresif tedavi yöntemlerin seçimi gerekmektedir. Periodik kontroller ve agresif tedavi yaklaşımları rekürrensin önlenmesinde etkili olabilir

Treatment of nonsyndromic dentigerous cysts in primary dentition

Mehmet Cemal Akay, Erdem Kaya, Mert ZeytinoğluFaculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ege University, Bornova, Izmir, TurkeyObjective: Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They usually occur singly and are located in the mandible. Nonsyndromic bilateral dentigerous cysts (NSBDC) are rarely seen during childhood. The aim of this study was to determine the long-term effects of the marsupialization technique in growing children with NSBDC.Study design: Seven patients with NSBDC (4 female, 3 male) ranging in age from 7 to 9 years (mean 8.35 years) were involved in the study. All the individuals were treated by marsupialization. Space-maintaining appliances were applied during permanent teeth eruption. Intraoral photographs, and panoramic and periapical films were taken before surgery and during healing.Results: The NSBDC were successfully treated by the marsupialization technique and rapid healing period was observed in the growing patients, without any loss of permanent teeth. No recurrence was seen in the long-term follow-up period (3–10 years).Conclusion: Our clinical and radiological results revealed that using the marsupialization technique in children with NSBDC provided safe healing of permanent teeth around the dentigerous cysts in a short period. However, treatment planning and regular clinical follow-ups are necessary to ensure clinical success.Keywords: nonsyndromic bilateral dentigerous cysts, primary dentition, marsupializatio