Chirapathomsakul Duangrudee, Sastravaha Panunn, Jansisyanont Pornchai
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jan;101(1):5-9; discussion 10. doi: 10.1016/j.tripleo.2005.03.023.
The purpose of this study is to report experiences of odontogenic keratocysts (OKCs) and analyze information regarding recurrences to better understand the nature of recurrences.
Fifty-one cases of OKC treated at the Faculty of Dentistry, Chulalongkorn University, from 1988 to 2003 were studied retrospectively. Clinicoradiographic features, histologic features, and methods of treatment were reviewed. Recurrences were analyzed and compared with respect to sites of involvement, relationship to the remaining teeth, and methods of treatment.
OKCs occurred predominantly in the 11- to 40-year-old age group. The body-angle-ramus area of mandible was the most common site of occurrence. Radiographically, the unilocular to multilocular radiolucency ratio was 2.5:1. Multilocular lesions occurred more frequently in the mandible (P < .05). Most of the lesions were diagnosed histologically as parakeratinized OKC (93.7%). The patients were followed from 1-14.6 years. However, 20 patients were lost to follow-up after a short period of time, and recurrences were found in 7 out of 31 cases (22.6%). The recurrent tumors occurred more frequently in patients who had an OKC associated with the remaining teeth and were treated by enucleation or enucleation with adjuvant therapy.
According to a high recurrent rate of OKCs treated by enucleation, clinicians should give more attention to the dentate area if the enucleation is chosen as the treatment of choice.
本研究旨在报告牙源性角化囊肿（OKC）的治疗经验，并分析复发相关信息，以更好地理解复发的本质。
对1988年至2003年在朱拉隆功大学牙科学院接受治疗的51例OKC患者进行回顾性研究。回顾临床影像学特征、组织学特征及治疗方法。分析复发情况，并就病变累及部位、与剩余牙齿的关系及治疗方法进行比较。
OKC主要发生于11至40岁年龄组。下颌骨体-角-升支区域是最常见的发病部位。影像学上，单房性与多房性透射区比例为2.5:1。多房性病变在下颌骨更常见（P <.05）。大多数病变经组织学诊断为不全角化型OKC（93.7%）。患者随访1至14.6年。然而，20例患者在短时间后失访，31例中有7例复发（22.6%）。复发肿瘤在伴有剩余牙齿且采用摘除术或摘除术加辅助治疗的OKC患者中更常见。
鉴于摘除术治疗OKC的复发率较高，如果选择摘除术作为首选治疗方法，临床医生应更多关注有牙区。
