Maurette Paul Edward, Jorge Jacks, de Moraes Márcio
Piracicaba Dental School of Campinas State University, Sao Paolo, Brazil.
J Oral Maxillofac Surg. 2006 Mar;64(3):379-83. doi: 10.1016/j.joms.2005.11.007.
The objective of this study was to report our experience with the treatment of 30 odontogenic keratocyst (OKC) patients with a conservative treatment protocol based on decompression with reference to the recurrence rate.
Twenty-eight patients (19 females, 9 males) with 30 OKCs attended the OMS Department of the Piracicaba Dental School of Campinas State University between 1995 and 2003. Age range was 13 to 69 years (mean, 30 years of age). Initial biopsy was carried out in all patients and the OKCs were diagnosed after histological examination by the Oral Pathology Department. The cases were treated according to the treatment employed in this department, consisting mainly of decompression and curettage of the remaining lesion. The average follow-up for the 28 cases was 24.89 months (+/-9.74).
The majority of the lesions (16 patients, 53.3%) occurred in the angle of the mandible and mandibular ramus. The most common histological pattern of OKC was parakeratinized (66.6%) and 13 of 28 patients presented impacted teeth associated with the lesion. The mean time for decompression was 9.27 months. Recurrence occurred in 4 patients (14.3%) with 4 OKCs. These patients were treated initially with decompression and curettage (2 cases), or with decompression only (2 cases). All the cases were monitored continuously with panoramic radiographies and clinical evaluations.
The treatment protocol for OKC based on decompression offers a conservative and effective option with low morbidity and similar recurrence rates to those reported in the literature. The systematic and long-term post-surgical follow-up is considered to be a key element for successful results.
本研究的目的是报告我们采用基于减压的保守治疗方案治疗30例牙源性角化囊肿（OKC）患者的经验，并参考复发率。
1995年至2003年间，28例（19例女性，9例男性）患有30个OKC的患者前往坎皮纳斯州立大学皮拉西卡巴牙科学院口腔颌面外科就诊。年龄范围为13至69岁（平均30岁）。所有患者均进行了初步活检，经口腔病理科组织学检查后确诊为OKC。这些病例按照该科室采用的治疗方法进行治疗，主要包括减压和刮除剩余病变。28例患者的平均随访时间为24.89个月（±9.74）。
大多数病变（16例患者，53.3%）发生在下颌角和下颌升支。OKC最常见的组织学模式是不全角化（66.6%），28例患者中有13例出现与病变相关的阻生牙。减压的平均时间为9.27个月。4例患者（14.3%）的4个OKC出现复发。这些患者最初接受减压和刮除治疗（2例），或仅接受减压治疗（2例）。所有病例均通过全景X线片和临床评估进行持续监测。
基于减压的OKC治疗方案提供了一种保守且有效的选择，发病率低，复发率与文献报道相似。系统的长期术后随访被认为是取得成功结果的关键因素。
