与 Carnoy 液相比，改良 Carnoy 液在预防牙源性角化囊肿复发方面同样有效。

Modified Carnoy's Compared to Carnoy's Solution Is Equally Effective in Preventing Recurrence of Odontogenic Keratocysts.

机构信息

Resident, Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, NC; Resident, Department of Oral and Maxillofacial Surgery, University of North Carolina Hospitals, Chapel Hill, NC.

Dental Student, UNC Adams School of Dentistry, Chapel Hill, NC.

出版信息

J Oral Maxillofac Surg. 2021 Sep;79(9):1874-1881. doi: 10.1016/j.joms.2021.03.010. Epub 2021 Mar 24.

DOI:10.1016/j.joms.2021.03.010

PMID:33901451

Abstract

PURPOSE

Carnoy's solution (CS), the gold standard for adjunctive chemical cautery in treatment of odontogenic keratocysts (OKCs), has been banned for 7 years, leading to substitution with the non-chloroform containing modified Carnoy's solution (MC) without data to support its effectiveness. We performed this study to compare the earlier data with CS to the more current outcomes with MC.

METHODS

A retrospective cohort study was conducted on patients diagnosed with OKC and treated by a single surgeon (GHB) with enucleation and curettage (EC), peripheral ostectomy, and application of CS or MC. The primary predictor variables were use of CS or MC. The primary outcome variables were recurrence (yes vs. no) and time to recurrence. Secondary variables included demographics, anatomic location, and whether teeth adjacent to the lesion were extracted. Statistical analyses included chi-squared test/Fisher's exact test, Wilcoxon rank sum test, and Kaplan-Meier curves.

RESULTS

77 patients, 36 patients in the CS group and 41 in the MC group, met inclusion criteria, including at least 1 year of follow-up time. Characteristics of the groups were similar: median age 41.5 and 46, 61% and 71% male gender, 81% and 90% posterior, and 64% and 50% mandibular lesions, respectively. Overall recurrence was similar, 14.29%, with 5 (13.9%) recurrences in the CS group and 6 (14.6%) in the MC group (P = 0.92). Median time to recurrence was 24 months for both groups. Preserving adjacent teeth was associated with a significant increase in recurrence (P = 0.0036).

CONCLUSION

Based on this comparison of retrospective outcome data, we found no significant difference in recurrence rate or distribution of time to recurrence between OKCs treated with CS or MC. Aggressiveness of surgical technique is likely a predictive factor in recurrence rate. Future studies should focus on prospective studies and continuing follow-up of the MC group.

摘要

目的

卡诺氏液（CS）是治疗牙源性角化囊肿（OKC）的辅助化学烧灼的金标准，已被禁用 7 年，导致非含氯的改良卡诺氏液（MC）取代，但没有数据支持其有效性。我们进行这项研究是为了将 CS 的早期数据与 MC 的更当前结果进行比较。

方法

对一位外科医生（GHB）采用切除和刮除术（EC）、骨切除术以及 CS 或 MC 应用治疗的 OKC 患者进行回顾性队列研究。主要预测变量是 CS 或 MC 的使用。主要结局变量是复发（是与否）和复发时间。次要变量包括人口统计学、解剖位置以及病变相邻的牙齿是否被拔除。统计分析包括卡方检验/ Fisher 精确检验、Wilcoxon 秩和检验和 Kaplan-Meier 曲线。

结果

77 例患者，CS 组 36 例，MC 组 41 例，符合纳入标准，包括至少 1 年的随访时间。两组的特征相似：中位年龄分别为 41.5 岁和 46 岁，61%和 71%为男性，81%和 90%为后位，64%和 50%为下颌病变。总体复发率相似，为 14.29%，CS 组有 5 例（13.9%）复发，MC 组有 6 例（14.6%）复发（P=0.92）。两组的中位复发时间均为 24 个月。保留相邻牙齿与复发率显著增加相关（P=0.0036）。