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颌骨牙源性角化囊肿的复发及复发的预后因素

Recurrence and Prognosticators of Recurrence in Odontogenic Keratocyst of the Jaws.

作者信息

Bera Rathindra Nath, Tandon Sapna, Tiwari Preeti, Mishra Madan

机构信息

Department of Oral and Maxillofacial Surgery, Dental College Rajendra Institute of Medical Sciences Ranchi, Ranchi, India.

Department of Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences and Hospital Lucknow, Lucknow, India.

出版信息

J Maxillofac Oral Surg. 2024 Oct;23(5):1304-1315. doi: 10.1007/s12663-022-01846-8. Epub 2023 Jan 5.

Abstract

INTRODUCTION

The incidence of recurrence of OKC varied from 2.5 to 62%. Studies have linked recurrence to treatment methods and also clinical and pathological features. The aim of this study was to evaluate the 5-year recurrence and the factors associated with recurrence in odontogenic keratocysts of the jaws.

METHODS

A retrospective review of records was done from the Institute's Medical Records Directory from 2010 to 2021. The following data were obtained of the lesion; age at presentation, gender, site, subsite, radiographic presentation (locularity), radiographic borders, presence or absence of satellite cysts, inflammatory infiltrate, and treatment rendered presence or absence of cortical perforation and soft-tissue extension and presence or absence of recurrence. Kaplan Meir estimator was used to evaluate recurrence rate and log rank test was used to compare the survival amongst groups. Cox regression analysis was used to evaluate the odds ratio to find out the possible factors influencing risk of recurrence. A value of < 0.05 was considered statistically significant at 95% confidence interval.

RESULTS

In our study cohort, 27.2% of patients had recurrence. Posterior maxillary lesions, multilocular lesions, lesions with scalloped borders, presence of soft-tissue extension and cortical perforation, presence of satellite cysts and inflammatory infiltrate and enucleation with peripheral ostectomy were significantly associated with recurrence. However, soft-tissue extension, cortical perforation, multilocular lesions and presence of satellite cysts were independent risk factors.

CONCLUSION

There is still debate on the best treatment modality for the management of OKCs. More studies are required to quantify the results.

摘要

引言

牙源性角化囊肿(OKC)的复发率在2.5%至62%之间。研究已将复发与治疗方法以及临床和病理特征联系起来。本研究的目的是评估颌骨牙源性角化囊肿的5年复发情况以及与复发相关的因素。

方法

对该研究所2010年至2021年病历目录中的记录进行回顾性分析。获取了以下关于病变的数据:就诊时的年龄、性别、部位、亚部位、影像学表现(分房情况)、影像学边界、卫星囊肿的有无、炎症浸润情况、所采取的治疗方法、皮质穿孔和软组织扩展情况以及复发情况。采用Kaplan-Meir估计量评估复发率,采用对数秩检验比较各组之间的生存率。采用Cox回归分析评估比值比,以找出影响复发风险的可能因素。在95%置信区间,P值<0.05被认为具有统计学意义。

结果

在我们的研究队列中,27.2%的患者出现复发。上颌后部病变、多房性病变、边界呈扇贝状的病变、存在软组织扩展和皮质穿孔、存在卫星囊肿和炎症浸润以及采用刮除术加周边骨切除术与复发显著相关。然而,软组织扩展、皮质穿孔、多房性病变和卫星囊肿的存在是独立的危险因素。

结论

对于牙源性角化囊肿的最佳治疗方式仍存在争议。需要更多的研究来量化结果。

相似文献

1
Recurrence and Prognosticators of Recurrence in Odontogenic Keratocyst of the Jaws.颌骨牙源性角化囊肿的复发及复发的预后因素
J Maxillofac Oral Surg. 2024 Oct;23(5):1304-1315. doi: 10.1007/s12663-022-01846-8. Epub 2023 Jan 5.

本文引用的文献

1
The odontogenic keratocyst revisited.牙源性角化囊肿再探讨。
Int J Oral Maxillofac Surg. 2022 Nov;51(11):1420-1423. doi: 10.1016/j.ijom.2022.02.005. Epub 2022 Mar 8.
5
How well do we manage the odontogenic keratocyst? A multicenter study.我们对牙源性角化囊肿的管理效果如何?一项多中心研究。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Apr;127(4):282-288. doi: 10.1016/j.oooo.2018.12.001. Epub 2018 Dec 14.

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