World Journal of Dentistry

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VOLUME 8 , ISSUE 6 ( November-December, 2017 ) > List of Articles

ORIGINAL RESEARCH

Enucleation with Peripheral Ostectomy and Chemical Cauterization for Unicystic Ameloblastoma and Odontogenic Keratocyst: Primary Modality of Choice or still a Secondary Alternative? A Report of 18 Cases

Saurabh Sharma, Tejraj P Kale, Lingaraj J Balihallimath, Sharadindu M Kotrashetti

Citation Information : Sharma S, Kale TP, Balihallimath LJ, M Kotrashetti S. Enucleation with Peripheral Ostectomy and Chemical Cauterization for Unicystic Ameloblastoma and Odontogenic Keratocyst: Primary Modality of Choice or still a Secondary Alternative? A Report of 18 Cases. World J Dent 2017; 8 (6):467-470.

DOI: 10.5005/jp-journals-10015-1488

License: CC BY-SA 4.0

Published Online: 01-12-2017


Abstract

Aim: The treatment of odontogenic keratocyst (OKC) and unicystic ameloblastoma (UA) remains controversial. With modern innovations, trend is shifting toward minimally invasive surgical procedures. The aim of this study was to report the outcome of our conservative treatment protocol for OKC and UA, particularly highlighting the effectiveness of enucleation and peripheral ostectomy with chemical cauterization using Carnoy’s solution compared with aggressive techniques. Materials and methods: Eight patients with UA and 10 with keratocystic odontogenic tumor (KCOT) who reported to the KLE Vishwanath Katti Institute of Dental Sciences (KLE VKIDS), Belgaum, India, between 2008 and 2015 were included in the study. In addition to clinical and radiographic examination, incisional biopsy was done to confirm the diagnosis. All the patients were treated using enucleation with peripheral ostectomy and application of Carnoy’s solution for 5 minutes as a primary modality of choice postoperatively; patients with extensive lesion received an intermaxillary fixation for 5 to 6 weeks. Surgical obturator to obliterate the pathological defect was given in large defects. Results: The mean length of follow-up was 76 months since the last operation. In our experience, no recurrence has been encountered until May 2017. Conclusion: Our study suggests that conservative treatment with adequate postoperative follow-up yields clinically acceptable results with less morbidity. However, the patients must adhere to close follow-ups. Our algorithm for managing OKCs and UA of the jaws is also presented. This technique shows comparable results to other more aggressive techniques and can be used especially in large lesions that when treated with resection will interrupt continuity of the jaw. Clinical significance: For a long time, KCOT and UA were treated aggressively, i.e., through resection, but our study shows conservative treatment holds good. It also reduces the risks and complications associated with surgical resection.


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