Keratocyst Odontogenic Tumor (KCOT): Treatment Methods at the Second Affiliated Hospital of Jiamusi University
Author(s)
Nyimi Bushabu Fidele1*,
Feng Duan1,
Em Kalala Kazadi2,
Jian Guan1,
Mantshumba Milolo Augustin3,
Yuwen Zhou4
Affiliation(s)
1 Department of Oral and Maxillofacial Surgery (Unit I), Second Affiliated Hospital of Jiamusi University, Jiamusi, China. 2 Stomatology and Maxillofacial Service (Unit of Periodontology Surgery), Affiliated Hospital of Kinshasa University, Kinshasa, DR. Congo. 3 Prosthodontics and Orthodontics Service, Affiliated Hospital of Kinshasa University, Kinshasa, DR. Congo. 4 Department of Prosthodontics, Second Affiliated Hospital of Jiamusi University, Jiamusi, China.
1 Department of Oral and Maxillofacial Surgery (Unit I), Second Affiliated Hospital of Jiamusi University, Jiamusi, China. 2 Stomatology and Maxillofacial Service (Unit of Periodontology Surgery), Affiliated Hospital of Kinshasa University, Kinshasa, DR. Congo. 3 Prosthodontics and Orthodontics Service, Affiliated Hospital of Kinshasa University, Kinshasa, DR. Congo. 4 Department of Prosthodontics, Second Affiliated Hospital of Jiamusi University, Jiamusi, China.
ABSTRACT
Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Carnoy’s solution or Cryosurgery. Currently, there is no consensus concerning the therapeutic choice for the KCOT. The purpose of this study was to evaluate the different treatment methods used for the management of KCOT in the Second Affiliated Hospital of Jiamusi University and the results obtained from those treatment methods. Settings and Design: Clinical study was done at the Second Affiliated Hospital of Jiamusi University. Materials and Methods: Analytical retrospective review of 63 cases treated surgically from 2009 to 2015 at the Maxillofacial and Oral Surgery Department of the Second Affiliated Hospital of Jiamusi University. All cases diagnosed as KCOT and registered in the archives were used. The level of statistical significance was set at P < 0.05. Results: Of the 63 cases, 55.56% were male and 44.44% female. The sex ratio was 1.25 in favor of male and the average age was 42 years. 81% of the lesions were located in the mandible. Of 40 cases treated by enucleation with peripheral ostectomy, curettage and electric cauterization with application of 2% iodine tincture, no recurrence was found. Of 20 cases treated by the same surgical method but without the application of 2% iodine tincture, recurrence was found in 3 cases (4.76%). 3 cases treated by resection had no recurrence. Significant relation between recurrence and type of treatment was found (P < 0.05). Conclusion: In our series, those cases that were treated by combination of surgical methods used with 2% iodine tincture showed an “improvement” in the reduction of recurrence, suggesting a future question to be examined in experimental study is to test the effectiveness of 2% iodine tincture.
Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Carnoy’s solution or Cryosurgery. Currently, there is no consensus concerning the therapeutic choice for the KCOT. The purpose of this study was to evaluate the different treatment methods used for the management of KCOT in the Second Affiliated Hospital of Jiamusi University and the results obtained from those treatment methods. Settings and Design: Clinical study was done at the Second Affiliated Hospital of Jiamusi University. Materials and Methods: Analytical retrospective review of 63 cases treated surgically from 2009 to 2015 at the Maxillofacial and Oral Surgery Department of the Second Affiliated Hospital of Jiamusi University. All cases diagnosed as KCOT and registered in the archives were used. The level of statistical significance was set at P < 0.05. Results: Of the 63 cases, 55.56% were male and 44.44% female. The sex ratio was 1.25 in favor of male and the average age was 42 years. 81% of the lesions were located in the mandible. Of 40 cases treated by enucleation with peripheral ostectomy, curettage and electric cauterization with application of 2% iodine tincture, no recurrence was found. Of 20 cases treated by the same surgical method but without the application of 2% iodine tincture, recurrence was found in 3 cases (4.76%). 3 cases treated by resection had no recurrence. Significant relation between recurrence and type of treatment was found (P < 0.05). Conclusion: In our series, those cases that were treated by combination of surgical methods used with 2% iodine tincture showed an “improvement” in the reduction of recurrence, suggesting a future question to be examined in experimental study is to test the effectiveness of 2% iodine tincture.
Cite this paper
Fidele, N. , Duan, F. , Kazadi, E. , Guan, J. , Augustin, M. and Zhou, Y. (2015) Keratocyst Odontogenic Tumor (KCOT): Treatment Methods at the Second Affiliated Hospital of Jiamusi University. Open Journal of Stomatology, 5, 251-258. doi: 10.4236/ojst.2015.511031.
Fidele, N. , Duan, F. , Kazadi, E. , Guan, J. , Augustin, M. and Zhou, Y. (2015) Keratocyst Odontogenic Tumor (KCOT): Treatment Methods at the Second Affiliated Hospital of Jiamusi University. Open Journal of Stomatology, 5, 251-258. doi: 10.4236/ojst.2015.511031.
References
[1] Barnes, L., Everson, J.W., Reichart, P. and Sidransky, D. (2005) Pathology and Genetics of Head and Neck Tumors: WHO Classification of Tumours Series. IARC Press, Lyon, 284-306. [2] Vered, M., Peleg, O., Taicher, S. and Buchner, A. (2009) The Immunoprofile of Odontogenic Keratocyst (Keratocystic Odontogenic Tumor) That Includes Expression of PTCH, SMO, GLI-1 and bcl-2 Is Similar to Ameloblastoma but Different from Odontogenic Cysts. Journal of Oral Pathology & Medicine, 7, 597-604.
http://dx.doi.org/10.1111/j.1600-0714.2009.00778.x [3] Kramer, I.R., Pindborg, J.J. and Shear, M. (1992) The WHO Histological Typing of Odontogenic Tumors: A Commentary on the Second Edition. Cancer, 12, 2988-2994.
http://dx.doi.org/10.1002/1097-0142(19921215)70:12<2988::AID-CNCR2820701242>3.0.CO;2-V [4] Sánchez-Burgos, R., González-Martín-Moro, J., Pérez-Fernández, E. and Burgueno-Garcia, M. (2014) Clinical, Radiological and Therapeutic Features of Keratocystic Odontogenic Tumors: A Study over a Decade. Journal of Clinical and Experimental Dentistry, 3, e259-e264.
http://dx.doi.org/10.4317/jced.51408 [5] González-Alva, P., Tanaka, A., Oku, Y., Yoshizawa, D., Itoh, S., Sakashita, H., Ide, F., Tajima, Y. and Kusama, K. (2008) Keratocystic Odontogenic Tumor: A Retrospective Study of 183 Cases. Journal of Oral Science, 2, 205-212.
http://dx.doi.org/10.2334/josnusd.50.205 [6] Habibi, A., Saghravanian, N., Habibi, M., Mellatit, E. and Habibi, M. (2007) Keratocystic Odontogenic Tumor: A 10-Year Retrospective Study of 83 Cases in an Iranian Population. Journal of Oral Science, 3, 229-235.
http://dx.doi.org/10.2334/josnusd.49.229 [7] Sharif, F.N.J., Oliver, R., Sweet, C. and Sharif, M.O. (2010) Interventions for the Treatment of Keratocystic Odontogenic Tumors (KCOT Odontogenic Keratocysts (OKC)). Cochrane Database of Systematic Reviews, 9, Article ID: CD008464.
http://dx.doi.org/10.1002/14651858.CD008464.pub2 [8] Nakamura, N., Mitsuyasu, T., Mitsuyasu, Y., Tabrizi, R., Zkan, B.T. and Dehgani, A. (2002) Marsupialization for Odotogenic Keratocyst: Long-Term Follow-Up Analysis of the Effects and Changes in Growth Characterstics. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontology, 5, 543-553.
http://dx.doi.org/10.1067/moe.2002.128022 [9] Voorsmit, R.A., Stoelinga, P.J. and Van Haelst, U.J. (1981) The Management of Keratocysts. Journal of Oral and Maxillofacial Surgery, 4, 228-236.
http://dx.doi.org/10.1016/s0301-0503(81)80049-5 [10] Bornstein, M.M., Filippi, A., Altermatt, H.J., Lambrecht, J.T. and Buser, D. (2005) Le kératokyste odontogène: Kyste odontogène ou tumeur bénigne? Revue Mensuelle Suisse d’Odonto-Stomatologie., 115, 123-128. [11] Leite, T.C., Meirelles, J.R.V. and Janimi, M.E.R. (2011) Odontogenic Keratocystic Tumor: A Clinical and Histopathologic Retrospective Study Based on the New WHO Classification. International Journal of Odontostomatology, 5, 227-234.
http://dx.doi.org/10.4067/S0718-381X2011000300004 [12] Zhao, Y.F., Wei, J.X. and Wang, S.P. (2002) Treatment of Odontogenic Keratocysts: A Follow-Up of 255 Chinese Patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 94, 151-156.
http://dx.doi.org/10.1067/moe.2001.125694 [13] Chemli, H., Dhouib, M., Karray, F. and Abdelmoula, M. (2010) Les facteurs de risque de récidive des kératokystes odontogéniques des maxillaire. Revue de Stomatologie et de Chirurgie Maxillo-faciale, 111, 189-192.
http://dx.doi.org/10.1016/j.stomax.2009.07.011 [14] Myoung, H., Hong, S.P., Hong, S.D., Lee, J.I., Lim, C.Y., Choung, P.H., Lee, J.H., Choi, J.Y., Seo, B.M. and Kim, M.J. (2001) Odontogenic Keratocyst: Review of 256 Cases for Recurrence and Clinicopathologic Parameters. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 91, 328-333.
http://dx.doi.org/10.1067/moe.2001.113109 [15] Kissi, L., Benyahya, I. and Rifki, A. (2006) Le keratokyste isole: A propos d’un cas. Journal de l’ordre des dentistes du Québec, 43, 321-328. [16] Shear, M. and Speight, P.M. (2007) Odontogenic Keratocyst of the Oral and Maxillofacial Regions. 4th Edition, Blackwell Munksgaard, Oxford, 6-58. [17] Dghoughi, S., Chbiched, S. and Wady, E.I.W. (2009) Une tumefaction gingivale anterieure. Revue de Stomatologie et de Chirurgie Maxillofaciale, 110, 242-245.
http://dx.doi.org/10.1016/j.stomax.2009.06.001 [18] Forsell, K. (1980) The Primordial Cyst. A Clinical and Radiographic Study. Proceedings of the Finnish Dental Society, 76, 129-174. [19] Morgan, T.A., Burton, C.C. and Quian, F. (2005) A Retrospective Review of Treatment of the Odontogenic Keratocyst. Journal of Oral and Maxillofacial Surgery, 63, 635-639.
http://dx.doi.org/10.1016/j.joms.2004.07.026 [20] Kondell, P.A. and Wiberg, J. (1988) Odontogenic Keratocysts. A Follow-Up Study of 29 Cases. Swedish Dental Journal, 12, 57-62. [21] Oda, D., Rivera, V., Ghanee, N., Kenny, E.A. and Dawson, K.H. (2000) Odontogenic Keratocyst: The Northwestern USA Experience. Journal of Contemporary Dental Practice, 1, 60-74. [22] Browne, R.M. (1970) The Odontogenic Keratocyst. Clinical Aspects. British Dental Journal, 128, 225-231. [23] Hyun, H.K., Hong, S.D. and Kim, J.W. (2009) Recurrent Keratocystic Odontogenic Tumor in the Mandible: A Case Report and Literature Review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 108, e7-e10.
http://dx.doi.org/10.1016/j.tripleo.2009.04.030 [24] Hajj, G.E.L. and Anneroth, G. (1996) Odontogenic Keratocysts. A Retrospective Clinical and Histologic Study. International Journal of Oral and Maxillofacial Surgery, 25, 124-129.
http://dx.doi.org/10.1016/S0901-5027(96)80057-9 [25] Shear, M. (2002) The Aggressive Nature of the Odontogenic Keratocyst: Is It a Benign Cystic Neoplasm? Part 2. Proliferation and Genetic Studies. Oral Oncology, 38, 323-331.
http://dx.doi.org/10.1016/S1368-8375(01)00066-5 [26] Pan, S. and Li, T.J. (2009) PTCH1 Mutations in Odontogenic Keratocysts: Are They Related to Epithelial Cell Proliferation. Oral Oncology, 45, 861-865.
http://dx.doi.org/10.1016/j.oraloncology.2009.02.003
[1] Barnes, L., Everson, J.W., Reichart, P. and Sidransky, D. (2005) Pathology and Genetics of Head and Neck Tumors: WHO Classification of Tumours Series. IARC Press, Lyon, 284-306. [2] Vered, M., Peleg, O., Taicher, S. and Buchner, A. (2009) The Immunoprofile of Odontogenic Keratocyst (Keratocystic Odontogenic Tumor) That Includes Expression of PTCH, SMO, GLI-1 and bcl-2 Is Similar to Ameloblastoma but Different from Odontogenic Cysts. Journal of Oral Pathology & Medicine, 7, 597-604.
http://dx.doi.org/10.1111/j.1600-0714.2009.00778.x [3] Kramer, I.R., Pindborg, J.J. and Shear, M. (1992) The WHO Histological Typing of Odontogenic Tumors: A Commentary on the Second Edition. Cancer, 12, 2988-2994.
http://dx.doi.org/10.1002/1097-0142(19921215)70:12<2988::AID-CNCR2820701242>3.0.CO;2-V [4] Sánchez-Burgos, R., González-Martín-Moro, J., Pérez-Fernández, E. and Burgueno-Garcia, M. (2014) Clinical, Radiological and Therapeutic Features of Keratocystic Odontogenic Tumors: A Study over a Decade. Journal of Clinical and Experimental Dentistry, 3, e259-e264.
http://dx.doi.org/10.4317/jced.51408 [5] González-Alva, P., Tanaka, A., Oku, Y., Yoshizawa, D., Itoh, S., Sakashita, H., Ide, F., Tajima, Y. and Kusama, K. (2008) Keratocystic Odontogenic Tumor: A Retrospective Study of 183 Cases. Journal of Oral Science, 2, 205-212.
http://dx.doi.org/10.2334/josnusd.50.205 [6] Habibi, A., Saghravanian, N., Habibi, M., Mellatit, E. and Habibi, M. (2007) Keratocystic Odontogenic Tumor: A 10-Year Retrospective Study of 83 Cases in an Iranian Population. Journal of Oral Science, 3, 229-235.
http://dx.doi.org/10.2334/josnusd.49.229 [7] Sharif, F.N.J., Oliver, R., Sweet, C. and Sharif, M.O. (2010) Interventions for the Treatment of Keratocystic Odontogenic Tumors (KCOT Odontogenic Keratocysts (OKC)). Cochrane Database of Systematic Reviews, 9, Article ID: CD008464.
http://dx.doi.org/10.1002/14651858.CD008464.pub2 [8] Nakamura, N., Mitsuyasu, T., Mitsuyasu, Y., Tabrizi, R., Zkan, B.T. and Dehgani, A. (2002) Marsupialization for Odotogenic Keratocyst: Long-Term Follow-Up Analysis of the Effects and Changes in Growth Characterstics. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontology, 5, 543-553.
http://dx.doi.org/10.1067/moe.2002.128022 [9] Voorsmit, R.A., Stoelinga, P.J. and Van Haelst, U.J. (1981) The Management of Keratocysts. Journal of Oral and Maxillofacial Surgery, 4, 228-236.
http://dx.doi.org/10.1016/s0301-0503(81)80049-5 [10] Bornstein, M.M., Filippi, A., Altermatt, H.J., Lambrecht, J.T. and Buser, D. (2005) Le kératokyste odontogène: Kyste odontogène ou tumeur bénigne? Revue Mensuelle Suisse d’Odonto-Stomatologie., 115, 123-128. [11] Leite, T.C., Meirelles, J.R.V. and Janimi, M.E.R. (2011) Odontogenic Keratocystic Tumor: A Clinical and Histopathologic Retrospective Study Based on the New WHO Classification. International Journal of Odontostomatology, 5, 227-234.
http://dx.doi.org/10.4067/S0718-381X2011000300004 [12] Zhao, Y.F., Wei, J.X. and Wang, S.P. (2002) Treatment of Odontogenic Keratocysts: A Follow-Up of 255 Chinese Patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 94, 151-156.
http://dx.doi.org/10.1067/moe.2001.125694 [13] Chemli, H., Dhouib, M., Karray, F. and Abdelmoula, M. (2010) Les facteurs de risque de récidive des kératokystes odontogéniques des maxillaire. Revue de Stomatologie et de Chirurgie Maxillo-faciale, 111, 189-192.
http://dx.doi.org/10.1016/j.stomax.2009.07.011 [14] Myoung, H., Hong, S.P., Hong, S.D., Lee, J.I., Lim, C.Y., Choung, P.H., Lee, J.H., Choi, J.Y., Seo, B.M. and Kim, M.J. (2001) Odontogenic Keratocyst: Review of 256 Cases for Recurrence and Clinicopathologic Parameters. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 91, 328-333.
http://dx.doi.org/10.1067/moe.2001.113109 [15] Kissi, L., Benyahya, I. and Rifki, A. (2006) Le keratokyste isole: A propos d’un cas. Journal de l’ordre des dentistes du Québec, 43, 321-328. [16] Shear, M. and Speight, P.M. (2007) Odontogenic Keratocyst of the Oral and Maxillofacial Regions. 4th Edition, Blackwell Munksgaard, Oxford, 6-58. [17] Dghoughi, S., Chbiched, S. and Wady, E.I.W. (2009) Une tumefaction gingivale anterieure. Revue de Stomatologie et de Chirurgie Maxillofaciale, 110, 242-245.
http://dx.doi.org/10.1016/j.stomax.2009.06.001 [18] Forsell, K. (1980) The Primordial Cyst. A Clinical and Radiographic Study. Proceedings of the Finnish Dental Society, 76, 129-174. [19] Morgan, T.A., Burton, C.C. and Quian, F. (2005) A Retrospective Review of Treatment of the Odontogenic Keratocyst. Journal of Oral and Maxillofacial Surgery, 63, 635-639.
http://dx.doi.org/10.1016/j.joms.2004.07.026 [20] Kondell, P.A. and Wiberg, J. (1988) Odontogenic Keratocysts. A Follow-Up Study of 29 Cases. Swedish Dental Journal, 12, 57-62. [21] Oda, D., Rivera, V., Ghanee, N., Kenny, E.A. and Dawson, K.H. (2000) Odontogenic Keratocyst: The Northwestern USA Experience. Journal of Contemporary Dental Practice, 1, 60-74. [22] Browne, R.M. (1970) The Odontogenic Keratocyst. Clinical Aspects. British Dental Journal, 128, 225-231. [23] Hyun, H.K., Hong, S.D. and Kim, J.W. (2009) Recurrent Keratocystic Odontogenic Tumor in the Mandible: A Case Report and Literature Review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 108, e7-e10.
http://dx.doi.org/10.1016/j.tripleo.2009.04.030 [24] Hajj, G.E.L. and Anneroth, G. (1996) Odontogenic Keratocysts. A Retrospective Clinical and Histologic Study. International Journal of Oral and Maxillofacial Surgery, 25, 124-129.
http://dx.doi.org/10.1016/S0901-5027(96)80057-9 [25] Shear, M. (2002) The Aggressive Nature of the Odontogenic Keratocyst: Is It a Benign Cystic Neoplasm? Part 2. Proliferation and Genetic Studies. Oral Oncology, 38, 323-331.
http://dx.doi.org/10.1016/S1368-8375(01)00066-5 [26] Pan, S. and Li, T.J. (2009) PTCH1 Mutations in Odontogenic Keratocysts: Are They Related to Epithelial Cell Proliferation. Oral Oncology, 45, 861-865.
http://dx.doi.org/10.1016/j.oraloncology.2009.02.003