Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up.

BACKGROUND: Odontogenic keratocysts have been reported with high recurrence rates in the literature so various treatment modalities from simple enucleation to resection have been performed to achieve the cure. The purpose of this retrospective study was to investigate the recurrence rate of odontogenic keratocysts (OKCs) treated by enucleation and peripheral ostectomy. MATERIAL AND METHODS: An electronic search of the database of the Hacettepe University, Faculty of Medicine, Department of Pathology, was undertaken to identify patients histologically diagnosed with OKCs treated at Department of Oral and Maxillofacial Surgery between 2001 and 2015. RESULTS: In total, 81 patients were studied. The mean age at the time of diagnosis was 42 years, and the male:female ratio was 1:0.7. OKCs were located primarily in the posterior mandibular region (41%). Twenty-seven patients were re-examined to determine the recurrence rate. The mean follow-up period was 5 years (range, 1-12 years). The recurrence rate was 14.8%. The relationship between location of the lesion and recurrence was not statistically significant (p = 0.559). There was also no statistically significant relation between the recurrence rate and treatment option of teeth involved in the lesion (p = 0.579). CONCLUSIONS: The authors conclude that treatment of OKCs by enucleation with peripheral ostectomy is associated with minimal morbidity and is preferred over other aggressive treatment modalities. Meticulous radiographic examination and careful surgical resection may decrease the recurrence rate of OKCs.

Alveolar ridge preservation with a free gingival graft in the anterior maxilla: volumetric evaluation in a randomized clinical trial.

The aim of this study was to evaluate and compare the dimensional changes in maxillary extraction sockets that have healed spontaneously and those treated with free gingival grafts. Ten subjects with at least two maxillary anterior teeth scheduled for extraction were selected for this study. Two maxillary teeth were allocated randomly to either the test group or the control group. In the test group, the extraction socket was covered with a free gingival graft harvested from the palate, while in the control group the sockets healed spontaneously. Cone beam computed tomography (CBCT) scans were taken on the day of extraction and at 3 months postoperative. Soft tissue healing of the extraction sockets was assessed visually by clinical inspection. Hard tissue measurements were obtained from the CBCT scans. After 3 months of healing, the control sockets had lost height in the buccal and lingual crestal bones (-1.03 and -0.56mm, respectively); however, the height in the buccal and lingual crestal bones was preserved at the test sites (+0.06 and +0.25mm, respectively). This difference between the two groups was statistically significant (P<0.05). In contrast, both the control and test groups lost width in the buccal and lingual crestal bones; the difference between the control and test groups was not statistically significant (P>0.05). The authors propose that covering the orifice of the extraction socket with a free gingival graft can result in preservation of the alveolar bone height.