Treatment of Large Multilocular and Unilocular Odontogenic Keratocysts of Mandible with Decompression as Primary Treatment Modality.

PURPOSE: Our study aimed to evaluate the outcome of decompression and enucleation at a later date as a treatment option for large Odontogenic keratocyst (OKC).

PATIENTS AND

METHODS

The study was a prospective study. 50 patients who satisfied the inclusion criteria were considered for the study, seven male and five female. Patients were between the ages range of 21 to 52 years with biopsy-proven OKC. All the patients had cysts in the mandibular region. 36 cysts (72%) were multilocular and 14 (28%) were unilocular. Decompression was done initially, the cyst dimensions were assessed at regular intervals, and enucleation was done once the cyst dimensions were considered satisfactory.

RESULTS

The initial cyst area ranged from 44 cm2 to 115.3 cm2 (mean-92.26 cm2). The final cyst area calculated just before definitive surgery ranged from 4.5 cm2 to 19.5 cm2 (mean 9.4 cm2). The reduction rate of the cyst between the first and final surgeries ranged from 75% to 91% (mean 89.54%). The Reduction rate of the cystic area was calculated per month and ranged from 3.7% to 12.5%. After the final surgery, a histopathologic examination of the excised specimen revealed that the pathologic tissue in 21 (42%) OKC turned into hypertrophic Squamous Epithelium with no evidence of cystic epithelium or satellite cysts.

CONCLUSION

We hereby conclude that pre-surgical decompression is a versatile treatment option for OKCs. Provided, the patient is cooperative, it can be used as a primary treatment option for large OKCs, thereby minimizing the extent of surgery.