Document Type: Case Report

Authors

1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Amongst odontogenic cysts, keratocystic odontogenic tumor (KOT) is a benign intra-osseous lesion, characterized by corrugated parakeratinized uniform stratified squamous epithelium, with potential for aggressive behavior and high tendency to recur. There are multiple treatment modalities for this cyst. Some surgeons prefer the conservative treatments such as marsupialization while the others prefer invasive treatments such as radical resection. The aim of this study was to present a case of KOT involving the right mandibular premolar area with an impacted tooth in a 9-year-old boy treated by marsupialization. The treatment resulted in eruption of the mandibular first premolar, and no signs of recurrence were observed after two years. Marsupialization was found to be an effective treatment in inducing the eruption of mandibular premolar associated with KOT in preadolescents and can be a reliable procedure to reduce recurrence tendency of KOT.

Keywords

[1]  Passi D, Singhal D, Singh M, Mishra V, Panwar Y, Sahni A. Odontogenic keratocyst (OKC) or keratocystic odontogenic tumor (KCOT). Journey of OKC from cyst to tumor to cyst again: comprehensive review with recent updates on WHO classification. Int J Curr Res. 2017; 9: 54080-54086.

[2]  Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. Elsevier Health Sciences: Missoouri, USA; 2015. p. 636-639.

[3]  Shudou H, Sasaki M, Yamashiro T, Tsunomachi S, Takenoshita Y, Kubota Y, et al. Marsupialization of Keratocystic Odontogenic Tumors of the Mandible: Longitudinal Image Analysis of Tumor Size via 3D Visualized CT Scans. In A Textbook of Advanced Oral and Maxillofacial Surgery. 1th ed. Intech Open: London, UK; 2013. p. 241-254.

[4]  Abdullah WA. Surgical treatment of keratocystic odontogenic tumour: A review article. Saudi Dent J. 2011; 23: 61-65.

[5]  de*Molon RS, Verzola MH, Pires LC, Mascarenhas VI, da*Silva RB, Cirelli JA, et al. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review. Contemp Clin Dent. 2015; 6(Suppl 1): S106.

[6]  Rajkumar GC, Hemalatha M, Shashikala R, Sonal P. Massive keratocystic odontogenic tumor of mandible: A case report and review of literature. Indian J Dent Res. 2011; 22: 181.

[7]  Telles DC, Castro WH, Gomez RS, Souto GR, Mesquita RA. Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization. Braz Oral Res. 2013; 27: 496-502.

[8]  Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, et al. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018; 9: 883-897.

[9]  Jordan RC. Histology and ultrastructural features of the odontogenic keratocyst. Oral Maxillofac Surg Clin North Am. 2003; 15: 325.

[10]          Al-Moraissi EA, Dahan AA, Alwadeai MS, Oginni FO, Al-Jamali JM, Alkhutari AS, et al. What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis. J Craniomaxillofac Surg. 2017; 45: 131-144.

[11]          Pogrel MA. Treatment of keratocysts: the case for decompression and marsupialization. J Oral Maxillofac Surg. 2005; 63: 1667-173.

[12]          Pogrel MA. Decompression and marsupialization as a treatment for the odontogenic keratocyst. Oral Maxillofac Surg Clin North Am. 2003; 15: 415-427.

[13]          Qian WT, Ma ZG, Xie QY, Cai XY, Zhang Y, Yang C. Marsupialization facilitates eruption of dentigerous cyst-associated mandibular premolars in preadolescent patients. J Oral Maxillofac Surg. 2013; 71: 1825-1832.

[14]          Hu X, Zhao Y, Man QW, Li RF, Liu B, Zhao YF. The effects of marsupialization on bone regeneration adjacent to keratocystic odontogenic tumors, and the mechanisms involved. J Oral Sci. 2017; 59: 475-481.

[15]          Oh JS, You JS, Kim SG. Clinical and histomorphometric evaluation of decompression followed by enucleation in the treatment of odontogenic keratocyst. J Dent Sci. 2018; 13: 329-333.