Recurrence of keratocysts and decompression treatment. A long-term follow-up of forty-four cases.

Recurrence was found in eight cases (18%) in a group of 44 patients (22 male) with odontogenic keratocysts treated at the Department of Oral Surgery and Oral Medicine, Odense University Hospital, from 1971 to 1983. All these recurrences were found in cysts with parakeratotic, thin, bandlike epithelium with palisade-like basal cells (Forssell group la). In 12 large cysts the use of a polyethylene drainage tube implanted at cystotomy and biopsy some months before primary cystectomy resulted in considerable reduction in the cystic lumen and also in alteration of the thin, fragile cystic epithelium into thick, solid cystic epithelium with no adhesion to the adjoining structures. No recurrence was seen in these 12 patients after an observation period of between 7 and 17 years. The decompression treatment seems to reduce the tendency to recurrence of the odontogenic keratocyst, which is far more important than the advantages to the surgeon of surgical simplicity and safety, and to the patient of less discomfort and pain.