Trond I Berge1, Saedeh B Helland2, Andreas Sælen3, Maria Øren3, Anne Christine Johannessen4, Liv Skartveit5, Bjarte Grung6. 1. Professor, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway; Senior consultant, Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway. Electronic address: trond.berge@iko.uib.no. 2. Resident in Oral and Maxillofacial Surgery, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway; Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway. 3. Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway. 4. Professor, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Senior consultant in Oral Pathology, Haukeland University Hospital, Bergen, Norway. 5. Associate professor (Retired), Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway. 6. Oral Surgeon, Department of Oral Surgery, Stavanger University Hospital, Stavanger, Norway.
Abstract
OBJECTIVE: To describe and analyze recurrent pattern of KOTs according to time. STUDY DESIGN: This retrospective chart study evaluated histologically confirmed nonsyndromic keratocystic odontogenic tumors (KOT) treated at our institutions between 1975 and 2012. RESULTS: Mean age at time of diagnosis was 48 years, and male/female ratio was 1.8:1. The typical nonsyndromic KOT lesion was most often found in the posterior mandible, had radiographically smooth borders, and was associated with symptoms and clinical findings, perforated bone, with a thin capsule. Anterior jaw KOT were found more frequently in patients 50 years or older, and maxillary KOTs were more frequently infected. Treatment was enucleation (n = 70) or marsupialization with subsequent enucleation (n = 22). Observation time ranged from 0.5 months to 25 years (mean 53 months). Crude recurrence rate was 29%. Risk of recurrence increased until 7 years after treatment and then remained stable. Patients with impaired general health had a significantly increased risk of recurrence. Tumors in the posterior mandible that had bone perforation and a thin capsule and contained keratin showed increased recurrence rates. Although recurrence rates were similar for both treatment groups, the groups differed in size and tumor site; thus, the results of this study need to be confirmed in a prospective study. CONCLUSIONS: Time-dependent recurrence pattern of KOTs is described and analyzed. The following follow-up protocol is suggested for patients with impaired health or large lesions: clinical and radiographic examinations at 2, 4, and 7 years, followed by intervals of 3 to 4 years; for other patients: clinical and radiographic examination at 4, 6, and 8 years, followed by intervals of 3 to 4 years.
OBJECTIVE: To describe and analyze recurrent pattern of KOTs according to time. STUDY DESIGN: This retrospective chart study evaluated histologically confirmed nonsyndromic keratocystic odontogenic tumors (KOT) treated at our institutions between 1975 and 2012. RESULTS: Mean age at time of diagnosis was 48 years, and male/female ratio was 1.8:1. The typical nonsyndromic KOT lesion was most often found in the posterior mandible, had radiographically smooth borders, and was associated with symptoms and clinical findings, perforated bone, with a thin capsule. Anterior jaw KOT were found more frequently in patients 50 years or older, and maxillary KOTs were more frequently infected. Treatment was enucleation (n = 70) or marsupialization with subsequent enucleation (n = 22). Observation time ranged from 0.5 months to 25 years (mean 53 months). Crude recurrence rate was 29%. Risk of recurrence increased until 7 years after treatment and then remained stable. Patients with impaired general health had a significantly increased risk of recurrence. Tumors in the posterior mandible that had bone perforation and a thin capsule and contained keratin showed increased recurrence rates. Although recurrence rates were similar for both treatment groups, the groups differed in size and tumor site; thus, the results of this study need to be confirmed in a prospective study. CONCLUSIONS: Time-dependent recurrence pattern of KOTs is described and analyzed. The following follow-up protocol is suggested for patients with impaired health or large lesions: clinical and radiographic examinations at 2, 4, and 7 years, followed by intervals of 3 to 4 years; for other patients: clinical and radiographic examination at 4, 6, and 8 years, followed by intervals of 3 to 4 years.