Lorenza A Donnelly1, Tavian H Simmons2, Bradley J Blitstein2, Matthew H Pham3, Pooja T Saha4, Ceib Phillips5, Raymond P White6, George H Blakey7. 1. Resident, Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, NC; Resident, Department of Oral and Maxillofacial Surgery, University of North Carolina Hospitals, Chapel Hill, NC. Electronic address: Lorenza_donnelly@med.unc.edu. 2. Dental Student, UNC Adams School of Dentistry, Chapel Hill, NC. 3. Resident, Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, NC; Resident, Department of Oral and Maxillofacial Surgery, University of North Carolina Hospitals, Chapel Hill, NC. 4. Graduate Student, Gillings School of Public Health, Department of Biostatistics, Chapel Hill, NC. 5. Professor and Program Director, Division of Oral & Craniofacial Biomedicine, UNC Adams School of Dentistry, Chapel Hill, NC. 6. Dalton L. McMichael Distinguished Professor of Oral and Maxillofacial Surgery, Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, NC. 7. Raymond P. White Distinguished Professor and Chair of Oral and Maxillofacial Surgery, UNC Adams School of Dentistry Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, NC.
Abstract
PURPOSE: Carnoy's solution (CS), the gold standard for adjunctive chemical cautery in treatment of OKCs, has been banned for 7 years, leading to substitution with the non-chloroform containing modified Carnoy's solution (MC) without data to support its effectiveness. We performed this study to compare the earlier data with CS to the more current outcomes with MC. METHODS: A retrospective cohort study was conducted on patients diagnosed with OKC and treated by a single surgeon (GHB) with enucleation and curettage (EC), peripheral ostectomy, and application of CS or MC. The primary predictor variables were use of CS or MC. The primary outcome variables were recurrence (yes vs. no) and time to recurrence. Secondary variables included demographics, anatomic location, and whether teeth adjacent to the lesion were extracted. Statistical analyses included chi-squared test/Fisher's exact test, Wilcoxon rank sum test, and Kaplan-Meier curves. RESULTS: 77 patients, 36 patients in the CS group and 41 in the MC group, met inclusion criteria, including at least 1 year of follow-up time. Characteristics of the groups were similar: median age 41.5 and 46, 61% and 71% male gender, 81% and 90% posterior, and 64% and 50% mandibular lesions, respectively. Overall recurrence was similar, 14.29%, with 5 (13.9%) recurrences in the CS group and 6 (14.6%) in the MC group (p=0.92). Median time to recurrence was 24 months for both groups. Preserving adjacent teeth was associated with a significant increase in recurrence (p = 0.0036). CONCLUSION: Based on this comparison of retrospective outcome data, we found no significant difference in recurrence rate or distribution of time to recurrence between OKCs treated with CS or MC. Aggressiveness of surgical technique is likely a predictive factor in recurrence rate. Future studies should focus on prospective studies and continuing follow-up of the MC group.
PURPOSE:Carnoy's solution (CS), the gold standard for adjunctive chemical cautery in treatment of OKCs, has been banned for 7 years, leading to substitution with the non-chloroform containing modified Carnoy's solution (MC) without data to support its effectiveness. We performed this study to compare the earlier data with CS to the more current outcomes with MC. METHODS: A retrospective cohort study was conducted on patients diagnosed with OKC and treated by a single surgeon (GHB) with enucleation and curettage (EC), peripheral ostectomy, and application of CS or MC. The primary predictor variables were use of CS or MC. The primary outcome variables were recurrence (yes vs. no) and time to recurrence. Secondary variables included demographics, anatomic location, and whether teeth adjacent to the lesion were extracted. Statistical analyses included chi-squared test/Fisher's exact test, Wilcoxon rank sum test, and Kaplan-Meier curves. RESULTS: 77 patients, 36 patients in the CS group and 41 in the MC group, met inclusion criteria, including at least 1 year of follow-up time. Characteristics of the groups were similar: median age 41.5 and 46, 61% and 71% male gender, 81% and 90% posterior, and 64% and 50% mandibular lesions, respectively. Overall recurrence was similar, 14.29%, with 5 (13.9%) recurrences in the CS group and 6 (14.6%) in the MC group (p=0.92). Median time to recurrence was 24 months for both groups. Preserving adjacent teeth was associated with a significant increase in recurrence (p = 0.0036). CONCLUSION: Based on this comparison of retrospective outcome data, we found no significant difference in recurrence rate or distribution of time to recurrence between OKCs treated with CS or MC. Aggressiveness of surgical technique is likely a predictive factor in recurrence rate. Future studies should focus on prospective studies and continuing follow-up of the MC group.