A Clinical Study of Keratocystic Odontogenic Tumors

Abstract

As keratocystic odontogenic tumors (KCOT) have a high level of proliferative activity in epithelial cells and tend to grow aggressively in the jaw, careful attention is required. The purpose of this study was to report experiences of KCOT and analyze information regarding recurrence.
A retrospective review was performed in 66 patients and 75 tumors with KCOT who underwent surgery and were followed up for at least 6 months at Nagasaki University Hospital from 1992 to 2014.
KCOT occurred more frequently in men (57.6%) than in women (42.4%), and occurred most commonly in the second decade (24.2%), followed by the first decade (19.7%); the mean age of patients was 36 years old. The most frequent clinical complaint at first admission was asymptomatic, followed by painless swelling and painful swelling. The mandibular molar and ramus were the most common sites of involvement. Surgical procedures included enucleation (84.0%) and marsupialization before enucleation (16.0%). The patients were followed for 6 to 252 months. Recurrences were found in 15 out of 75 tumors (20.0%). Univariate and multivariate analysis showed that treatment of the tooth root in contact with the primary lesion is a significant independent factor for recurrence (P<0.05).
It is suggested that the tooth root in contact with the primary lesion should be extracted to reduce the incidence of recurrence. The period between primary operation and recurrence ranged from 10 to 137 months. For these reasons, careful long-term follow-up is required.