Management and recurrence of the odontogenic keratocyst: an overview of systematic reviews

• Published in: Oral and maxillofacial surgery 2024-12, Vol.28 (4), p.1457-1478
• Main Authors: Gonçalves, Thayanne Oliveira de Freitas, Rangel, Renata Matuck Roque, Marañón-Vásquez, Guido Artemio, Soares-Silva, Larissa, Agostini, Michelle, Abrahão, Aline Corrêa, Romañach, Mário José, Maia, Lucianne Cople
• Format: Article
• Language: English
• Subjects: Adjuvants; Citation management software; Cysts; Dentistry; Humans; Maxillofacial surgery; Medicine; Medicine & Public Health; Odontogenic Cysts - surgery; Oral and Maxillofacial Surgery; Recurrence; Review; Systematic review
• ISSN: 1865-1569; 1865-1550; 1865-1569
• DOI: 10.1007/s10006-024-01277-4

Materials and methods An extensive literature search among six eletronic databases and Grey Literature was used to identify systematic reviews (S) that could respond if: in individuals diagnosed with OKC (P), is there any influence of the treatment method (I/C) on the recurrence rate of the lesion (O)? After evaluating all titles and abstracts and then applying the eligibility criteria, the included studies were read in full, and data were extracted based on a standardized sheet ordered in the PICO sequence. The assessment of the quality of the systematic reviews included, was determined by AMSTAR2, and final synthesis were descriptively made based on the results and quality of the systematic reviews. Results From a total of 19 included systematic reviews, it was observed that the most used treatment for OKC was enucleation, followed by enucleation with adjuvant techniques and marsupialization. The mean percentage of recurrence was 16,2%, and the highest OKC recurrence rate was 43.2% after simple enucleation. The use of adjuvant techniques promoted reductions in OKC recurrence rates. The overall methodological quality of systematic reviews was critically low, and this parameter demonstrate the need for more studies to facilitate the choose of the treatment. Conclusion Despite being the most used treatment, simple enucleation is related to the highest rate of recurrence, except when performed after marsupialization/decompression. In addition, the use of adjuvant techniques has a strong impact on reducing the likelihood of recurrence. However, these findings are not conclusive because of the critically low quality of the systematic reviews.