Treatment of large odontogenic keratocysts by decompression and later cystectomy: a long-term follow-up and a histologic study of 23 cases.
OBJECTIVE
The purpose of this study was to determine the course of healing, the frequency of recurrence, and the changes in the epithelium of keratocysts after decompression treatment.


METHODS
The treatment of 23 keratocysts, which had been divided into two groups (12 and 11 patients, respectively), was carried out in two phases: (1) insertion of a polyethylene drain and removal of a biopsy specimen from the cyst wall, and (2) cystectomy and removal of the drain approximately 1 year later. Histologic examination of the biopsy material from the two phases was carried out, and the material classified according to Forssell.


RESULTS
Reduction in cyst volume together with bone healing occurred in all cases, although there was recurrence in two patients. Decompression resulted in substantial histologic changes in the epithelium in 19 cases (83%).


CONCLUSIONS
(1) Decompression results in new bone formation and thickening of the cyst wall. (2) This treatment conserves bone and anatomic structures. (3) The frequency of recurrence is low. (4) The keratocyst epithelium is modulated histologically to nonkeratocyst after decompression.
Marker
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P
Department of Oral and Maxillofacial Surgery and Oral Medicine, Odense University Hospital, Denmark.
Brøndum
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N
Clausen
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PP
Bastian
H L
HL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D019299:Decompression, Surgical / Q000379:methods; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009807:Odontogenic Cysts / Q000473:pathology / Q000601:surgery*