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Is conservative treatment (enucleation using modified Carnoy’s solution) of odontogenic keratocyst in the maxilla good prognosis?

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2023, v.49 no.5, pp.287-291
https://doi.org/10.5125/jkaoms.2023.49.5.287
Woo Young Jeon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)
Jung Ho Park (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)
Jeong-Kui Ku (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)
Jin-A Baek (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)
Seung-O Ko (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)

Abstract

Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, such as resection. As an alternative, this report introduces a modified Carnoy’s solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy’s solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy’s solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy’s solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

keywords
Adjuvant chemotherapy, Odontogenic cysts, Prognosis

Journal of the Korean Association of Oral and Maxillofacial Surgeons