Factors affecting odontogenic keratocyst recurrence: a retrospective chart review

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Sirinda Thanarojvanich
Teeranut Chaiyasamut


Objectives: The aim of this study was to assess the association between the sociodemographic, clinical, radiological, and surgical characteristics and odontogenic keratocyst (OKC) recurrence and evaluate the recurrence rate.
Materials and Methods: A retrospective chart review of patients diagnosed and treated for OKC from 2001–2018 was performed using the hospital records. We reviewed the medical records of 129 patients to extract their sociodemographic, clinical features, radiological features, surgical treatment and its characteristics, follow-up period, and re-occurrence information. The parametric numerical variables (age) are described as mean and standard deviation, whereas the categorical variables are presented as frequency and percentage. The association between the socio-demographic, clinical, radiological, and surgical factors and OKC recurrence was assessed using logistic regression. The Nelson-Aalen estimator of survival function in the survival analysis was used to estimate the cumulative hazard of OKC recurrence with time. A p-value <0.05 was considered significant.
Results: Eighty-one patients who were diagnosed and treated for OKC were included in this study after meeting the inclusion criteria. Fifty percent of them were females. The mean age of the patients at diagnosis and treatment for OKC was 28.6 ± 12.6 years old. Among the risk factors, root resorption was significantly associated with OKC recurrence (p=0.004). Removal of teeth associated with root resorption demonstrated a significantly lower risk of recurrence (p=0.031). No other variable had a significant relationship with OKC recurrence. After a 2-year (24 months) follow-up, the recurrence was found in 14 cases with a cumulative probability of 27.5%.
Conclusions: Root resorption due to OKC is significantly associated with an increased recurrence rate. The removal of teeth associated with root resorption resulted in a significantly lower recurrence rate. However, other demographic, clinical, radiological, and surgical factors did not demonstrate significant differences in their OKC recurrence.

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Thanarojvanich S, Chaiyasamut T. Factors affecting odontogenic keratocyst recurrence: a retrospective chart review. M Dent J [Internet]. 2022 Dec. 13 [cited 2024 May 22];42(3):209-22. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/258441
Original articles


Speight PM, Takata T. New tumour entities in the 4th edition of the World Health Organization Classification of Head and Neck tumours: odontogenic and maxillofacial bone tumours. Virchows Arch 2018; 472: 331-9.

Ribeiro-Júnior O, Borba AM, Alves CAF, Gouveia MM, Deboni MCZ, Naclério-Homem MDG. Reclassification and treatment of odontogenic keratocysts: A cohort study. Braz Oral Res 2017; 31: e98.

Mendes RA, Carvalho JF, van der Waal I. Characterization and management of the keratocystic odontogenic tumor in relation to its histopathological and biological features. Oral Oncol 2010; 46: 219-25.

Chrcanovic BR, Gomez RS. Recurrence probability for keratocystic odontogenic tumors: An analysis of 6427 cases. J Craniomaxillofac Surg 2017; 45: 244-51.

Al-Moraissi EA, Dahan AA, Alwadeai MS, Oginni FO, Al-Jamali JM, Alkhutari AS, et al. What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis. J Craniomaxillofac Surg 2017; 45: 131-44.

Sharif FN, Oliver R, Sweet C, Sharif MO. Interventions for the treatment of keratocystic odontogenic tumours. Cochrane Database Syst Rev 2015; 2015: CD008464.

Antonoglou GN, Sándor GK, Koidou VP, Papageorgiou SN. Non-syndromic and syndromic keratocystic odontogenic tumors: systematic review and meta-analysis of recurrences. J Craniomaxillofac Surg 2014; 42: e364-71.

Kaczmarzyk T, Mojsa I, Stypulkowska J. A systematic review of the recurrence rate for keratocystic odontogenic tumour in relation to treatment modalities. Int J Oral Maxillofac Surg 2012; 41: 756-67.

Noy D, Rachmiel A, Zar K, Emodi O, Nagler RM. Sporadic versus syndromic keratocysts-Can we predict treatment outcome? A review of 102 cysts. Oral Dis 2017; 23: 1058-65.

Fidele NB, Yueyu Z, Zhao Y, Tianfu W, Liu J, Sun Y, et al. Recurrence of odontogenic keratocysts and possible prognostic factors: Review of 455 patients. Med Oral Patol Oral Cir Bucal 2019; 24: e491-e501.

Giovacchini F, Bensi C, Paradiso D, Belli S, Mitro V, Tullio A. Factors influencing the recurrence of keratocysts: monocentric study. J Oral Med Oral Surg 2020; 26: 1.

El-Naggar AK, Chan JKC, Takata T, Grandis JR, Slootweg PJ. WHO Classification of Head and Neck Tumours 4th Edition. 4th éd. France: IARC Publications; 2017.

Chi AC, Neville BW, Damm DD, Allen CM. Oral and Maxillofacial Pathology-E-Book: Elsevier Health Sciences; 2017.

Tiranon A, Kongyadee W, Klanrit P, Rattanapan P. The Retrospective Study of Prevalence, Treatment and Recurrence Rate of Odontogenic Keratocyst (OKC) in Faculty of Dentistry, Khon Kaen University. Khon Kaen University Dental Journal 2020; 23: 66-76.

Chirapathomsakul D, Sastravaha P, Jansisyanont P. A review of odontogenic keratocysts and the behavior of recurrences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 5-9; discussion 10.

Kinard B, Hansen G, Newman M, Dennis P, Haeffs T, Perez S, et al. How well do we manage the odontogenic keratocyst? A multicenter study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127: 282-8.

Berge TI, Helland SB, Sælen A, Øren M, Johannessen AC, Skartveit L, et al. Pattern of recurrence of nonsyndromic keratocystic odontogenic tumors. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122: 10-6.

Boffano P, Ruga E, Gallesio C. Keratocystic odontogenic tumor (odontogenic keratocyst): preliminary retrospective review of epidemiologic, clinical, and radiologic features of 261 lesions from University of Turin. J Oral Maxillofac Surg. 2010; 68: 2994-9.

Sánchez-Burgos R, González-Martín-Moro J, Pérez-Fernández E, Burgueño-García M. Clinical, radiological and therapeutic features of keratocystic odontogenic tumours: a study over a decade. J Clin Exp Dent 2014; 6: e259-64.

de Castro MS, Caixeta CA, de Carli ML, Ribeiro Júnior NV, Miyazawa M, Pereira AAC, et al. Conservative surgical treatments for nonsyndromic odontogenic keratocysts: a systematic review and meta-analysis. Clin Oral Investig 2018; 22: 2089-101.

Kinard BE, Chuang SK, August M, Dodson TB. How well do we manage the odontogenic keratocyst? J Oral Maxillofac Surg 2013; 71: 1353-8.

Titinchi F, Nortje CJ. Keratocystic odontogenic tumor: a recurrence analysis of clinical and radiographic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 136-42.

Chow HT. Odontogenic keratocyst: a clinical experience in Singapore. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86: 573-7.

Haring JI, Van Dis ML. Odontogenic keratocysts: a clinical, radiographic, and histopathologic study. Oral Surg Oral Med Oral Pathol 1988; 66: 145-53.

Brannon RB. The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part I. Clinical features. Oral Surg Oral Med Oral Pathol 1976; 42: 54-72.

Partridge M, Towers JF. The primordial cyst (odontogenic keratocyst): its tumour-like characteristics and behaviour. Br J Oral Maxillofac Surg 1987; 25: 271-9.

Clark TG, Bradburn MJ, Love SB, Altman DG. Survival analysis part I: basic concepts and first analyses. Br J Cancer 2003; 89: 232-8.