Clinical observation of a conservative treatment for large keratocystic odontogenic tumors in the mandible：enucleation followed by open packing
10.7518/hxkq.2014.06.008
- VernacularTitle:下颌骨大型牙源性角化囊性瘤口内摘除开放愈合的临床观察
- Author:
Chuan LIU
1
;
Hongzhi ZHOU
;
Rui HOU
;
Yuxiang DING
;
Ruifeng QIN
;
Kaijin HU
Author Information
1. 第四军医大学口腔医院口腔外科
- Keywords:
mandible;
keratocystic odontogenic tumors;
enucleation;
secondary healing
- From:
West China Journal of Stomatology
2014;(6):566-569
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible. Methods A retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regeneration and surgical complications were observed. The long-term effects of the treatment were followed up. Results The inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The postoperative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed. Conclusion Enucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.
