Influência de parâmetros clínicos, radiográficos, cirúrgicos e histopatológicos na taxa de recidiva dos ceratocistos odontogênicos: uma análise retrospectiva de coorte

Abstract

There is no consensus, in the literature, regarding the best protocol of treatment of Odontogenic Keratocyst (OKC). This is due to several factors, including the lack of adequate standardization of data assessed in the studies. This failure is usually inherent to retrospective studies. The objective of this study is to evaluate the influence of clinical, radiographic, surgical and microscopic parameters in the relapse rate of the disease. The differential aspect is in the uniform and detailed treatment applied by the same surgeon in all cases. The treatment applied was the enucleation with peripheral ostectomy, preceded by lesion decompression or not. The sample (n=24) was composed of patients, with a mean age of 32.1 years, presenting for the management of one untreated OKCs. Fourteen lesions (58.4%) were submitted to previous decompression procedure. The mean follow-up time was 60.5 months (SD=31.3). Eight patients (33%) developed recurrent lesions and a mean of disease-free interval for recurrent lesions of 19 months (SD=4.9). All recurrence lesions were diagnosed in two first years of follow-up and were significantly associated with: 1) poor clinical response to decompression (P=0.027); 2) remaining tooth with radiographic evidence of insinuation of the lesion between the dental roots (P=0.009); 3) presence of budding of the basal cells layer together with epithelial islands in the fibrous capsule (P=0.019). Our study suggests that these clinical, radiographic and microscopic parameters could affect relapse rate of patients with OKC and may individually guide the treatment choice.