Volumetric changes in the size of odontogenic keratocysts after decompression followed by enucleation, peripheral ostectomy, and Carnoy's solution: A retrospective study

OKCs are intrabony lesions affecting the jaw bones. These lesions are benign, developmental, and locally aggressive. They are recurrent and may appear as single or multiple lesions. Furthermore, they may be non-syndromic or associated with certain syndromes, such as Gorlin Goltz and basal cell nevus syndromes (; Karhade et al., 2019; Hadziabdic et al., 2019; Leung et al., 2016). They were formerly categorized as odontogenic tumors (Rajendra Santosh, 2020), nevertheless they are now considered cystic lesions. This is due to a lack of evidence supporting their neoplastic origin (Stoelinga, 2022; Mohanty et al., 2021; Stoelinga and da Silva, 2021). OKCs are the third most common type of cyst, accounting for 21% of all jaw cysts. (Tay et al., 2021; Karaca et al., 2018; Al-Moraissi et al., 2017).

There are numerous treatment options for their management, ranging from conservative to aggressive. Conservative treatment includes decompression and EN, with or without adjunctive therapy. On the other hand, the aggressive treatment option includes radical surgery with resection (Noy et al., 2017; Kaczmarzyk et al., 2012). Unfortunately, there is no gold standard treatment protocol for OKCs, and surgeon interactions with OKCs are uncertain. Furthermore, bone regeneration in the residual cavity remains controversial. Following the EN of OKCs, there is a choice between filling and not filling the residual bony cavity with bone grafts (Ettl et al., 2012). Many authors advocated for the treatment of OKCs without the use of bone grafts (Shi et al., 2022; Chacko et al., 2015). Surgeons continue to raise many questions about this issue that lack definitive answers, such as the quality of bone healing and regeneration after their treatments, the speed and direction of bone formation in bony defects after surgical removal, and the appropriate time to insert dental implants into the residual bony defect to replace missing teeth at the affected area in which bone healing occurs spontaneously.

As a result, this study was conducted to address the following issues: 1) What is the reduction pattern in the size of OKC and bony defect after decompression, followed by EN, PO, and CS? 2) When does bone regeneration in residual bony defects occur? 3) Does the study’ treatment protocol provide a long-term effective treatment? The study's hypothesis was that its treatment protocol eliminates the need for resections and bone graft, allows for good bone healing with normal textures, simplifies OKC treatment, and allows for faster jaw rehabilitation. So, the study aimed to retrospectively investigate the reduction pattern in the size of bony defects after OKC management in order to determine the best timing for jaw rehabilitation with dental implants following their removal, and to assess the long-term success of the decompression, followed by EN, PO, and CS in OKC management.

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