[Risk factors for recurrence of maxillary odontogenic keratocysts]

Abstract

Purpose: The odontogenic keratocyst is a benign tumor with a high recurrence rate and aggressive behavior. We analyzed the risk factors for recurrence of odontogenic keratocysts and compared our results to published ones.

Patients and methods: Thirty-two patients (36 odontogenic keratocysts) were treated in our department between 1996 and 2006. We retrospectively analyzed recurrence according to anatomoclinic, histopathological, and prognostic parameters.

Results: The patients' mean age was 41 years. The sex ratio was 1.28 with male predominance. The mandible was the most common site (30 cases). The most common radiological finding was a unilocular cyst in 75 % of cases. The primary treatment was conservative surgery for all patients. Twelve recurrences were observed in eight patients between 2 and 10 years of follow-up. All recurrences occurred in the mandible with 41 % in the angle and ramus. Multilocular cysts recurred in 55 % of cases, unilocular in 11 %. The recurrence rate of orthokeratocysts was 40 %. The presence of satellite cysts and extension to soft tissues were associated with a high rate of recurrence (60 %). Sixty-six percent of infected cysts recurred and among these, eight were enucleated in several fragments.

Discussion: The recurrence rate of odontogenic keratocysts is higher in case of mandibular posterior region localization and multilocular keratocysts. This might be explained by the difficult surgical accessibility. Some histological findings including the presence of satellite cysts and orthokeratocysts are associated with a higher recurrence rate. Cyst infection and treatment modalities influence the recurrence rate.