Using Carnoy's Solution in Treatment of Keratocystic Odontogenic Tumor

Abstract

Aim: The aim of this study was to assess the treatment of keratocystic odontogenic tumor using enucleation and Carnoy's solution with peripheral ostectomy.

Materials and methods: Twenty-nine patients (14 females and 15 males) with age range from 12 to 62 years were included in this study and followed up for 7 years; all the patients were treated in the Department of Oral and Maxillofacial Surgery of the Specialized Surgeries Teaching Hospital (Al-Shaheed Ghazi Al-Hariri Hospital-Medical City, Baghdad, Iraq). Enucleation followed by peripheral ostectomy and the application of Carnoy's solution is the standardized method of treatment.

Results: This study showed (32.7%) unilocular radiolucency for the lesions (19.9%) as multilocular radiolucency. Furthermore, it showed that the recurrence rate by this method was 0% with a minimum neurosensory disturbance.

Conclusion: The complications and morbidity originating from the application of Carnoy's solution occurred less frequently and were less serious than those associated with resection while the recurrence rate is 0% which is equal to the recurrence rate of resection.

Keywords: Carnoy's solution; keratocyst; keratocystic odontogenic tumor.

Figure 1

(a) Intraoral approach, mucuoperiosteal flap reflection and enucleation. (b) Enucleation of the keratocystic odontogenic tumor. (c) The inferior alveolar bundle (arrow) exposed and protected to be isolated during peripheral ostectomy and the application of Carnoy's solution. (d) Carnoy's solution. (e) Application of the Carnoy's solution in the bony defect after peripheral ostectomy. (f) When the 3 min of the application is elapsed, immediately before gauze removal, showing the change in the color of the gauze due to cauterization and fixation action of the solution. (g) Before wound closure. (h) Iodoform packing then suturing

Figure 2

Unilocular radiolucency with anterioposterior cortical and cancellous expansion

Figure 3

Keratocystic odontogenic tumor with multilocular radiolucency in the central region (symphyseal and parasymphyseal) of the mandible

Figure 4

(a) Preopreative radiograph for 19-year-old male patient with keratocystic odontogenic tumor at the right side of the ramus of the mandible (arrow), date of photograph: October 2011. (b) The same case during the follow-up in January 2015, the bone continuity was restored and there was no recurrence (it was treated in October 2011 by enucleation with peripheral ostectomy then Carnoy's solution application)

Figure 5

(a) Preoperative radiograph for 47-year-old male patient with a huge unilocular radiolucency (arrow), this case was prepared to be treated by other treatment modalities (jaw resection) in another hospital. However, it was included in this study and treated by enucleation with peripheral ostectomy then Carnoy's solution application. (b) The bony defect in millimeter, 7 days postoperatively. (c) Follow-up of more than 3 years shows the bone regeneration at the surgical site although we use Carnoy's solution. Furthermore, it shows no recurrence. (d) The defect in millimeter during follow-up periods (decreased)

Figure 6

(a) Preoperative radiograph for a female patient, operated previously and show recurrence within less than a year. (b) Panoramic radiograph after more than 2 years postoperatively, the bony defect is totally filled by regenerated bone