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Chemical adjuncts and cryotherapy in the management Of odontogenic keratocysts: A systematic review

Tay, ZW; Sue, WL; Leeson, RMA; (2021) Chemical adjuncts and cryotherapy in the management Of odontogenic keratocysts: A systematic review. Advances in Oral and Maxillofacial Surgery , 3 , Article 100116. 10.1016/j.adoms.2021.100116. Green open access

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Abstract

INTRODUCTION: Odontogenic keratocysts are benign lesions but are locally aggressive, forming multiple daughter cysts which have a tendency to recur. Practitioners who advocate a conservative approach suggest enucleating the lesion and then treating the residual bony cavity with an adjunctive therapy in order to minimise the possibility of recurrence. Many forms of adjunctive therapy have been described such as cryotherapy, chemical cauterisation with Carnoy's or Modified Carnoy's solution and the use of topical 5-fluorouracil (5-FU) but there has not been a systematic review to compare these various adjunctive treatments in the management of odontogenic keratocysts. METHOD: PRISMA guidelines for systematic reviews were followed. An electronic literature search from the databases Medline, PubMed, the Cochrane database and the Web of Sciences were performed, and relevant articles were selected based on the inclusion criteria. Disputes were resolved by an independent third party. Statistical analysis was performed to identify trends of recurrence for each treatment arm. RESULTS: A total of 28 studies managing a total of 1430 odontogenic keratocysts were included in the review. It was observed that only Carnoy's solution resulted in statistically different outcomes compared to no adjunct therapy. There was weak evidence on the efficacy of modified Carnoy's solution but no evidence that cryotherapy or 5-FU resulted in statistically different outcome compared to no adjunct therapy. CONCLUSION: Carnoy's solution appears to be the best adjunct therapy for now but further studies are needed to establish the roles of modified Carnoy's solution, cryotherapy and 5-FU in the management of odontogenic keratocyst.

Type: Article
Title: Chemical adjuncts and cryotherapy in the management Of odontogenic keratocysts: A systematic review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.adoms.2021.100116
Publisher version: https://doi.org/10.1016/j.adoms.2021.100116
Language: English
Additional information: © 2021 The Authors. Published by Elsevier Ltd on behalf of British Association of Oral and Maxillofacial Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Odontogenic keratocyst, Keratocystic odontogenic tumour, Carnoy’s solution, Modified Carnoy’s solution, Cryotherapy, 5-Fluorouracil
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10183599
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