A Retrospective Study Of 257 Patients With Keratocystic Odontogenic Tumor

Objective:Patients with mandibular odontogenic keratocyst treated in the Jilin University Dental Hospital from October 2009 to October 2014 were selected and the variability and clinical effect were evaluated by the proportions of the disease、the age、the lesion、the lesion diameter、the clinical treatment、the recurrence.Methods:257 cases with odontogenic keratocyst from October 2009 to October 2014 in the Jilin University Dental Hospital were selected using the electronic medical records system. The age、the lesion、the duration of symptoms、the lesion diameter、the clinical treatment、the follow-up observation recurrence and the clinical outcomes were involved in the research.Results:257 cases with odontogenic keratocyst from October 2009 to October 2014 in the Jilin University Dental Hospital were selected. The research shows the male and female ratio was 1.32: 1;the occurring age from 7 to 84 years, the average age 38 years, of which the high-risk ages for patients are 20-49 years.Keratocystic odontogenic tumor usually single occurs, 211(82.10%)cases single occurred while 46(17.89%) patients with multiple. 218(84.82%) cases of the diseases showed a single room while 39(15.18%)cases showed multiple.In the mandible, most of the cysts were located in the posterior body and the ramus; in the maxilla, mostly located in the anterior and posterior segments. The mandible was involved in 157(61.09%) and the maxilla100(38.9%). 25(7.55%) cases in the anterior of the maxilla, 75(22.66%)cases in the posterior of the maxilla; the anterior mandible cases 15(4.53%), the posterior 133(40.18%), the ramus 83(25.08%).24 cases showed no obvious clinical symptoms, accounting for9.34%; 122 cases the patients felt swelling, accounting for 47.47% while78 cases felt pain, accounting for 30.35%. In addition, trismus(7.00%)、mandibular paresthesia(25.29%) 、 loose teeth(5.45%) or oral lesion abscesses(14.40%) are the symptoms people usually have.Clinically, 67 cases(26.07%)showed no cortical expansion, 134(52.14%)showed cortical expansion, 6(2.33%)lingual expansion. Always associated with the bone missing.The most common clinical treatment methods are: Enucleation,Mandible Resection, Fenestration Decompression.169 cases were treated by enucleation, 1 case treated by resection, 87 cases treated by decompression. It recorded that 29(17.16%) cases recurred after enucleation, 4(4.60%)cases with decompression recurred while 0 cases of resection.We chose 30 cases which had more complete follow-up from the 87 cases with decompression. 19 cases had underwent secondary surgical treatment now. The time of decompression from 6 months to 5 years,with the average time of 14.3 months. 2(10.53%)cases recurred after secondary surgery; 1(3.33%)patient showed no effect.Conclusion:1. Keratocystic odontogenic tumor have a high-risk population of young, mostly male, usually with swelling and pain;2. Keratocystic odontogenic tumors usually occur in the posterior body and the ramus, mostly single;3. The most common clinical treatment methods of the Keratocystic odontogenic tumors are: Enucleation, Mandible Resection, Fenestration Decompression.4. Clinically, enucleation usually used for small-medium sized keratocystic odontogenic tumor while the decompression used for the medium-large. Most of patients treated by enucleation and decompression had significant changes in bone lesions within six months, it shows on the thickening of the bone 、 increasing bone density 、 the ease of facial deformity.5. Clinically, the treatment of decompression showed a stable and reliable effect on medium-large size KCOT, it can be used as the preferred choice to treat medium-large size KCOT. The selected time of followed treatment usually after a year, it depends on the recovery conditions of the lesions.