Surgical Removal of Ameloblastoma and Keratocystic Odontogenic Tumors in Maxilla and Mandible, a Literature Review on Surgical Techniques and Risk of Recurrence

This literature review examines the literature on surgical management of ameloblastoma and keratocystic odontogenic tumours (KCOT). KCOT represent 3 % - 11 % of all the cystic lesions in the jaws and ameloblastoma 11 % of the odontogenic tumours. Treatment involves removal of the tumours by means of enucleation, curettage, marsupialization or resection. The first three can be combined with each other or with the adjunctive therapies: applications of Carnoy´s solution or cryotherapy. The aim of this literature review is to evaluate the risk of complications correlated to different surgical techniques for removal of KCOT or ameloblastoma. A search was performed in PubMed based on our keywords (Marsupialization, decompression, fenestration, enukleation, KCOT, OKC, KOT, keratocystic odontogenic tumor, odontogenic keratocyst, ameloblastoma, outcome, follow-up, relapse, prognosis, recurrence). The data was managed with Excel. Twenty articles met our criteria: 12 articles reported KCOT in 667 patients and 8 articles reported 191 patients concerning Ameloblastoma. The articles almost exclusively presented the risk of recurrence for different treatment modalities. Subsequently the results mainly contain recurrence rates for different surgical techniques. 412 KCOT patients received enucleation alone and 92 recurred, resulting in a recurrence rate of 22.3 %. 91 patients with ameloblastoma received resection and four recurred, resulting in a recurrence rate of 4.4 %. This review fails to identify any reliable evidence on recurrence rates in relation to treatment modalities for KCOT and ameloblastoma. Further prospective controlled clinical trials are essential to address this important issue