Enucleation with or without Adjuvant Therapy versus Marsupialization with or without Secondary Enucleation in the Treatment of Keratocystic Odontogenic Tumors

Authors

  • Ambereen Humayun Assistant Professor, Department of Anatomy, Peshawar Dental College, Peshawar, Pakistan
  • Sobia Tariq MDS Trainee Institute name: Ziauddin University
  • Mohammad Umar Assistant Professor Oral and Maxillofacial Surgery Rawal Institute of Health Sciences Rawalpindi
  • Noor UL Wahab Head of Department (Department of Oral Maxillofacial Surgery) Institute name: Ziauddin Medical University
  • Atif Iqbal Butt Associate professor Omfs Ziauddin University Karachi
  • Sufyan Ammar Training Medical Officer (TMO) of Oral and Maxillofacial Surgery Khyber College of Dentistry

Abstract

Objective: In order to assess enucleation with or without adjuvant therapy and marsupialization with or without secondary enucleation on patient outcomes regarding recurrence rates, complications and healing times in the context of KOT.

Method: In this cohort study, a total of 150 participants diagnosed with Keratocystic Odontogenic Tumors. Patients were divided into four groups: enucleation with adjuvant therapy; enucleation without adjuvant therapy; marsupialization alone; and marsupialization then second surgery for enucleation. The outcomes of the study were recorded in terms of recurrence of the tumor and its complete regression Other outcomes like the recovery period of the patient, the occurrence of complications, and functional capacities were also noted for all the patients. All these variables were entered and analyzed for descriptive and inferential analysis with SPSS version 25.

Results: The recurrence rates in the enucleation with adjuvant therapy group was 8%, mean time to recurrence: 20±3.5 months while for enucleation without adjuvant therapy was 18% with mean time to recurrence of 21±4.0 months. Higher complications rate was noted in enucleation with adjuvant therapy at 10% and 15% in enucleation without adjuvant therapy. Marsupialization alone resulted in a recurrence rate of 13% (mean time to recurrence: 22±3.8 months, the complication rate was 7%. Marsupialization followed by secondary enucleation showed the lowest recurrence rate at 4% (mean time to recurrence: 25±4.1 months and the complication rate of 8%. Using statistical analysis, the differences between the recurrence rates of the groups were brought out ((p = 0.04) for the enucleation with adjuvant therapy and (p = 0.03) for marsupialization with/without secondary enucleation.

Conclusion: Thus, adjuvant therapy and marsupialization with secondary enucleation proved to be less likely to result in the high recurrence rate that marsupialization alone causes and enucleation is less likely to result in high recurrence rate that leaving the mass in causes.

Keywords: Keratocystic Odontogenic Tumors, Enucleation, Adjuvant Therapy, Marsupialization, Recurrence Rates, Treatment Efficacy.

Published

2024-06-11

Issue

Section

Original Articles