关键词: Odontogenic keratocyst Recurrence rates Surgery Systematic review Treatment

来  源:   DOI:10.1007/s10006-024-01277-4

Abstract:
METHODS: An extensive literature search among six eletronic databases and Grey Literature was used to identify systematic reviews (S) that could respond if: in individuals diagnosed with OKC (P), is there any influence of the treatment method (I/C) on the recurrence rate of the lesion (O)? After evaluating all titles and abstracts and then applying the eligibility criteria, the included studies were read in full, and data were extracted based on a standardized sheet ordered in the PICO sequence. The assessment of the quality of the systematic reviews included, was determined by AMSTAR2, and final synthesis were descriptively made based on the results and quality of the systematic reviews.
RESULTS: From a total of 19 included systematic reviews, it was observed that the most used treatment for OKC was enucleation, followed by enucleation with adjuvant techniques and marsupialization. The mean percentage of recurrence was 16,2%, and the highest OKC recurrence rate was 43.2% after simple enucleation. The use of adjuvant techniques promoted reductions in OKC recurrence rates. The overall methodological quality of systematic reviews was critically low, and this parameter demonstrate the need for more studies to facilitate the choose of the treatment.
CONCLUSIONS: Despite being the most used treatment, simple enucleation is related to the highest rate of recurrence, except when performed after marsupialization/decompression. In addition, the use of adjuvant techniques has a strong impact on reducing the likelihood of recurrence. However, these findings are not conclusive because of the critically low quality of the systematic reviews.
摘要:
方法:在六个电子数据库和灰色文献中进行了广泛的文献检索,以确定系统评价(S),如果:在诊断为OKC(P)的个体中,治疗方法(I/C)对病变(O)的复发率是否有影响?在评估所有标题和摘要并应用合格标准后,纳入的研究已阅读全文,数据是根据按PICO顺序排序的标准化表格提取的。系统评价的质量评估包括,由AMSTAR2确定,并根据系统评价的结果和质量进行描述性综合。
结果:从总共19项系统评价中,据观察,OKC最常用的治疗方法是摘除,然后用佐剂技术和有袋化摘除。平均复发率为16.2%,单纯摘除术后OKC复发率最高,为43.2%。辅助技术的使用促进了OKC复发率的降低。系统评价的总体方法论质量极低,这个参数表明需要更多的研究来促进治疗的选择。
结论:尽管是最常用的治疗方法,单纯摘除与复发率最高有关,除非在有袋化/减压后进行。此外,辅助技术的使用对降低复发的可能性有很大影响.然而,由于系统评价的质量极低,因此这些发现并不具有结论性.
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