The odontogenic keratocyst (OKC) is a frequently developing odontogenic cyst that accounts for 10%-14% of all jaw cysts. Due to the high recurrence rate, aggressive therapeutic techniques such as jaw resection and marsupialization are indicated. Following a conservative marsupialization procedure in which Carnoy\'s solution and an iodoform packing were used, the clinical, radiological, and histological evaluation of OKC in a 12-year-old female patient revealed no evidence of recurrence over the subsequent year of follow-up.

Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, which depicted presence of numerous basal cell carcinoma in conjunction with multiorgan abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the keratocystic odontogenic tumour are usually one of the first manifestations of the syndrome. This article includes a case report of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumour and treatment modalities.

Odontogenic keratocysts (OKC) are aggressive cysts with a high recurrence potential. Treating them with surgical enucleation procedures alone is associated with high recurrence rates; therefore, additional or supportive treatment approaches, such as peripheral osteotomy, cryotherapy, and chemical solutions, are warranted. The objective of the present review was to evaluate the existing literature on the efficacy of chemical approaches, such as Carnoy\'s solution (CS), in preventing recurrence after the enucleation of OKC. An electronic search was conducted on PubMed, Scopus, and Google Scholar databases to find articles published from January 2010 to December 2022 by using the Medical Subject Headings (MeSH) terms \"Odontogenic Keratocyst\" \"Carnoy\'s Solution,\" \"Treatment,\" and \"Enucleation.\" Articles published in the English language were selected for the study. The PICOS criteria (population: patients with non-syndromic OKC with histopathological diagnosis and a minimum follow-up of six months; intervention and comparison: enucleation followed by adjunctive chemical therapy and standard procedure; outcome: recurrence rates; study design: retrospective and prospective studies, randomized controlled trials, and case series involving at least 10 cases of OKC) were employed. Studies involving syndromic (nevoid basal cell carcinoma) cases were excluded from the search. Seventeen studies fulfilled the inclusion criteria and the majority of them were retrospective studies, with a few case series. OKC was found more frequently in the mandible, with a recurrence rate of 11%, when treated with CS following enucleation after four years of follow-up. Modified Carnoy\'s solution (MC) was used in two studies. The mean follow-up period was 44 months. Based on our findings, adjuvant therapy using a chemical approach following enucleation is a more effective and beneficial modality for the treatment of OKC.

Maxillary sinus odontogenic keratocyst (OKC) is very rare and occupies less than 1% of the total OKC cases reported in the literature. OKCs have characteristic features that are unique compared to other cysts of the maxillofacial region. Considering their peculiar behaviour, varied origin, debated development, discourse treatment modalities, and high recurrence rate, OKCs have been a subject of interest for various oral surgeons and pathologists globally. This case report presents an unusual case of invasive maxillary sinus OKC into the orbital floor, pterygoid plates, and hard palate in a 30-year-old female. The case report confers that cystic maxillary sinus lesions should always be treated very extensively irrespective of the nature of the lesion as the site makes it highly susceptible to secondary infection and recurrence. The case also establishes a set of imaging modalities and specific treatment approaches to be followed for maxillary sinus OKC based on the literature of all the previous cases reported.

Carnoy\'s solution, a chemical cauterisation agent, has been indicated as one of the adjuvant treatment modalities for odontogenic keratocyst. In 2000, after the ban of chloroform many surgeons adopted the use of Modified Carnoy\'s solution. The purpose of this study is to compare the depth of penetration and amount of bone necrosis of Carnoy\'s versus Modified Carnoy\'s solution on the mandible of Wistar rats at different time intervals. Twenty-six male Wistar rats of six to eight weeks old, weighing approximately 150-200 grams, were allocated for this study. The predictor variables were type of solution and application time. The outcome variable was depth of penetration and amount of bone necrosis. Carnoy\'s solution was applied on the defect on the right side of the mandible and Modified Carnoy\'s solution on the left side for five minutes on eight rats, eight minutes on eight rats, and 10 minutes on eight rats. All specimens were subjected to histomorphometric analysis done using Mia image AR software. Univariate ANOVA test, and paired sample t test was done to compare the results. The depth of penetration for Carnoy\'s solution was more than Modified Carnoy\'s solution in the three different exposure times. Statistically significant results were observed at five minutes and eight minutes. The amount of bone necrosis was more in Modified Carnoy\'s solution. The results were not statistically significant at the three different exposure times. To conclude, when one wants to use Modified Carnoy\'s solution, the minimum exposure time should be 10 minutes to achieve similar results as those of Carnoy\'s solution.

To date, few studies have been conducted to test the effectiveness of Carnoy\'s (CS) versus modified Carnoy\'s (MC) solution for preventing the recurrence of odontogenic keratocysts, which are potentially aggressive lesions. To evaluate the efficacy of MC application, we conducted a retrospective cohort study over an 18-year period, from October 2004 to October 2022, in 122 patients treated surgically with adjunctive chemical cautery, with either CS (n = 73; median age: 30 years) or MC (n = 49; median age: 42 years), by a single surgeon. The primary outcome variables were observed recurrence and interval to recurrence. Independent variables were demographics, location, clinical presentation at baseline, adjacent tooth extraction, and bone grafting. Males predominated in both groups. No statistically significant differences were observed between the two arms in terms of recurrences in particular months, with six patients (8.2%) in the CS arm and 5 (10.2%) in the MC arm. Of the 11 recurrences, 10 were observed within the first 2 years post-surgery, with only one occurring in the 7th year of follow-up. Thus, when used as adjunctive therapy, the application of MC has an efficiency comparable to that of CS for lowering the recurrence rate of odontogenic keratocysts.

Odontogenic keratocysts (OKC) are benign but aggressive lesions. As there is a lack of well randomized clinical studies assessing the effectiveness of the different treatment options for OKC, a network meta-analysis (NMA) was performed to identify the best treatment option with the lowest recurrence rate. An electronic search was performed following the PRISMA guidelines to identify all clinical studies comparing treatment options against enucleation alone. The outcome variable was recurrence. The predictor variables were treatments. The eight included treatments were: enucleation with peripheral ostectomy/curettage (E + PO/curettage); enucleation with cryotherapy (E + CRYO); enucleation with/without PO followed by modified Carnoy\'s solution (E ± PO+MCS); enucleation with PO and with topical 5-fluorouracil (E + PO+5FU); enucleation with/without PO followed by original Carnoy\'s solution (E ± PO+CS); marsupialization alone (MARS); marsupialization followed by secondary enucleation with/without PO (MARS+2°E ± PO); and resection. The odds ratio was used to estimate the recurrence rate. A frequentist NMA was performed using Stata software. A total of 2989 patients in 40 studies were included. Both direct pairwise meta-analysis and NMA showed that E + 5FU+PO was significantly superior to E ± PO+MCS. However, no statistically significant difference was found between E ± PO+CS vs E + 5FU+PO, E ± PO+MCS, and resection, respectively (all very low quality evidence). The three most effective treatments in reducing the recurrence rate were E + PO+ 5FU (98.1%; very low quality evidence), resection (83.5%; very low quality evidence), and E ± PO+CS (63.8%; moderate quality evidence). The findings from this study suggest that CS remains the most effective fixative agent after enucleation and PO until proven otherwise. Additionally, 5FU appears to be an effective method with promising results that needs further research. Finally, the efficacy of MCS remains controversial; further in vivo and in vitro studies are required to determine new protocols. As this NMA included retrospective studies, the results should be interpreted with great caution (level of evidence: type III).

The Odontogenic Keratocyst (OKC) is one of the most aggressive odontogenic cysts. OKCs of the maxilla are particularly rare with less than 1% of cases reported in the literature. A 29-year-old female patient presented with pain and loose upper molars. Imaging confirmed an ectopic tooth at the osteomeatal complex and a maxillary OKC. These were endoscopically surgically removed and two teeth were encountered at the maxillary antrum. Histopathology confirmed the diagnosis of OKC of the maxilla. Surveillance with CT imaging and clinical assessment at 6 months shows no evidence of recurrence.

Unicystic ameloblastoma is a distinct pathological variant with varying evidence published about its behaviour and surgical management. Due to a paucity of large studies in the literature with long-term follow up, the aim of this study was to analyse its surgical management and identify clinicopathological features associated with recurrences. All histopathologically confirmed lesions diagnosed at two referral centres between 1995 and 2020 were retrospectively analysed. Demographic, clinical, radiological, and histopathological features were analysed along with surgical methods and follow-up data. Univariate regression analyses were performed to identify risk factors for recurrence. Sixty-three patients were included in the study with mean age of 26.3 years and a male to female ratio of 1:0.75. The majority of lesions occurred in the posterior mandible (57.1%) and were unilocular (88.9%). Most lesions were managed with enucleation followed by application of Carnoy\'s solution (ferric chloride: 1g; chloroform: 3 mL; glacial acetic acid: 1 mL; ethyl alcohol 96%: 6 mL) and burring of the peripheral bone margin which resulted in the lowest recurrences (9.1%) besides resection. Significantly associated clinicopathological features with recurrences included patients who were male, large lesions (>90 mm), presence of root resorption, cortical perforation, mural subtype, and retention of associated teeth. In conclusion, decision making in the management of unicystic ameloblastoma should be based on the clinicopathological features and not be solely based on the histopathological subtype. Enucleation followed by application of Carnoy\'s solution and burring of the peripheral bone margin was demonstrated to be the least invasive method with an acceptable low recurrence rate.

BACKGROUND: To compare the number of lymph nodes (LNs) detected when using Carnoy\'s solution (CS) versus 10% neutral buffered formalin (NBF) to fix specimens after radical gastrectomy for gastric cancer.
METHODS: LNs were routinely detected using NBF until 2020, since then, for the fixation procedure, residual fat was fixed in CS for 24 hours and dissected again for the detection of further LNs. Of 143 specimens, 117 were included in the NBF group and 26 in the CS group.
RESULTS: The mean numbers of LNs examined were 27.85±14.89 and 36.30±12.41 in the NBF and CS groups, respectively (p=0.008). The mean number of additional LNs detected using CS was 8.07±2.91, of which 0.38±1.02 were metastatic. Additional LNs were found in all patients of the CS group, and all were ≤3 mm. Of the 26 patients in the CS group, metastatic LNs were detected in four, disease in two of whom was up-staged.
CONCLUSIONS: CS is an appropriate alternative to NBF for the fixation of gastric cancer specimens, and more LNs were detected in the resected specimens fixed when using CS compared with NBF.