目的:牙源性角化囊肿经常复发,独特的组织病理学特征,具有攻击性的临床行为倾向,以及与卵圆形基底细胞癌综合征的潜在联系。本系统评价的目的是收集有关控制这种情况的见解,并评估各种治疗方法在降低复发可能性方面的有效性。
方法:以下系统评价遵循PRISMA指南。在PROSPERO上进行了系统的修订,并围绕与人口有关的问题进行了组织,干预,control,结果和研究设计(PICOS)。
结果:在PubMed数据库上进行搜索后,我们最初确定了944条记录。使用尾注软件删除重复条目后,结果共有462条不同的记录。对这些文章的标题和摘要进行了全面审查,最终选择了50篇论文进行深入审查。最终,根据我们的资格标准,我们将11篇文章纳入主要结局分析.
结论:在所检查的研究中,发现这些病变最常见的位置是下颌支区域和下颌骨的后部区域。在未指定确切位置的情况下,下颌骨成为主要部位。当我们在提到局灶性的研究中考虑这些病变的特征时,在两项研究中,大多数被描述为单眼的,而在另外两项研究中,观察了多房性病变的患病率.与角化囊肿复发相关的危险因素包括患者年龄较小,多房性病变的存在,较大的病变大小,和更长的前后尺寸。某些治疗方法已证明缺乏复发。其中包括使用5-氟尿嘧啶,有袋化,眼球摘除伴周围骨切除术或切除术,摘除术和刮宫术,以及切除而不产生连续性缺陷。然而,重要的是要注意,进一步的研究是必不可少的。需要进行前瞻性研究和随机试验,以收集有关各种治疗方法和随访方案治疗牙源性角化囊肿的有效性的更全面的证据。
结论:牙源性角化囊肿仍可与影响颌骨的其他病变(如成釉细胞瘤和其他肿瘤形式)进行鉴别诊断,此外,它不是免于复发,因此,旨在消除病变的治疗方法可以影响可能的复发和并发症,了解手术方法,为随访和复发的管理提供最可预测和临床相关的结果。
OBJECTIVE: Odontogenic keratocysts exhibit frequent recurrence, distinctive histopathological traits, a tendency towards aggressive clinical behavior, and a potential linkage to the nevoid basal cell carcinoma syndrome. The aim of this systematic review is to compile insights concerning the control of this condition and assess the effectiveness of various treatment approaches in reducing the likelihood of recurrence.
METHODS: The following systematic review adhered to the PRISMA guidelines. The systematic revision was registered on PROSPERO and structured around the questions related to the population, intervention, control, outcome and study design (PICOS).
RESULTS: After conducting a search on the PubMed database, we initially identified 944 records. After using end-note software to remove duplicate entries, results totally with 462 distinct records. A thorough review of the titles and abstracts of these articles led to the selection of 50 papers for in-depth examination. Ultimately, following the application of our eligibility criteria, we incorporated 11 articles into our primary outcome analysis.
CONCLUSIONS: Among the studies examined, the most common location for these lesions was found to be in the area of the mandibular ramus and the posterior region of the mandible. In cases where the exact location wasn\'t specified, the mandible emerged as the predominant site. When we considered the characteristics of these lesions in studies that mentioned locularity, most were described as unilocular in two studies, while in two other studies, the prevalence of multilocular lesions was observed. Risk factors associated with keratocyst recurrence include younger patient age, the presence of multilocular lesions, larger lesion size, and a longer anteroposterior dimension. Certain treatment methods have demonstrated a lack of relapses. These include the use of 5-fluorouracil, marsupialization, enucleation with peripheral ostectomy or resection, enucleation and curettage, as well as resection without creating continuity defects. However, it is important to note that further research is essential. Prospective studies and randomized trials are needed to collect more comprehensive evidence regarding the effectiveness of various treatment approaches and follow-up protocols for managing odontogenic keratocysts.
CONCLUSIONS: Odontogenic keratocysts still enter into differential diagnoses with other lesions that affect the jaw bones such as ameloblastama and other tumor forms, furthermore it is not free from recurrence, therefore the therapeutic approach to the lesion aimed at its elimination can influence both the possible recurrence and complications, knowledge of the surgical methods that offer the most predictable and clinically relevant result for the management of follow-up and recurrences.