Systematic review of the treatment and prognosis of the odontogenic keratocyst.

OBJECTIVES To clarify the natural history of the odontogenic keratocyst (OKC) and to evaluate treatments with respect to the likelihood of recurrence. STUDY DESIGN A systematic review of the literature was completed pertaining to the treatment and prognosis of the OKC. Each investigation was evaluated based on 4 inclusion criteria. Each study that met the 4 inclusion criteria was then evaluated based on 8 standards. RESULTS Of 2290 citations reviewed pertaining to the OKC, 14 investigations were found to meet the 4 inclusion criteria. Resection was found to have the lowest recurrence rate (0%) but the highest morbidity rate. Simple enucleation was reported to have a recurrence rate of 17% to 56%. Simple enucleation combined with adjunctive therapy, such as the application of Carnoy's solution or decompression before enucleation, was reported to have recurrence rates of 1% to 8.7%. CONCLUSIONS Although the existing literature consists of retrospective consecutive case series, it appears that resection or enucleation with adjunctive therapy is associated with recurrence rates that are lower than those associated with enucleation alone.