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Carnoy’ solution: an effective weapon against odontogenic keratocyst—a retrospective study and review of literature
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Pathology
ameloblastomas were treated by this method over a 10-year period. The period of decompression varied from 2 to 9 months. Enucleation with chemical cauterization using carnoys solution was done following a 50–60% reduction in the size of the lesion. Follow-up ranged from 8 months to 5 years. Unilocular lesions required a shorter period of decompression when compared to multilocular lesions to achieve the same percentage reduction in size. Decompression helped preserve jaw continuity, contour and integrity of adjacent important structures. Enucleation of odontogenic keratocysts after decompression was easier and complete as the lining was thicker; with no recurrences at the end of follow-up. There was one case of recurrence of cystic ameloblastoma which was treated by repeated enucleation. Odontogenic keratocysts and cystic ameloblastomas can therefore be considered for conservative management thereby avoiding radical resections and associated morbidity. A larger sample and longer period of follow-up are however necessary to draw firm conclusions. doi:10.1016/j.ijom.2007.08.264
O12.10 Large odontogenic keratocyst: conservative verses aggressive management V. S. Manekar Government Dental College and Hospital, Nagpur, Maharashtra, India Shear in 2002 labelled odontogenic keratocyst (OKC) as benign neoplasm rather than a non-neoplastic cyst. Owing to the aggressive nature and high recurrence rate of OKC there is always a debate among clinicians regarding its management. The goal of treatment is eradiation of pathologic lesion and minimizing the risk of recurrence and patient morbidity. The large, multilocular/multicystic kratocyst cases are frequently associated with cortical perforations and extension in to adjacent soft tissue. In such cases achieving treatment goals with conservative management is increasingly difficult. The radical or aggressive surgical results in severe disfigurement needing precise reconstructive surgery. Hence the controversy continues for conservative verses aggressive surgical treatment. This presentation is to review literature regarding this controversy. This presentation also includes series of large keratocyst cases treated in our department in last 5 years with respect to
recurrence, potential morbidity and functional outcome. doi:10.1016/j.ijom.2007.08.265
O12.11 Carnoy’ solution: an effective weapon against odontogenic keratocyst—a retrospective study and review of literature A. Gupta Department of Oral & Maxillofacial Surgery, PB Govt. Dental College and Hospital, Amritsar 143001, Punjab, India Objective: The purpose of this paper is to evaluate the clinical results and recurrence rate in patients with mandibular odontogenic keratocysts who were treated by enucleation and application of Carnoy’s solution (CS) in all. Materials and methods: Nine cases of mandibular odontogenic keratocyst included in this retrospective study underwent surgical treatment consisting of enucleation, with or without removal of overlying mucosa and an average 3 min application of CS to the walls of bony defect. Cases were followed up for a period of 6 months to 2 years for any evidence of recurrence. Results: All cases showed good postoperative results with no evidence of recurrence till date except one which recurred after 2 years and was retreated. Conclusion: Treatment of odontogenic keratocysts using Carnoy’s solution as adjunctive intralesional therapy has a low rate of recurrence. It has the advantage of preserving the jaw continuity, dental structures and soft tissues. CS requires only a short application time intraoperatively. Furthermore, the agent cauterizes the wound bed and has published longterm results available. This study suggests a possible benefit of Carnoy’s solution against recurrence of odontogenic keratocyst. doi:10.1016/j.ijom.2007.08.266
O12.12 Decompression of OKC, shrinking the various treatment modalities! A clinical study R.V. Gaikwad*, S.V. Kumaraswamy, R.Keerthi VSDC&H, Bangalore, India The odontogenic keratocyst was first described in 1956 by Philipsen. Since then it has proven to be a dilemma to the
treating surgeon. The difficulty in treatment has centered around its recurrence which has been reported to range from 0% to 56%. The surgical options employed have ranged from: decompression, marsupialization, enucleation, enucleation and curettage, enucleation and adjuvant treatment with cryotherapy or Carnoy’s solution, and resection. Decompression of OKCs provides us with a platform to wait over a period of time for the cyst to shrink in size and at the same time allow for the thickening of the cyst lining hence decreasing both, the surgical site morbidity as well as allowing easier enucleation due to the thicker nature of the cystic lining post decompression and thus lesser recurrence, and it also allows the simultaneous deposition of bone along the cystic cavity along which the lining keeps shrinking during decompression, which is an added advantage. In this study, we have adopted the practice of decompression of large OKCs followed by enucleation thus obviating the need for more aggressive surgery. doi:10.1016/j.ijom.2007.08.267
O12.13 A new conditional polyomavirus middle T antigen gene transgenic mice model: haemangioma or venous malformation? Y.A. Wang*, J.-w. Zheng, X.-q. Jiang, Q Q. Xu, Z.-g. Wang, Z.-y. Zhang Department of Oral & Maxillofacial Surgery, Ninth People’s Hospital, School of Stomatology, Shanghai Jiaotong University, Shanghai 200011, PR China Vascular anomalies mostly occur in the head and neck region and there is no ideal animal models of this disease. The purpose of this study was to construct the conditional polyomavirus middle T antigen gene (MT) transgenic mice model and provide a basis for the study of MT’s molecular function, as well as the treatment of vascular anomalies in vivo. A new conditional transgenic vector combining the two transcriptional units of tetracycline-controlled expression system on a single plasmid was constructed successfully. After the experiment in vitro, pronuclear microinjection method was used to introduce the purified transgene into the chromosomes of fertilized mice eggs, and five transgenic positive mouse were obtained. The positive animals went down to future generation by hybridization. After induction of MT’s expression in
Pathology
ameloblastomas were treated by this method over a 10-year period. The period of decompression varied from 2 to 9 months. Enucleation with chemical cauterization using carnoys solution was done following a 50–60% reduction in the size of the lesion. Follow-up ranged from 8 months to 5 years. Unilocular lesions required a shorter period of decompression when compared to multilocular lesions to achieve the same percentage reduction in size. Decompression helped preserve jaw continuity, contour and integrity of adjacent important structures. Enucleation of odontogenic keratocysts after decompression was easier and complete as the lining was thicker; with no recurrences at the end of follow-up. There was one case of recurrence of cystic ameloblastoma which was treated by repeated enucleation. Odontogenic keratocysts and cystic ameloblastomas can therefore be considered for conservative management thereby avoiding radical resections and associated morbidity. A larger sample and longer period of follow-up are however necessary to draw firm conclusions. doi:10.1016/j.ijom.2007.08.264
O12.10 Large odontogenic keratocyst: conservative verses aggressive management V. S. Manekar Government Dental College and Hospital, Nagpur, Maharashtra, India Shear in 2002 labelled odontogenic keratocyst (OKC) as benign neoplasm rather than a non-neoplastic cyst. Owing to the aggressive nature and high recurrence rate of OKC there is always a debate among clinicians regarding its management. The goal of treatment is eradiation of pathologic lesion and minimizing the risk of recurrence and patient morbidity. The large, multilocular/multicystic kratocyst cases are frequently associated with cortical perforations and extension in to adjacent soft tissue. In such cases achieving treatment goals with conservative management is increasingly difficult. The radical or aggressive surgical results in severe disfigurement needing precise reconstructive surgery. Hence the controversy continues for conservative verses aggressive surgical treatment. This presentation is to review literature regarding this controversy. This presentation also includes series of large keratocyst cases treated in our department in last 5 years with respect to
recurrence, potential morbidity and functional outcome. doi:10.1016/j.ijom.2007.08.265
O12.11 Carnoy’ solution: an effective weapon against odontogenic keratocyst—a retrospective study and review of literature A. Gupta Department of Oral & Maxillofacial Surgery, PB Govt. Dental College and Hospital, Amritsar 143001, Punjab, India Objective: The purpose of this paper is to evaluate the clinical results and recurrence rate in patients with mandibular odontogenic keratocysts who were treated by enucleation and application of Carnoy’s solution (CS) in all. Materials and methods: Nine cases of mandibular odontogenic keratocyst included in this retrospective study underwent surgical treatment consisting of enucleation, with or without removal of overlying mucosa and an average 3 min application of CS to the walls of bony defect. Cases were followed up for a period of 6 months to 2 years for any evidence of recurrence. Results: All cases showed good postoperative results with no evidence of recurrence till date except one which recurred after 2 years and was retreated. Conclusion: Treatment of odontogenic keratocysts using Carnoy’s solution as adjunctive intralesional therapy has a low rate of recurrence. It has the advantage of preserving the jaw continuity, dental structures and soft tissues. CS requires only a short application time intraoperatively. Furthermore, the agent cauterizes the wound bed and has published longterm results available. This study suggests a possible benefit of Carnoy’s solution against recurrence of odontogenic keratocyst. doi:10.1016/j.ijom.2007.08.266
O12.12 Decompression of OKC, shrinking the various treatment modalities! A clinical study R.V. Gaikwad*, S.V. Kumaraswamy, R.Keerthi VSDC&H, Bangalore, India The odontogenic keratocyst was first described in 1956 by Philipsen. Since then it has proven to be a dilemma to the
treating surgeon. The difficulty in treatment has centered around its recurrence which has been reported to range from 0% to 56%. The surgical options employed have ranged from: decompression, marsupialization, enucleation, enucleation and curettage, enucleation and adjuvant treatment with cryotherapy or Carnoy’s solution, and resection. Decompression of OKCs provides us with a platform to wait over a period of time for the cyst to shrink in size and at the same time allow for the thickening of the cyst lining hence decreasing both, the surgical site morbidity as well as allowing easier enucleation due to the thicker nature of the cystic lining post decompression and thus lesser recurrence, and it also allows the simultaneous deposition of bone along the cystic cavity along which the lining keeps shrinking during decompression, which is an added advantage. In this study, we have adopted the practice of decompression of large OKCs followed by enucleation thus obviating the need for more aggressive surgery. doi:10.1016/j.ijom.2007.08.267
O12.13 A new conditional polyomavirus middle T antigen gene transgenic mice model: haemangioma or venous malformation? Y.A. Wang*, J.-w. Zheng, X.-q. Jiang, Q Q. Xu, Z.-g. Wang, Z.-y. Zhang Department of Oral & Maxillofacial Surgery, Ninth People’s Hospital, School of Stomatology, Shanghai Jiaotong University, Shanghai 200011, PR China Vascular anomalies mostly occur in the head and neck region and there is no ideal animal models of this disease. The purpose of this study was to construct the conditional polyomavirus middle T antigen gene (MT) transgenic mice model and provide a basis for the study of MT’s molecular function, as well as the treatment of vascular anomalies in vivo. A new conditional transgenic vector combining the two transcriptional units of tetracycline-controlled expression system on a single plasmid was constructed successfully. After the experiment in vitro, pronuclear microinjection method was used to introduce the purified transgene into the chromosomes of fertilized mice eggs, and five transgenic positive mouse were obtained. The positive animals went down to future generation by hybridization. After induction of MT’s expression in