0662 Use of Carnoy's Solution in management of odontogenic keratocysts
K.R. MAGLIOCCA, E.M. LEUNG, B.B. WARD, D.R. LUCAS, and J.I. HELMAN, University of Michigan, Ann Arbor, USA

Objectives: The odontogenic keratocyst (OKC) represents 5% of odontogenic cysts found in the jaws. The OKC is locally destructive, has a high recurrence rate, and an association with the Basal Cell Nevoid Syndrome. Controversy exists regarding the most appropriate surgical intervention and the subsequent influence on rate of recurrence. The purpose of this report is to examine a series of odontogenic keratocysts treated by enucleation, with or without curettage, and an application of Carnoy's Solution (CS) and to evaluate recurrence rate.

Methods: A retrospective review of 58 patients treated between January 1996 and August 2005 with a diagnosis of OKC. Patients with Basal Cell Nevoid Syndrome were not included in the review. Five of 58 patients were found to demonstrate the orthokeratinizing histological variant of OKC and were subsequently excluded from the database. Demographic, clinical, radiographic, and histological data was collected about the remaining 53 patients. Surgical treatment consisted of enucleation, with or without curettage, and an average 3-minute application of CS to the walls of the bony defect. In 5 instances, CS was withheld.

Results: Review of 53 records revealed a single patient treated with enucleation, curettage and CS with evidence of cyst recurrence, six years after initial treatment. Of the 5 patients diagnosed with an OKC who did not receive treatment with CS, 2 patients developed a recurrent lesion within two years of initial treatment.

Conclusions: Treatment of an odontogenic keratocyst using CS in addition to enucleation, with or without curettage, has a low rate of recurrence. Adjuvant therapy with CS has the advantage of preserving jaw continuity, dental structures and soft tissues. CS requires only a short application time intra-operatively. Furthermore, the agent cauterizes the wound bed and has published long-term results available. Based on our results we advocate the use of CS in treatment of OKC's.

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