Treatment of Multiple Odontogenic Keratocysts Involving Chinese Patients.

PURPOSE: The optimal treatment of odontogenic keratocysts (OKCs) remains a matter of debate in reported studies. The present study aimed to estimate the postoperative recurrence rates of multiple OKCs (MOKCs) in Chinese patients. MATERIALS AND METHODS: A retrospective cohort study of histologically confirmed MOKCs treated from 2003 to 2017 using enucleation, marsupialization alone, enucleation and peripheral ostectomy, or marsupialization followed by secondary enucleation was performed. Patients with MOKCs who had undergone follow-up for 12 or more months with panoramic radiographs and radiographs of the chest and skull available from the first visit and had been treated by the same team using the same treatment protocol were included in the study. Patients were excluded if the lesion had been treated previously, they had a solitary OKC, or their medical records were not available for review. The treatment methods, recurrence rate, and interval to recurrence were evaluated. The Kaplan-Meier method was used to estimate the survival rate and median time to recurrence. Univariate analysis was used to identify the risk factors associated with recurrence. Significant differences were determined at an α level of 5%. RESULTS: The sample included 81 patients with MOKCs; 21 (25.6%) were male and 60 (74.07%) were female. The age range was 7 to 63 years (mean ± standard deviation, 18.4 ± 4). The overall recurrence rate was 26.63%, with an overall recurrence-free interval of 26.85 months. The average length of follow-up was 55.68 months. No association was found between the treatment method used and the risk of recurrence (P = .178). Although the interval to recurrence was not affected by any of the study variables, the average interval to the recurrence of MOKCs involving the maxilla was short compared with that of MOKCs involving the mandible. CONCLUSIONS: The surgical treatment method did not influence the risk of recurrence in patients with MOKCs, and the interval to recurrence was not associated with any of the study variables.

Oral cancer awareness and knowledge: Survey of dentists in Democratic Republic of the Congo.

Oral cancer (OC) is one of the global diseases that is the eighth rank among different others. Early intervention therapy had a positive impact on increasing the prognosis and the survival rate up to 5 years. The aim of the current study was to evaluate the knowledge, attitude, and practice of dentists about OC in the Democratic Republic of the Congo (DRC). MATERIEL AND METHODS: It was a cross-sectional analytical survey conducted in the primary oral health care centers in DR. Congo from February to April 2021. Only dentists working at any of the primary oral health care centers, public or private was included. Data were collected by using a survey of a 33-item questionnaire. The practice level, knowledge, risk factors, diagnosis for OC, attitude, and opinions of the dentists were recorded and evaluated. The SPSS 20 was used for data analysis and P < 0.05 was considered significant. RESULTS: Out of 162 dentists recorded, 65.4% were male and 34.6% were females. Half of the dentists (50.6%) had more than 5-15 years of practical experience, and 81.5% of the participants were general practice dentists. A majority of dentists were not familiar with the proper physical oral examination steps (80.2%). The practice level of the dentists was highly poor. The knowledge level about clinical features and diagnostic procedures (frequent anatomical region, common type of OC, associated factor with OC, frequent stage diagnosis of OC, and condition associated with OC) was very low. The dentists' gender was associated with a poor level of practice (P = 0.009). However, the age experience of work was associated with the high knowledge of the clinical presentation of oral cancer (P = 0.040). CONCLUSION: The dentists in DRC have obvious problems in the knowledge of OC diagnosis. More continued education and training programs for dentists would serve to address the knowledge deficits and practice shortcomings about oral cancer screening, prevention, and early detection.

Management of mandibular odontogenic keratocyst through radical resection: Report of 35 cases.

The present study reported the clinical outcomes of 35 patients with mandibular odontogenic keratocysts (OKCs) following treatment by radical resection and immediate defect reconstruction. Amongst 565 patients with OKCs that were treated between April 2003 and May 2015, 35 patients underwent segmental or marginal mandibulectomy. The use of radical resection was based on clinical and/or radiographic evidence of size, cortical perforation and subsequent soft tissue involvement, and on the history of previous recurrence of the same lesion. Recurrence, justifications of the main major factor for resection, and functional and cosmetic results of the patients following mandibular reconstruction were systematically evaluated. There were 26 OKCs in the mandibular molar-ramus region, eight in the mandibular anterior-premolar region and one in the mandibular molar-ramus and anterior-molar regions. Among the 35 patients, 20 had primary OKCs and 15 had recurrent OKCs. A total of 31 patients underwent segmental mandibulectomy, of which 28 were immediately reconstructed with a vascularized flap, whereas four patients underwent marginal mandibulectomy. The functional and cosmetic outcomes of patients were evaluated as satisfactory. The length of the follow-up period ranged from 2 to 17 years following operation (average, 5.82 years). Recurrence was identified in one patient who had been treated with marginal mandibulectomy. In conclusion, the findings from the present study suggested that radical resection may be recommended for patients with OKCs and locally aggressive features. Immediate mandibular reconstruction with a vascularized flap may be a crucial part of this aggressive treatment method that may reduce OKCs-associated morbidity.