Treatment options for keratocyst odontogenic tumour (KCOT): a systematic review

Abstract Background The keratocystic odontogenic tumour (KCOT) is a benign intraosseous odontogenic lesion relatively frequent in the oral cavity. It has a locally aggressive behaviour and exhibits a high propensity to recur after treatment. All the singular characteristics of this pathology have originated controversy in the scientific community regarding the most appropriate surgical approaches for the successful treatment of this tumour. Objectives To analyse the optimal treatment choice for this tumour, ensuring high success rates of treatment, preventing future recurrences and allowing the maintenance of the patient's quality of life. Materials and methods A search was conducted in Cochrane – 1 result – and in PubMed – 756 results. The selection of articles was based on abstracts and inclusion and exclusion criteria. Three research studies were considered for the final analysis. Results One hundred and nineteen lesions were identified (73 males and 46 females). Twenty‐nine tumours were found in the maxilla and 91 in the mandible; the applied therapeutic methods were: marsupialization/decompression, marsupialization followed by enucleation and adjunctive therapies (peripheral ostectomy and Carnoy's solution), solely enucleation, enucleation and Carnoy's solution, enucleation followed by peripheral ostectomy and Carnoy's solution and resection. Discussion and conclusions Treatment by enucleation, in combination with adjunctive measures, is associated with minor recurrence rates when compared with enucleation alone. The small number of KCOT that were treated with en bloc resection did not obtain statistically relevant results. Therefore, more studies with well‐established criteria are necessary to enable an adequate analysis of recurrence rates associated with each treatment modality.