Vojnosanitetski pregled 2013 Volume 70, Issue 8, Pages: 789-793
https://doi.org/10.2298/VSP1308789M
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Early reconstruction of bone defect created after initial surgery of a large keratocystic odontogenic tumor: A case report
Matijević Stevo (Military Medical Academy, Department of Oral Surgery, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade)
Damjanović Zoran (Military Medical Academy, Clinic for Dentistry, Clinic for Maxillofacial Surgery, Belgrade)
Cerović Snežana (University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Department of Pathology, Belgrade)
Introduction. Keratocystic odontogenic tumor (KCOT) is defined as a benign
cystic neoplasm of the jaws of odontogenic origin with a high rate of
recurrence. The most lesions occur in the posterior part of the mandible.
Treatment of KCOT remains controversial, but the goals of treatment should
involve eliminating the potential for recurrence while minimizing surgical
morbidity. However, another significant therapeutic problem related to the
management of KCOT is an adequate and early reconstruction of the existing
jaw defect, as well as appropriate aesthetic and functional rehabilitation of
a patient, especially in cases of a very large destruction of the jaws bone.
Case report. We presented a 65-year-old female patient with very large KCOT
of the mandible. Orthopantomographic radiography showed a very large
elliptical multilocular radiolucency, located on the right side of the
mandible body and the ascending ramus of the mandible, with radiographic
evidence of cortical perforation at the anterior border of the mandibular
ramus and the superior border of the alveolar part of the mandible. The
surgical treatment included two phases. In the first phase, the tumor was
removed by enucleation and additional use of Carnoy solution, performing
peripheral ostectomy and excision of the affected overlying mucosa, while in
the second phase, restorative surgery of the existing mandibular defect was
performed 6 months later. Postoperatively, we did not register any of
postoperative complications, nor recurrence within 2 years of the follow-up.
Conclusion. Adequate and early reconstruction of the existing jaw defect and
appropriate aesthetic and functional rehabilitation of the patient should be
the primary goal in the treatment of KCOT, having in mind the need for a
long-term post-surgical follow-up.
Keywords: odontogenic cysts, oral surgical procedures, recurrence, reconstructive surgical procedures, mandible, treatment outcome