Avaliação da recorrência de ceratocisto odontogênico e ameloblastomas tratados cirurgicamente no Hospital Geral de Fortaleza
DOI:
https://doi.org/10.22456/2177-0018.138439Palavras-chave:
Ameloblastoma, Cistos odontogênicos, RecidivaResumo
Objetivo: O presente estudo tem como objetivo avaliar a ocorrência de recidiva do ceratocisto odontogênico e dos ameloblastomas após tratamento cirúrgico ao longo de 14 anos em Hospital de referência no Estado do Ceará. Materiais e métodos: Foi realizado um estudo retrospectivo guiado pela iniciativa STROBE, cuja amostra contou com pacientes diagnosticados com ceratocisto odontogênico e ameloblastoma durante o período de 2006 a 2020. Os dados coletados foram idade, sexo, naturalidade, tipo histológico, recorrência, data da recorrência ou tempo de acompanhamento, localização da lesão, características imaginológicas e protocolo cirúrgico. Resultados: A amostra foi composta por 33 pacientes, sendo 12 como ceratocisto odontogênico e 21 diagnosticados como ameloblastoma. Houve um total de 5 recidivas (15.2%), sendo 01 ceratocisto odontogênico e 04 ameloblastomas. A maioria das lesões localizadas em mandíbula (90,09%), sendo todas as lesões com padrão imaginológico hipodenso/ radiolúcido. O tempo médio livre de recorrência foi de 50,4±6,7 (IC95% = 37,3-63,6) meses ao longo de um tempo mediano de acompanhamento de 11 meses. Discussão: A recorrência das lesões está frequentemente associada à terapêutica empregada no tratamento, sendo este um fator importante no prognóstico das lesões. Considerações Finais: Nosso estudo verificou que para assegurar um maior tempo de sobrevida livre de recorrência dessas lesões, as associações de técnicas cirúrgicas, como as terapias adjuvantes, buscam diminuir a recidiva e a morbidade dos tratamentos.
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Referências
Santosh AB. Odontogenic cysts. Dent Clin N Am. [Internet]. 2020 [cited 2021 Oct 10];64(1):105-119. Available from: https://dx.doi.org/10.1016/j.cden.2019.08.002.
Kinard BE, Chuang SK, August M, Dodson TB. How well do we manage the odontogenic keratocyst? J Oral Maxillofac Surg. [Internet]. 2013 [cited 2021 Nov 23]; 71(8):1353–1358. Available from: https://dx.doi.org/10.1016/j.joms.2013.01.029.
Cakarer S, Selvi F, Isler SC, Keskin C, Olgac V, Soluk-Tekkesin M. Treatment for the large aggressive benign lesions of the jaws. J Maxillofac Oral Surg.[Internet]. 2018 [cited 2021 Oct 18];17(3):372–378. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028335/.
Sammartino G, Tia M, Gentile E, Marenzi G, Claudio PP. Effectiveness of a new decisional algorithm in managing mandibular ameloblastomas: a 10-years experience. Br J Oral Maxillofac Surg.[Internet]. 2006 [cited 2021 Oct 12];45(4):306–310. Available from: https://dx.doi.org/10.1016/j.bjoms.2006.08.023.
Raj Y, Siddiqui S, Singh S, Singh M, Sharma R, Singh G. Evaluation of the Nature of Collagen Fibers in KCOT, Dentigerous Cyst and Ameloblastoma using Picrosirius Red Stain–A Comparative Study. J Clin Diagn Res.[Internet]. 2015 [cited 2021 Oct 13];9(11):ZC01- ZC04. Available from: https://dx.doi.org/10.7860/JCDR/2015/14154.6708.
Martin LHC, Speight PM. Odontogenic cysts: an update. Diagnostic Histopathology. [Internet]. 2017 [cited 2021 Oct 10];23(6):260–265. Available from: https://doi.org/10.1016/j.mpdhp.2017.04.006.
Soluk-Tekkesin M, Cakarer S, Aksakalli N, Alatli C, Olgac V. New World Health Organization classification of odontogenic tumours: impact on the prevalence of odontogenic tumours and analysis of 1231 cases from Turkey. Br J Oral Maxillofac Surg.[Internet]. 2018 [cited 2021 Oct 20];56(1):8-13. Available from: https://dx.doi.org/10.1016/j.bjoms.2017.09.007.
Wright JM, Vered M. Update from the 4th edition of the World Health Organization classification of head and neck tumours: odontogenic and maxillofacial bone tumors. Head Neck Pathol. [Internet]. 2017 [cited 2021 Oct 02];11(1):68-77. Available from: https://dx.doi.org/10.1007/s12105-017-0794-1.
Molon RS, Gabrielli MF, Gabrielli MA, Pereira AA, Hochuli-Vieira E. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review. Contemp Clin Dent. [Internet]. 2015 [cited 2021 Nov 12];6(1):106-110. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374304/.
Goyal S, Verma P, Ladgotra A, Mehta M, Sandhu HK. Non-syndromic multiple keratocyst odontogenic tumor: A rare case report. J Oral Biol Craniofac Res.[Internet]. 2017[cited 2021 Oct 15];7(1):61-64. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228524/.
Pogrel MA. The keratocystic odontogenic tumor. Oral Maxillofac Surg Clin North Am.[Internet]. 2013 [cited 2021 Oct 19];25(1):21-30. Available from: https://dx.doi.org/10.1016/j.coms.2012.11.003.
Al-Moraissi EA, Dahan AA, Alwadeai MS, Oginni FO, Al-Jamali JM, Alkhutari AS, Al-Tairi NH, Almaweri AA, Al-Sanabani JS. What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis. J CranioMaxilloFac Surg.[Internet]. 2017 [cited 2021 Oct 18];45(1):131-144. Available from: https://www.sciencedirect.com/science/article/abs/pii/S101051821630258X?via%3Dihub.
Haq J, Siddiqui S, McGurk M. Argument for the conservative management of mandibular ameloblastomas. Br J Oral Maxillofac Surg.[Internet]. 2016 [cited 2021 Nov 23];54(9):1001-1005. Available from: https://dx.doi.org/10.1016/j.bjoms.2016.07.017.
Almeida RA, Andrade ESS, Barbalho JC, Vajgel A, Vasconcelos BCE. Recurrence rate following treatment for primary multicystic ameloblastoma: systematic review and meta-analysis. Int J Oral Maxillofac Surg. [Internet].2016 [cited 2021 Oct 17];45(3):359-367. Available from: https://dx.doi.org/10.1016/j.ijom.2015.12.016.
Pogrel MA, Montes DM. Is there a role for enucleation in the management of ameloblastoma? Int J Oral Maxillofac Surg.[Internet]. 2009 [cited 2021 Oct 19];38(8):807-812. Available from: https://dx.doi.org/10.1016/j.ijom.2009.02.018.
Antonoglou GN, Sándor GK. Recurrence rates of intraosseous ameloblastomas of the jaws: A systematic review of conservative versus aggressive treatment approaches and meta-analysis of non-randomized studies. J CranioMaxilloFac Surg.[Internet]. 2015 [cited 2021 Oct 10];43(1):149-157. Available from: https://www.sciencedirect.com/science/article/abs/pii/S101051 8214003047.
Vanoven BJ, Parker NP, Petruzelli GJ. Peripheral ameloblastoma of the maxilla: a case report and literature review. Am J Otolaryngol. [Internet]. 2008 [cited 2021 Oct 20];29(5):357-360. Available from: https://dx.doi.org/10.1016/j.amjoto.2007.10.002.
Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP. STROBE initiative: guidelines. Rev Saúde Pública [Internet]. 2010 [ cited 2021 Oct 10]; 44:1–5. Available from: https://doi.org/10.1590/S0034-89102010000300021.
França GM, Silva LBA, Mafra RP, Silva WR, Lima KC, Galvão HC. Recurrence-free survival and prognostic factors of odontogenic keratocyst: a single-center retrospective cohort. Eur Arch Oto-Rhino-Laryngology. [Internet]. 2021[ cited 2021 Nov 23] ;278(4):1223–1231. Available from: https://doi.org/10.1007/s00405-020-06229-8.
Kinard BE, Chuang SK, August M, Dodson TB. For treatment of odontogenic keratocysts, is enucleation, when compared to decompression, a less complex management protocol? J Oral Maxillofac Surg.[Internet]. 2015 [ cited 2021 Nov 10] ;73(4):641–648. Available from: https://dx.doi.org/10.1016/j.joms.2014.11.001.
Sigua-Rodriguez EA, Asprino L, de Sousa SM, de Araujo MM, de Almeida OP, Kowalski LP, et al. Is Surgical Treatment Based on a 1-Step or 2-Step Protocol Effective in Managing the Odontogenic Keratocyst? J Oral Maxillofac Surg.[ Internet] 2019 [ cited 2021 Oct 27];77(6):1210 e1- 1210 e7. Available from: https://doi.org/10.1016/j.joms.2019.02.040.
Ahlem B, Wided A, Amani L, Nadia Z, Amira A, Faten F. Study of Ki67 and CD10 expression as predictive factors of recurrence of ameloblastoma. Eur Ann Otorhinolaryngol Head Neck. [Internet]. 2015 [ cited 2021 Oct 19];132(5):275–279. Available from: https://doi.org/10.1016/j.anorl.2015.08.016.
Borghesi A, Nardi C, Giannitto C, Tironi C, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging.[Internet]. 2018 [ cited 2021 Oct 19];9(5):883- 897. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206371/.
Au SW, Li KY, Choi WS, Su YX. Risk factors for recurrence of ameloblastoma: a long-term follow-up retrospective study. Int J Oral Maxillofac Surg.[Internet]. 2018 [cited 2021 Oct 14];48(10):1330-1336. Available from: https://doi.org/10.1016/j.ijom.2018.05.006.
Zecha JAEM, Mendes RA, Lindeboom VB, van der Waal I. Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without adjunctive therapies - A 35-year single institution experience. Oral Oncol. [Internet]. 2010 [cited 2021 Oct 20];46(10):740–742. Available from: https://dx.doi.org/10.1016/j.oraloncology.2010.07.004.
Kinard B, Chuang SK, August M, Dodson TB, Kaban LB, Peacock ZS, et al. How well do we manage the odontogenic keratocyst? A multicenter study. Oral Surg Oral Med Oral Pathol Oral Radiol. [Internet]. 2019 [cited 2021Nov 23];127(4):282–288. Available from: https://dx.doi.org/10.1016/j.oooo.2018.12.001.
Hong J, Yun PY, Chung IH, Myoung H, Suh JD, Seo BM, et al. Long-term follow up on recurrence of 305 ameloblastoma cases. Int J Oral Maxillofac Surg.[Internet]. 2007 [cited 2021 Nov 13];36(4):283–288. Available from: https://doi.org/10.1016/j.bjoms.2016.07.017.
Boffano P, Ruga E, Gallesio C. Keratocystic odontogenic tumor (odontogenic keratocyst): Preliminary retrospective review of epidemiologic, clinical, and radiologic features of 261 lesions from University of Turin. J Oral Maxillofac Surg.[Internet]. 2010 [cited 2021 Oct 13];68(12):2994- 2999. Available from: https://www.joms.org/article/S0278-2391(10)00653-1/fulltext.
Kim SG, Jang HS. Ameloblastoma: A clinical, radiographic, and histopathologic analysis of 71 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. [Internet] 2001 [cited 2021 Nov 10];91(6):649– 653. Available from: https://dx.doi.org/10.1067/moe.2001.114160.
Apajalahti S, Kelppe J, Kontio R, Hagström J. Imaging characteristics of ameloblastomas and diagnostic value of computed tomography and magnetic resonance imaging in a series of 26 patients. Oral Surg Oral Med Oral Pathol Oral Radiol. [Internet]. 2015 [ cited 2021 Oct 13];120(2):118– 130. Available from: https://www.oooojournal.net/article/S2212-4403(15)00897-4/fulltext.
Bataineh AB. Effect of preservation of the inferior and posterior borders on recurrence of ameloblastomas of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. [Internet]. 2000 [cited 2021 Oct 16];90(2):155–63. Available from: https://www.oooojournal.net/article/S1079-2104(00)51063-4/fulltext.
Tsukamoto G, Nakamura T, Noguchi M, Ohishi M. A comparative study of odontogenic keratocysts associated with and not associated with an impacted mandibular third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. [Internet]. 2002 [cited 2021 Oct 10];94(2):272– 275. Available from: https://dx.doi.org/10.1067/moe.2002.126888.
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