Oral and Maxillofacial Pathology
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Abstract
Abstract
Background: The odontogenic keratocyst (OKC) is an aggressive intraosseous cyst with a high recurrence rate. Optimal surgical management remains debated, and independent predictors of recurrence require further analysis. The aim of this study is to evaluate surgical treatment outcomes for OKC across a spectrum of approaches and to identify clinical, demographic, and histopathological predictors of recurrence over long-term follow-up. Methods: A multicenter retrospective study was conducted. A total of 113 patients with histologically confirmed OKC treated between 2015 and 2025 were included. univariate and multivariate logistic regression analyses were performed to assess associations between clinical variables and recurrence. Results: First-stage recurrence occurred in 47/113 patients (41.6%). Histotype was the only independent predictor of recurrence, with 85% of parakeratinized and 15% of orthokeratinized cases. No recurrences were observed among 8 patients treated with excision combined with adjuvant therapy (cryotherapy or topical 5-fluorouracil), compared with 44.8% in the remaining cohort. Analyses for second- and third-stage recurrence did not identify significant predictors, likely due to limited event numbers. Conclusions: Parakeratinized histotype is the dominant predictor of OKC recurrence. Adjuvant therapy — particularly topical 5-fluorouracil or cryotherapy — was associated with absence of recurrence and should be considered in standard management. Long-term follow-up is essential.
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@article{Ferretti2026Surgical,
title = {Surgical Management of Odontogenic Keratocyst and Predictors of Recurrence: A Multicenter Retrospective Study},
author = {Fabrizio Ferretti and Fabio Roccia and Giorgia Cigna and Andrea Novaresio and Emanuele Zavattero and Claudia Borbon and Maurizio Giordano and Luca Giordano and Elena Giaccone and Francesca Antonella Bianchi and Marco Bernardi and Paolo Asperio and Guglielmo Ramieri},
journal = {Preprints.org},
year = {2026},
doi = {10.20944/preprints202608.0646.v1},
url = {https://doi.org/10.20944/preprints202608.0646.v1}
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