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54 rev port estomatol med dent cir maxilofac. 2020;61(2):52-56

preserving important structures like dental elements and ner- a mean of 41.1 years, and half of the patients had white skin
vous structures. 7 (n=7; 50.0%). The time of the relapse ranged from 8 to 168
The present study aimed to perform a retrospective months, with a mean of 70.4 ± 59.5 months. Most cases oc-
clinical -pathological study of cases diagnosed as OKC at the curred in the posterior region of the mandible (n=11; 78.6%),
Oral Pathology Service of the Federal University of Rio Grande followed by the anterior region (n=2; 14.3%), and three cases
do Norte (UFRN) from 1970 -2018, and to assess recurrence (21.4%) were associated with pain.
rates and their clinical and radiographic features. Radiographically, five cases presented as a unilocular le-
sion (35.7%), and only one case was associated with teeth
(7.1%). No case was associated with Gorlin syndrome. Regard-
Material and methods ing treatment during the first occurrence, prior to recurrence,
two cases (14.3%) were treated conservatively, by decompres-
The study protocol was approved by the Ethics Committee of sion and enucleation, whereas four cases were treated by enu-
the Federal University of Rio Grande do Norte (UFRN) (Ap- cleation followed by ostectomy and use of Carnoy’s solution.
proval Number 1.998.353). The present cross -sectional study In eight cases (57.1%), no information about the treatment
consisted of a retrospective analysis of OKC cases diagnosed modality was available in the clinical record, and no satisfac-
between January 1970 and July 2018, archived in the Laborato- tory contact with the clinician was obtained.
ry of Oral Pathology of the Department of Dentistry, UFRN, Rio
Grande do Norte, Brazil. This service is one of the referral
centers in oral and maxillofacial pathology in Brazil. Discussion
Data such as patient’s age and sex, OKC’s anatomical site,
association with teeth and radiographical aspect (unilocular OKC is one of the most controversial oral and maxillofacial
or multilocular), type of biopsy, symptomatology, and associ- pathological entities. In contrast to other odontogenic lesions,
ation with Gorlin syndrome were compiled for all cases from OKCs are noted for their potentially aggressive clinical behav-
the clinical data sent with the biopsy records. For recurrent ior, with a predisposition for local recurrence. 9
OKC cases, the time of relapse (in months) and the treatment Few studies evaluating recurrence rates and clinical OKC
modality were also evaluated. Regarding the inclusion and ex- characteristics are available, with some studies indicating re-
clusion criteria, only cases histopathologically diagnosed as currence rate discrepancies. 3,4,7 In this retrospective analysis,
OKC were included. OKCs with no sufficient clinical data in recurrence was observed in 13.2% of the 106 cases histopatho-
the patients’ biopsy request forms were excluded. All selected logically diagnosed as OKC, while 86.8% did not relapse.
7
cases exhibited the typical histopathological OKC characteris- According to a previous study, the presence of multiple
tics, described by WHO in 2017, namely, an uninflamed fibrous OKCs in the craniofacial region and high recurrence rates are
wall lined by a folded, thin, regular parakeratinized epithelium most often associated with Gorlin -Goltz syndrome. In the
5 -8 cell layers thick, without rete ridges; the parakeratinized present study, however, only 5.4% of all analyzed cases were
surface was corrugated, and the basal layer was well -defined associated with this syndrome, with no recurrence after the
and often palisaded, with hyperchromatic nuclei and focal ar- initial treatment. These findings differ from other studies in
eas displaying reversed nuclear polarity. 6 which syndromic cases presented an average recurrence rate
10
The data were tabulated and analyzed by descriptive sta- of 35.4%. Multiple cystic lesions associated with this syn-
tistics using the IBM SPSS Statistics program (version 20.0; IBM drome are often non -synchronous, and recurrent lesions may
Corp., Armonk, NY, USA). be difficult to distinguish from new cases, appearing in con-
tiguous, not initially detected, sites; also, a recurrence sur-
charge is probable.
Results In the present study, the frequency of non -recurrent OKC
cases presented a female -to -male ratio of 1.09:1, being slight-
A total of 15,670 cases of oral and maxillofacial lesions were re- ly more frequent in women. The literature is inconclusive, as
corded during the study period. Of these, 106 (0.67%) presented some authors have stated that OKC has a slight male predilec-
a histopathological diagnosis of OKC, including 92 cases (86.8%) tion, 1,3,4 while others indicate a slight preference for fe-
with no recurrence and 14 cases (13.2%) with recurrence. males, 2,3,11 corroborating the findings reported herein.
Concerning non -recurrent OKC cases, a higher frequency The age at which patients are affected by OKC commonly
th
nd
was observed in women (n=48; 52.2%) (female:male ratio of ranges from the 2 to 9 decades of life. 1,2,8,9 In the present
1.09:1), patients’ age ranged from 9 to 85 years old, with a mean study, the patients’ age in non -recurrent OKCs ranged from 9
of 34.3 years, and most patients had white skin (n=48; 52.2%). to 85 years old, with a mean of 34.3 years. These results are
Most cases occurred in the posterior region of the mandible similar to others described in the literature, 1,2,8 indicating a
(n=62; 67.4%), and 18 cases (19.6%) were associated with pain. wide age distribution of patients affected by OKC. 4,5
Unilocular lesions were slightly more frequent (n=20, 21.7%) OKC is one of the most common odontogenic lesions af-
than multilocular lesions (n=19; 20.7%), and association with fecting the mandible, usually involving the mandible angle
10
teeth was evidenced in 14 cases (15.2%). Five cases (5.4%) were and branch. In the present study, most non -recurrent OKCs
associated with Gorlin syndrome (Table 1). were detected in the posterior region of the mandible, corre-
Among recurrent OKCs, a similar frequency between gen- sponding to 67.4% of all cases. Pain was reported in only 18
ders was noted, patients’ age ranged from 13 to 72 years, with cases. OKC most often present as an asymptomatic lesion,