Nasser Al Alami¹*, Yaqeen Alaa Aldin AlNaqawa²

¹Department of Oral and Maxillofacial Surgery, Current working organization, EHS - Emirates Health Service, UAE
²Intern Dentist trained in Department of Oral and Maxillofacial Surgery EHS, UAE

*Corresponding Author: Department of Oral and Maxillofacial Surgery, Current working organization, EHS - Emirates Health Service, UAE.

Received: March 06, 2025; Published: April 09, 2025

Abstract

Background:: Odontogenic keratocysts (OKCs) are complex odontogenic lesions with high recurrence rates despite advances in treatment approaches. Conservative surgical methods like marsupialization and curettage have shown promise in reducing morbidity compared to aggressive resection, but long-term outcomes remain uncertain.

Case Presentation: We report a case of a 19-year-old patient diagnosed with an orthokeratinized OKC extending from #36 to #46 in the mandible. The patient underwent initial curettage and marsupialization followed by conservative post-operative care. Three years later, recurrence was noted but treated with repeated curettage with peripheral ostectomy and marsupialization. Nine years after the initial treatment, follow-up examination showed excellent bone regeneration without signs of recurrence.

Discussion: This case demonstrates the potential effectiveness of conservative surgical approaches like marsupialization and curettage in managing recurrent OKCs, particularly in young patients. While resection offers lower recurrence rates, conservative methods may be viable alternatives with less morbidity. The WHO's 2017 classification of OKC as a developmental cyst supports conservative treatment approaches. Future studies are needed to investigate long-term outcomes of conservative management in aggressive OKCs.

Conclusion: This report advocates for further exploration of conservative surgical options in treating OKCs, balancing efficacy with patient-centered outcomes.

Keywords: Surgical Treatment; Odontogenic; Keratocyst; 10 Years

References

1. Bhargava Anurag., et al. “Can Social Interventions Prevent Tuberculosis?” The Papworth Experiment (1918-1943) Revisited”. American Journal of Respiratory and Critical Care Medicine5 (2012): 442-449.
2. World Health Organization. “Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management. Geneva, World Health Organization (2018).
3. World Health Organization. “TB, a Global Emergency”. Geneva, WHO (1994).
4. Schwenk Achim and Douglas C Macallan. "Tuberculosis, Malnutrition and Wasting”. Current Opinion in Clinical Nutrition and Metabolic Care 3 (2000): 285-291.
5. Scrimshaw Nevin S and John P SanGiovanni. "Synergism of Nutrition, Infection, and Immunity: An Overview”. American Journal of Clinical Nutrition2 (1997): 464S-477S.
6. Macallan Douglas C. "Malnutrition in Tuberculosis”. Diagnostic Microbiology and Infectious Disease 34 (1999): 153-157.
7. Macallan Douglas C. "Malnutrition in Tuberculosis”. Diagnostic Microbiology and Infectious Disease2 (1999): 153-157.
8. Sinha Pranab., et al. “Undernutrition and Tuberculosis: Public Health Implications”. Journal of Infectious Diseases9 (2019): 1356-1363.
9. Lönnroth Knut., et al. “A Consistent Log-Linear Relationship Between Tuberculosis Incidence and Body Mass Index”. International Journal of Epidemiology1 (2009): 149-155.
10. Niki Masanori., et al. “Nutritional Status Positively Impacts Humoral Immunity Against Mycobacterium Tuberculosis, Disease Progression, and Vaccine Development”. PLoS One8 (2020): e0237062.
11. Putri Fitriani A., et al. “Body Mass Index Predictive of Sputum Culture Conversion Among MDR-TB Patients in Indonesia”. International Journal of Tuberculosis and Lung Disease5 (2014): 564-570.
12. Podewils Laura J., et al. “Impact of Malnutrition on Clinical Presentation, Clinical Course, and Mortality in MDR-TB Patients”. Epidemiology and Infection1 (2011): 113-120.
13. Cegielski John P and David N McMurray. "The Relationship Between Malnutrition and Tuberculosis: Evidence from Studies in Humans and Experimental Animals”. International Journal of Tuberculosis and Lung Disease 3 (2004): 286-298.
14. Sinha Pranab., et al. “Food for Thought: Addressing Undernutrition to End Tuberculosis”. The Lancet Infectious Diseases10 (2021): e318-e325.
15. Abulfathi AA., et al. “Clinical Pharmacokinetics and Pharmacodynamics of Rifampicin in Human Tuberculosis”. Clinical Pharmacokinetics9 (2019): 1103-1129.
16. Verrest Lisanne., et al. “Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review”. Clinical Pharmacokinetics9 (2021): 1149-1169.
17. Chauhan A., et al. “Prevalence of Tuberculosis Infection Among Various Risk Groups in India: A Systematic Review and Meta-Analysis”. Indian Journal of Community Medicine5 (2024): 669-680.
18. Garrow JS and J Webster. "Body Mass Index: Obesity, BMI, and Health: A Critical Review”. Nutrition Today3 (2015): 117-128.
19. Dyussenbayev A. "Age Periods of Human Life”. Advances in Social Sciences Research Journal6 (2017): 183-190.
20. Javalkar SR., et al. “Socioeconomic Status Assessment in India: History and Updates for 2024”. International Journal of Community Medicine and Public Health 11 (2024): 1369-1377.
21. Subramanian SV., et al. “Age and Gender Trends in Tuberculosis Prevalence: A Study from Urban Slums of India”. International Journal of Public Health3 (2015): 295-301.
22. Banu S., et al. “Socio-Economic Factors Influencing Tuberculosis Prevalence in Urban Slums”. International Journal of Tuberculosis and Lung Disease6 (2017): 657-663.
23. Das R., et al. “Gender Differences in the Risk of Tuberculosis in Urban Slums”. Indian Journal of Tuberculosis2 (2020): 98-105.
24. World Health Organization. “Global Tuberculosis Report 2023”. World Health Organization, 2023, Geneva (2023).
25. Kamat SR., et al. “Socioeconomic and Demographic Determinants of Tuberculosis Incidence in Urban Slums: A Study in Mumbai”. Journal of Urban Health1 (2017): 46-54.
26. Sharma SK., et al. “Malnutrition and Tuberculosis: A Vicious Cycle”. Indian Journal of Tuberculosis1 (2018): 14-19.
27. Shah P., et al. “Family Dynamics and Health Outcomes in TB Patients in Urban Slums: A Qualitative Study”. Indian Journal of Community Medicine1 (2020): 34-38.
28. Gautam S., et al. “Nutritional Status and Dietary Patterns in TB Patients: A Study in Urban Slums of Delhi”. Indian Journal of Public Health2 (2016): 121-124.
29. Kumar P., et al. “Nutritional Implications of Tuberculosis: An Analysis of TB Patient Diet and Treatment Adherence in Slums”. Nutrition and Health4 (2019): 321-327.
30. Sharma SK., et al. “Malnutrition and Tuberculosis: A Vicious Cycle”. Indian Journal of Tuberculosis1 (2018): 14-19.
31. Murray CJ., et al. “Global Tuberculosis Incidence and Mortality Trends: The Relationship with Co-Morbidities”. Lancet Infectious Diseases7 (2017): 711-721.
32. Rajendran K., et al. “Impact of Tobacco Use on Tuberculosis Progression: A Longitudinal Study in Urban Slums”. Tobacco Control2 (2017): 235-239.
33. Borghesi A., et al. “Nutritional Status in Tuberculosis Patients: A Critical Factor in Treatment Outcomes”. International Journal of Tuberculosis and Lung Disease10 (2018): 1185-1190.
34. Ghosh A., et al. “Malnutrition and Tuberculosis in Kolkata Slums: A Cross-Sectional Study”. BMC Infectious Diseases 20 (2020): 635.
35. Sinha P., et al. “Recurrent Tuberculosis in a High-Risk Population: A Cohort Study in Urban Slums”. Indian Journal of Community Medicine1 (2019): 56-62.

Citation

Citation: Nasser Al Alami and Yaqeen Alaa Aldin AlNaqawa. “Conservative Surgical Treatment of Recurrent Odontogenic Keratocyst: A Case Report with 10 Years Follow Up"Acta Scientific Dental Sciences 9.5 (2025): 18-23.

Copyright

Copyright: © 2025 Nasser Al Alami and Yaqeen Alaa Aldin AlNaqawa. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.