Clinicopathologic features associated with recurrence of the odontogenic keratocyst: a cohort retrospective analysis.

OBJECTIVE: The aim of this study was to evaluate the influence of clinical, radiographic, surgical and histopathologic parameters in the recurrence of disease in a series of odontogenic keratocysts (OKCs). STUDY DESIGN: The sample comprised 24 sporadic OKC lesions from 24 patients. All patients had no previous treatment history and were treated by the same surgeon using a uniform treatment protocol (enucleation with peripheral ostectomy preceded or not preceded by decompression). RESULTS: Fourteen lesions (58.4%) were first submitted to decompression procedure. Eight patients (33%) developed recurrent lesions, with a mean follow-up time of 60.5 months (standard deviation [SD] = 31.3) and a mean disease-free interval for recurrent lesions of 19 months (SD = 4.9). Recurrence was significantly associated with poor clinical response to decompression (P = .027), remaining tooth with radiographic evidence of insinuation of the lesion between the dental roots (P = .009), and the presence of budding of the basal cells layer together with epithelial islands in the fibrous capsule (P = .019). CONCLUSIONS: Clinical, radiographic and histopathologic parameters may affect the relapse rate of OKCs and should individually guide treatment choice.