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The Keratocystic Odontogenic Tumour (KCOT) - An Odyssey PDF
The Keratocystic Odontogenic Tumour (KCOT) - An Odyssey PDF
A Personal View
M. A. Pogrel
Oral and Maxillofacial Surgery, University of
California San Francisco, San Francisco, CA,
USA
M.A. Pogrel: The keratocystic odontogenic tumour (KCOT)an odyssey. Int. J. Oral
Maxillofac. Surg. 2015; 44: 15651568. # 2015 International Association of Oral and
Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Abstract. The most appropriate management for the lesion now known as the
keratocystic odontogenic tumour (previously known as the odontogenic keratocyst)
remains controversial. This article reviews the different management protocols
adopted by one surgical unit over the last 30 years and the results obtained from the
different treatment modalities. A current treatment protocol consisting of initial
decompression followed by aggressive curettage and peripheral ostectomy with
methylene blue staining appears to be successful, but our longest follow-up is only 6
years.
0901-5027/01201565 + 04
# 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
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Pogrel
Fig. 1. A drainage tube made from a paediatric feeding tube and wired around the first molar.
The tube is going into a large cyst of the left mandibular angle area, and the tube ends opposite
the first bicuspid tooth making it easier for the patient to irrigate.
Fig. 2. Radiograph showing a large keratocystic odontogenic tumour extending from the lower left first molar over to the lower right first molar
region (A). This was drained from two separate sites (the drainage tubes can be seen on the radiograph), resulting in almost complete resolution of
the lesion (B).
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None.
Competing interests
None declared.
Ethical approval
Not required.
Patient consent
Fig. 3. The technique of peripheral ostectomy. (A) The area is opened up, the overlying mucosa
is excised, and the cyst is enucleated. (B) The bony margins are painted with methylene blue on a
Q-tip, and then all the blue-stained bone is removed with a pineapple bur taking care to avoid
trauma to the inferior alveolar nerve.
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Pogrel
References
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Address:
M. Anthony Pogrel
Oral and Maxillofacial Surgery
University of California San Francisco
Room C522
Box 0440
521 Parnassus Avenue
San Francisco
CA 94143-0440
USA
Tel: +1 415 476 8225;
Fax: +1 415 476 6305
E-mail: tony.pogrel@ucsf.edu