Use of Carnoy’s solution and its modifications for reducing the number of recurrences after surgical removal of keratocystic odontogenic tumors and ameloblastomas: A systematic review
Abstract
The paper is a systematic review of use of the pharmaceutical substance — Camoy’s solution — to reduce the number of recurrences of such tumors as keratocystic odontogenic tumor and ameloblastoma. These are benign, but yet aggressive, jaw tumors with a high percentage of recurrences (up to 60—80%). Surgical treatment of the above-described formations can be performed using: 1) marsupialization (recurrence rate up to 24.8%); 2) enucleation with or without additional therapy; therapy may include cryotherapy with liquid nitrogen (recurrence rate up to 23.1%), peripheral ostectomy (recurrence rate up to 20%), bone cavity treatment with Carnoy's solution (recurrence rate up to 6.6%); 3) marginal/segmental resection of the jaw (recurrence rate up to 2.5%). Despite of the low percentage of recurrences when using marginal/segmental resection, this method requires a longer and more expensive anesthetic and surgical intervention, as well as longer postoperative and rehabilitation periods. With the use of Carnoy’s solution, it became possible to reduce the risks of recurrence of keratocystic odontogenic tumors and ameloblastomas from 60—80% to 6.6—11.5%. Today, in all the world, not only Carnoy’s solution recommended by Cutler and Zollinger in 1933 is applied, but also its modifications which are not inferior to the original substance in terms of removal efficiency of the remaining cystic cells. The safety of the use of the solution near the vessels and nerves is confirmed by works of a number of authors. Despite of the large number of surgical treatments of both keratocystic odontogenic tumors and ameloblastomas, the use of enucleation with the use of Carnoy’s solution is the optimal method of choice for these diseases.
About the Authors
V. V. LebedevRussian Federation
Department of Maxillofacial Surgery.
Ul. Timura Frunze 16, Moscow, 119021
S. B. Butsan
Russian Federation
Department of Maxillofacial Surgery.
Ul. Timura Frunze 16, Moscow, 119021
References
1. Philipsen H.P. On keratocysts in the jaws // Tandlaegebladet. 1956. Vol. 60. P. 963-980.
2. de Molon R.S., Verzola M.H., Pires L.C., Mascarenhas V.I., da Silva R.B., Cirelli J.A., Roberto H.B. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review // Contemp. Clin. Dent. 2015. Vol. 6. Suppl. 1. P. 106-110.
3. Philipsen H.P. Keratocystic odontogenic tumour // Pathology and genetics of head and neck tumours. WHO classification of tumours, 3rd edition, vol. 9 / Eds. L. Barnes, J.W. Eveson, P. Reichart, D. Sidransky. Lyon: IARC, 2005. P. 306-307.
4. Robles P, Roa I. Keratocystic odontogenic tumor: Clinicopathological aspects and treatment // J. Oral Res. 2014. Vol. 3. N 4. P. 249-256.
5. Ljubenovic M, Ljubenovic D, BinicI., Jovanovic D, Stanojevic M. Gorlin-Goltz syndrome // Acta Dermatoven. APA. 2007. Vol. 16. N 4. Р. 166-169.
6. Leger M, Quintana A., Tzu J, Yee H, Kamino H, Sanchez M. Nevoid basal cell carcinoma syndrome // Dermatol. Online J. 2011. Vol. 17. N 10. P. 23.
7. Soufir N, Gerard B., Portela M, Brice A., Liboutet M, Saiag P, Descamps V., Kerob D, Wolkenstein P., Gorin I., Lebbe C, Dupin N, Crickx B. , Basset-Seguin N, Grandchamp B. PTCH mutations and deletions in patients with typical nevoid basal cell carcinoma syndrome and in patients with a suspected genetic predisposition to basal cell carcinoma: A French study // Br. J. Canc. 2006. Vol. 95. N 4. Р. 548-553.
8. Tang J.Y., Wu A., Linos E, Parimi N, Lee W, Aszterbaum M, Asgari M.M., Bickers D.R., Epstein E.H. Jr. High prevalence of vitamin D deficiency in patients with basal cell nevus syndrome // Arch. Dermatol. 2010. Vol. 146. N 10. Р. 1105-1110.
9. Пустынский И.Н., Кропотов М.А., Ткачев C. И., Пачес А.И., Алиева С.Б., Ягубов А.С., Бажу-това Г.А., Сланина С.В. Лечение больных плоскоклеточным раком кожи головы и шеи // Рос. он-кол. ж. 2013. N 1. С. 42-46.
10. Беренбейн Б.А., Лезвинская Е.М., Красно-щекова Н.Ю., Ильинская Т.Б. Синдром Горлина-Гольца // Вестн. дерматол. 1993. N 5. С. 63-67.
11. Guimarгes A.C., Santos M.D.D.C.F., de Carvalho G.M., Chone C.T., Pfeilsticker L.N. Giant keratocystic odontogenic tumor: three cases and literature review // Iran. J. Otorhinolaryngol. 2013. Vol. 25. N 73. P. 245-252.
12. Stoelinga P.J.W. Excision of the overlying, attached mucosa, in conjunction with cyst enucleation and treatment of the bony defect with Carnoy solution // Oral. Maxillofac. Surg. Clin. 2003. Vol. 15. N 3. P. 407-414.
13. Mendes R.A., Carvalho J.F.C., van der Waal I. Characterization and management of the keratocystic odontogenic tumor in relation to its histopathological and biological features // Oral Oncol. 2010. Vol. 46. N 4. P. 219-225.
14. Yashoda Devi B.K., Rakesh N, Nisha A., Sagar P, Prasad K. Bilateral keratocystic odontogenic tumor of mandible // India. J. Multidiscip. Dent. 2010. Vol. 1. N 1. P. 12-14.
15. Matijevic S, Damjanovic Z., Cerovic S. Early reconstruction of bone defect created after initial surgery of a large keratocystic odontogenic tumor: A case report // Vojnosanit. Pregl. 2013. Vol. 70. N 8. P. 789-793.
16. Jafaripozve N, Jafaripozve S, Khorasgani M.A. Kerathocyst odontogenic tumor: importance of selection the best treatment modality and a periodical follow-up to prevent from recurrence: a case report and literature review // Int. J. Prev. Med. 2013. Vol. 4. N 8. P. 967-970.
17. Pindborg J.J., Hansen J. Studies on odontogenic cyst epithelium: 2. Clinical and roentgenologic aspects of odontogenic keratocysts // Acta Pathol. Microbiol. Scand. Pathol. 1963. Vol. 58. N 3. P. 283-294.
18. Chrcanovic B.R., Gomez RS. Recurrence probability for keratocystic odontogenic tumors: An analysis of 6427 cases // J. Cranio. Maxill. Surg. 2017. Vol. 45. N 2. P. 244-251.
19. Reichart P.A., Philipsen H.P., Sonner S. Ameloblastoma: biological profile of 3677 cases // Eur. J. Canc. B Oral Oncol. 1995. Vol. 31. N 2. P. 86-99.
20. Семкин В.А., Григорьян А. С., Бабиченко И.И., Усачев Е.С., Зарецкая А.С. Особенности хирургической тактики при различных формах аме-лобластических опухолей // Стоматол. 2012. Т. 91. N 4. С. 25-27.
21. Junquera L, Ascani G, Vicente J.C., Garcia-Consuegra L., Roig P. Ameloblastoma revisited // Ann. Otol. Rhinol. Laryngol. 2003. Vol. 112. N 12. P. 1034-1039.
22. Juuri E, Isaksson C, Jussila М, Heikinheimo К., Thesleff I. Expression of the stem cell marker, SOX 2, in ameloblastoma and dental epithelium // Eur. J. Oral Sci. 2013. Vol. 121. N 6. P. 509-516.
23. Yang R, Liu Z, Peng C, Cao W, Ji T. Maxillary ameloblastoma: Factors associated with risk of recurrence // Head Neck. 2017. Vol. 39. N 5. P. 996-1000.
24. Семкин В.А., Бабиченко И.И., Усачев Е.С., Зарецкая А.С. Клинико-морфологическая характеристика амелобластом // Стоматол. 2013. Т. 92. N 4. С. 40-43.
25. Gardner D.G., Heikinheimo K., Shear M, Philipsen H.P., Coleman H. Ameloblastomas // Pathology and genetics of head and neck tumours. WHO classification of tumours, 3rd Edition, Vol. 9 / Eds. L. Barnes, J.W. Eveson, P. Reichart, D. Sidransky. Lyon: IARC, 2005. P. 298-302.
26. Luan X., Ito Y, Diekwisch T.G.H. Evolution and development of Hertwig’s epithelial root sheath // Dev. Dynam. 2006. Vol. 235. N 5. P. 11671180.
27. Nam H, Kim J.H., Kim J.W., Seo B.M., Park J.C., Kim J.W., Lee G. Establishment of Hertwig’s epithelial root sheath/epithelial rests of Malassez cell line from human periodontium // Mol. Cells. 2014. Vol. 37. N 7. P. 562-567.
28. Shaikhi K, Neiders M, Chen F, Aguirre A. Morphological variants of ameloblastoma and their mimickers // N. A. J. Med. Sci. 2012. Vol. 5. N 1. P. 20-28.
29. Page-McCaw A., Ewald A.J., Werb Z. Matrix metalloproteinases and the regulation of tissue remodelling // Nat. Rev. Mol. Cell. Biol. 2007. Vol. 8. N 3. P. 221-233.
30. Pinheiro J.J. V., Freitas V.M., Moretti A.I.S., Jorge A.G., JaegerR.G. Local invasiveness of ameloblastoma. Role played by matrix metalloproteinases and proliferative activity // Histopathology. 2004. Vol. 45. N 1. P. 65-72.
31. Кириченко Е.Н. Использование стереолитографического моделирования у пациентов с амелобластомой нижней челюсти // Альм. соврем. науки и образ. 2014. Т. 5-6. N 84. С. 78-82.
32. Бабиченко И.И., Рыбальская В.Ф., Цимбалист Н.С., Семкин В.А. Пролиферативная активность клеток опухоли и распределение SOX2+ плюрипотентных стволовых клеток в различных гистологических вариантах амелобластомы // Арх. патол. 2018. Т. 80. N 1. С. 21-26.
33. Haq J, Siddiqui S, McGurk M. Argument for the conservative management of mandibular ameloblastomas // Brit. J. Oral Max. Surg. 2016. Vol. 54. N 9. P. 1001-1005.
34. Al-Moraissi E.A., Dahan A.A., Alwadeai M.S., Oginni F.O., Al-Jamali J.M., Alkhutari A.S., Al-Tairi N.H., Almaweri A.A., Al-Sanabani J.S. What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor?: A large systematic review and meta-analysis // J. Cranio Maxill. Surg. 2017. Vol. 45. N 1. P. 131-144.
35. Cutler E.C., Zollinger R. The use of sclerosing solutions in the treatment of cysts and fistulae // Am. J. Surg. 1933. Vol. 19. N 3. P. 411-418.
36. Pitak-Arnnop P, Chaine A., Oprean N, Dhanuthai K., Bertrand J.C., Bertolus C. Management of odontogenic keratocysts of the jaws: A ten-year experience with 120 consecutive lesions // J. Cranio Maxill. Surg. 2010. Vol. 38. N 5. P. 358-364.
37. Voorsmit R.A.C.A, Stoelinga P.J.W., van Haelst U.J.G.M. The management of keratocysts // J. Maxillofac. Surg. 1981. Vol. 9. P. 228-236.
38. Madhulaxmi M, Abdul Wahab P.U. Carnoy's solution as a surgical medicament in the treatment of KCOT // Int. J. Pharma Bio Sci. 2014. Vol. 5. N 1. P. 492-495.
39. Ecker J., ter Horst R., Koslovsky D. Current role of Carnoy’s solution in treating keratocystic odontogenic tumors // J. Oral Maxillofac. Surg. 2016. Vol 74. N 2. P. 278-282.
40. Saulacic N., Stajcic Z, Stajcic L.S., Piattelli A., Iizuka T, Lombardi T. Effects of Carnoy’s solution on blood vessels of the axillary fossa of rats // Int. J. Oral Maxillofac. Surg. 2009. Vol. 38. N 8. P. 876-879.
41. Frerich B, Cornelius C.P., Wieth^ter H. Critical time of exposure of the rabbit inferior alveolar nerve to Carnoy’s solution // J. Oral Maxillofac. Surg. 1994. Vol. 52. N 6. P. 599-606.
42. Gao L, Wang X.L., Li S.M., Liu C.Y., Chen C., Li J.W., Yan X.J., Zhang J., Ren W.H., Zhi K.Q. Decompression as a treatment for odontogenic cystic lesions of the jaw // J. Oral Maxillofac. Surg. 2014. Vol. 72. N 2. P. 327-333.
43. Brшndum N, Jensen V.J. Recurrence of keratocysts and decompression treatment: A longterm follow-up of forty-four cases // Oral Surg. Oral Med. Oral Pathol. 1991. Vol. 72. N 3. P. 265-269.
44. Nakamura N, Mitsuyasu T, Mitsuyasu Y., Taketomi T, Higuchi Y, Ohishi M. Marsupialization for odontogenic keratocysts: Long-term followup analysis of the effects and changes in growth characteristics // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2002. Vol. 94. N 5. P. 543-553.
45. Афанасьев В.В. Хирургическая стоматология. Москва: ГЭОТАР-Медиа, 2011. 880 c.
46. Kaczmarzyk T, Mojsa I., Stypulkowska J. A systematic review of the recurrence rate for keratocystic odontogenic tumour in relation to treatment modalities // Int. J. Oral Maxillofac. Surg. 2012. Vol. 41. N 6. P. 756-767.
47. Johnson N.R., Batstone M.D., Savage N.W. Management and recurrence of keratocystic odontogenic tumor: a systematic review // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2013. Vol. 116. N 4. P. 271-276.
48. Stoelinga P.J.W. The treatment of odontogenic keratocysts by excision of the overlying, attached mucosa, enucleation, and treatment of the bony defect with Carnoy solution // J. Oral Maxillofac. Surg. 2005. Vol. 63. N 11. P. 1662-1666.
49. Tolstunov L, Treasure T. Surgical treatment algorithm for odontogenic keratocyst: combined treatment of odontogenic keratocyst and mandibular defect with marsupialization, enucleation, iliac crest bone graft, and dental implants // J. Oral Maxillofac. Surg. 2008. Vol. 66. N 5. P. 1025-1036.
50. Pogrel M.A. The keratocystic odontogenic tumor // Oral Maxillofac. Surg. Clin. 2013. Vol. 25. N 1. P. 21-30.
51. Salmassy D.A., Pogrel M.A. Liquid nitrogen cryosurgery and immediate bone grafting in the management of aggressive primary jaw lesions // J. Oral Maxillofac. Surg. 1995. Vol. 53. N 7. P. 784-790.
52. Tonietto L, Borges H.O.I., Martins C.A.M., Silva D.N., Filho M.S. Enucleation and liquid nitrogen cryotherapy in the treatment of keratocystic odontogenic tumors: a case series // J. Oral Maxillofac. Surg. 2011. Vol. 69. N 6. P. 112-117.
53. Schmidt B.L., Pogrel M.A. The use of enucleation and liquid nitrogen cryotherapy in the management of odontogenic keratocysts // J. Oral Maxillofac. Surg. 2001. Vol. 59. N 7. P. 720-725.
54. Kanoi A.V., Banerjee T, Sundaramurthy N., Sarkar A., Kanoi P., Saha S. Defining giant mandibular ameloblastomas - Is a separate clinical sub-entity warranted? // Indian J. Plast. Surg. 2018. Vol. 51. N 2. P. 208-215.
Review
For citations:
Lebedev V.V., Butsan S.B. Use of Carnoy’s solution and its modifications for reducing the number of recurrences after surgical removal of keratocystic odontogenic tumors and ameloblastomas: A systematic review. Vestnik Moskovskogo universiteta. Seriya 16. Biologiya. 2019;74(2):135–145. (In Russ.)