Comparing 5-Fluorouracil Versus Modified Carnoy's Solution for the Treatment of Odontogenic Keratocysts: A Systematic Review and Meta-Analysis

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Oral and Maxillofacial Surgery Pub Date : 2024-11-01 DOI:10.1016/j.joms.2024.06.181
Tyler Jacobs DDS, MD , Disha Patil , Rabie Shanti DMD, MD , Vincent B. Ziccardi DDS, MD
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Abstract

Purpose

The primary aim of this study was to compare time to odontogenic keratocyst (OKC) recurrence with 5-fluorouracil (5-FU) versus modified Carnoy's solution (MCS) following enucleation and curettage and peripheral ostectomy. The secondary aim was to compare the frequency (%) of permanent peripheral nerve injury characterized by hypoesthesia and neuropathic pain present at 12 months or more after surgery with 5-FU versus MCS.

Methods

The Cox hazard ratio was calculated to compare time to recurrence between the 2 groups. To compare the frequencies of permanent nerve damage, we fitted a fixed-effects model to the data and calculated the risk ratio. Other variables collected were sex, age, follow-up time, and cyst size.

Results

No significant differences in sex, age, follow-up time, and cyst size were found. The median follow-up time for all patients was 60 months (range: 12-180 months, Q1 = 32 months, Q3 = 86 months, interquartile range = 54 months). Of the 114 patients treated with MCS, 27 recurrences with a median recurrence time of 42 months (range = 12-108 months, Q1 = 26.3 months, Q3 = 54 months, interquartile range = 27.7 months) were recorded; no recurrences were observed among the 99 patients treated with 5-FU (hazard ratio = 0.02, 95% CI = 0.00018-0.16, P = 2.27e-07). Of the 112 patients treated with MCS, there were 20 (17.86%) instances of permanent peripheral nerve injury; of the 98 patients treated with 5-FU, there were 7 (7.14%) instances of permanent peripheral nerve injury (risk ratio = 0.44, 95% CI = 0.20-0.97, P = .04).

Conclusion

The results of this meta-analysis significantly favored 5-FU over MCS for lower OKC recurrence and peripheral nerve injury, supporting the use of 5-FU as the superior adjuvant following enucleation and curettage and peripheral ostectomy for the treatment of OKCs.
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比较 5-氟尿嘧啶和改良卡诺溶液治疗牙源性角化囊肿:系统回顾与元分析
目的 本研究的主要目的是比较牙源性角化囊肿(OKC)复发的时间,即在进行去核、刮除术和周边切除术后,使用 5-氟尿嘧啶(5-FU)与改良卡诺氏液(MCS)的复发时间。次要目的是比较 5-FU 与 MCS 术后 12 个月或更长时间内出现以感觉减退和神经性疼痛为特征的永久性周围神经损伤的频率(%)。为了比较永久性神经损伤的频率,我们对数据拟合了一个固定效应模型,并计算了风险比。收集的其他变量包括性别、年龄、随访时间和囊肿大小。所有患者的随访时间中位数为 60 个月(范围:12-180 个月,Q1 = 60 个月):12-180个月,Q1=32个月,Q3=86个月,四分位数间距=54个月)。在接受 MCS 治疗的 114 例患者中,有 27 例复发,中位复发时间为 42 个月(范围:12-108 个月,Q1 = 26.3 个月,Q3 = 54 个月,四分位间范围 = 27.7 个月);在接受 5-FU 治疗的 99 例患者中,未观察到复发(危险比 = 0.02,95% CI = 0.00018-0.16,P = 2.27e-07)。在接受 MCS 治疗的 112 例患者中,有 20 例(17.86%)出现永久性周围神经损伤;在接受 5-FU 治疗的 98 例患者中,有 7 例(7.14%)出现永久性周围神经损伤(风险比 = 0.44,95% CI = 0.20-0.97,P = .04)。结论:该荟萃分析结果表明,5-FU 比 MCS 更能降低 OKC 复发率和周围神经损伤,支持将 5-FU 作为治疗 OKC 的 "去核、刮除术 "和 "周围切除术 "后的首选辅助药物。
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来源期刊
Journal of Oral and Maxillofacial Surgery
Journal of Oral and Maxillofacial Surgery 医学-牙科与口腔外科
CiteScore
4.00
自引率
5.30%
发文量
0
审稿时长
41 days
期刊介绍: This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association.
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