Comparative Evaluation of Topical Application of 5-Fluorouracil and Modified Carnoy’s Solution in Management of Odontogenic Keratocyst

Abstract

The study was designed to assess the efficacy of topical application of 5-fluorouracil (5-FU) in the management of odontogenic keratocysts (OKC). The prospective, comparative, clinical study was conducted on seventeen patients with non-recurrent, non-syndromic OKC of the mandible who underwent cyst enucleation and peripheral osteotomy, followed by the application of 5-FU (group A, n = 9) and modified Carnoy’s solution (MC) (group B, n = 8). Patients were assessed for nerve paresthesia, recurrence, and bone healing. Intergroup comparison of age, gender, location, and size was done by analysis of variance and Chi-square test. Recurrence was studied by Kaplan-Meier analysis. Bone healing was compared between the groups using an unpaired t-test. Age of patients ranged from 26-61 years, with male-to-female ratio of 1.8: 1. Patients were followed-up for 43.7 and 47.5 months in groups A & B, respectively. They showed no recurrence in the 5-FU group and 25% (n=2) recurrence in the MC group. Kaplan-Meier analysis showed a disease-free survival probability of 0.9 at 30 months, which reduced to 0.7 at 60 months in group B. Although temporary paresthesia was seen in both group A (28.5%, n=2) and group B (42.8%, n-3), complete recovery was seen in all the patients. Bone healing assessment showed a mean increase in grey-level score by 36.52 ± 2.96 and 34.064 ± 6.52 in groups A and B respectively, which was statistically insignificant (p-value 0.225184). 5-FU is a novel option for the management of OKC. Its use resulted in lower post-operative paresthesia with no recurrence.