Abstract
Odontogenic keratocyst (OKC) is known for its benign but aggressive clinical behaviour,
and presents a challenge in its management due to high recurrence rate following surgical
intervention. The sourcing of Carnoy’s solution, the widely used adjunct in OKC treatment,
has lately become difficult especially after its banning by the United States Food
and Drugs Agency (FDA). This has generated interest in exploring alternative chemical
agents such as 5-Fluorouracil (5-FU) and Modified Carnoy’s solution (MCS). We conducted
a systematic review and meta-analysis to assess the effectiveness of 5-FU as an adjunct
following surgical intervention of OKC. A protocol was registered in PROSPERO prior
to the literature search. All studies reporting the use of 5-FU in OKC treatment were
included in the initial search of multiple literature databases. Of the 148 initially
identified articles, three met the criteria for the final appraisal. The relevant
data were extracted and a meta-analysis was undertaken in relation to recurrence rate
and nerve paraesthesia. There were no recurrence observed in cases treated with 5-FU
(n=56), and the incidence of nerve paraesthesia was 20% (none permanent). This systematic
review has revealed early encouraging results for 5-FU as an adjunct, however a caution
is recommended due to overall low quality of evidence related to individual studies.
We present the cumulative evidence on the effectiveness of 5-FU in OKC treatment with
discussion on its mechanism of action, safety profile, application protocol, and the
implications for clinical practice.
Keywords
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Article Info
Publication History
Published online: February 16, 2022
Accepted:
February 11,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
