Résumé

<p>Abstract. The present study reported the clinical outcomes of&nbsp;<br>35 patients with mandibular odontogenic keratocysts (OKCs)&nbsp;<br>following treatment by radical resection and immediate&nbsp;<br>defect reconstruction. Amongst 565 patients with OKCs that&nbsp;<br>were treated between April 2003 and May 2015, 35 patients&nbsp;<br>underwent segmental or marginal mandibulectomy. The use&nbsp;<br>of radical resection was based on clinical and/or radiographic&nbsp;<br>evidence of size, cortical perforation and subsequent soft tissue&nbsp;<br>involvement, and on the history of previous recurrence of the&nbsp;<br>same lesion. Recurrence, justifications of the main major factor&nbsp;<br>for resection, and functional and cosmetic results of the patients&nbsp;<br>following mandibular reconstruction were systematically eval-<br>uated. There were 26 OKCs in the mandibular molar-ramus&nbsp;<br>region, eight in the mandibular anterior-premolar region&nbsp;<br>and one in the mandibular molar-ramus and anterior-molar&nbsp;<br>regions. Among the 35 patients, 20 had primary OKCs and&nbsp;<br>15 had recurrent OKCs. A total of 31 patients underwent&nbsp;<br>segmental mandibulectomy, of which 28 were immediately&nbsp;<br>reconstructed with a vascularized flap, whereas four patients&nbsp;<br>underwent marginal mandibulectomy. The functional and&nbsp;<br>cosmetic outcomes of patients were evaluated as satisfactory.&nbsp;<br>The length of the follow-up period ranged from 2 to 17 years&nbsp;<br>following operation (average, 5.82 years). Recurrence was&nbsp;<br>identified in one patient who had been treated with margina<br>mandibulectomy. In conclusion, the findings from the presen<br>study suggested that radical resection may be recommended&nbsp;<br>for patients with OKCs and locally aggressive features.&nbsp;<br>Immediate mandibular reconstruction with a vascularized flap&nbsp;<br>may be a crucial part of this aggressive treatment method that&nbsp;<br>may reduce OKCs-associated morbidity.</p>