Poster Session
proximal segment following bilateral or unilateral IVRO
focused on the osteotomy line.
Patients and Methods: IVRO was performed on 120
patients (185 sides) who had mandibular prognathism
with and without Le Fort I osteotomy from August 2001
to December 2013. Out of 118 patients evaluated; 67 pa-
tients (134 sides) underwent bilateral IVRO surgical pro-
cedure, 51 patients (51 sides) underwent unilateral
IVRO surgical procedure. The relative osteotomy line
and complications were determined by panoramic x-ray
after the operation. We classified osteotomy line into
three types as follows; vertical type, C-shaped type, and
oblique type.
Results: According to our classification of osteotomy
line, vertical type consists of 98 sides, C-shaped type
contains 37 sides, and oblique type had 50 sides. Inter-
ference of proximal segment occurred in 5 sides
(2.7%), and all cases were showed vertical type of os-
teotomy line (5.1% in vertical type). Moreover, condylar
luxation were found in 6 sides (3.2%) in which 4 cases
indicated vertical type (4.1% in vertical types) and
2 cases demonstrated C-shaped type (5.4% in C-shaped
type).
Conclusions: In this study, condylar luxation and an
interference of proximal segment were observed in
5.9% (11/185) after IVRO. Interestingly, there were no
complications in oblique type cases. These results sug-
gest that oblique type of osteotomy line tend not to occur
in the complications.
References:
1. Yamauchi K, Takenobu T, Takahashi T. Condylar luxation following
bilateral intraoral vertical ramus osteotomy. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod. 2007 Dec;104(6):747-51.
2. Ritto F, Parente E, da Silveira HM, Medeiros PJ, de Moraes M. Avoid-
ing condylar displacement after intraoral vertical ramus osteotomy. J
Craniofac Surg. 2010 May;21(3):826-9.
POSTER 146
Dredging Method-A Conservative
Approach for the Treatment of
Keratocystic Odontogenic Tumor -
T. Yamada: Department of Oral and Maxillofacial Surgery,
Division of Oral Pathobiological Science, Graduate School
of Dental Medicine, Hokkaido Unversity, Y. Ohiro,
Y. Totsuka, K. Tei
Background and Purpose: Keratocystic odonto-
genic tumor (KCOT) was previously designated as
odontogenic keratocyst, which stresses the benign
behavior of this lesion. In 2005, WHO Working Group
recommends the term KCOT as it better reflects its
neoplastic nature.
AAOMS  2014
The most important clinical feature of the KCOT is its
potential for locally destructive behavior, its recurrence
rate, and its tendency to multiplicity. The traditional
method for the treatment of KCOT is surgical enucle-
ation. However, due to the lining of the cyst being deli-
cate, the presence of the daughter cyst and the fact that
KCOT frequently recur, this method is not sufficient. In
such cases, additional surgical treatment, such as mar-
ginal resection or segmental resection should be consid-
ered. The resection of the mandible including involving
condyle, wide anterior region and young patient is asso-
ciated with numbers of complications, such as loss of
jaw support, deformity, dysfunction and psychological
distress even after reconstruction. To overcome these
disadvantages by invasive surgery, to eliminate the tu-
mor completely and to restore the normal form and
function of the jaw, dredging method is performed for
the treatment of KCOT in our division. In this study,
we evaluate the clinical outcome of KCOT treated
with dredging method.
Patients and Methods: The term ‘‘Dredging Method’’
is a conservative surgical procedure in which, deflation
and enucleation or only enucleation, followed by
repeated dredging is applied to accelerate new bone for-
mation by removing out the scar tissue from the bony cav-
ity. In 132 patients, 122 patients had a single lesion and
the other had multiple lesions, so that 151 KCOTs were
treated in our university between 1985 and 2005. The le-
sions more than 25mm in greatest dimension, were
treated by dredging methods and the other lesions were
treated by enucleation alone or deflation followed by
enucleation.
Results: The daughter cysts was found in 50% patients
with multiple lesions and in 18% of patients with single
lesions. The daughter cyst was found in 31.8% of multiloc-
ular lesion that was much higher rate than the unilocular
lesions in 18.6%. In 57 lesions treated with dredging
method, only 28 lesions were cleared out at enucleation
step, but the other lesions were still found the remaining
cyst at dredging step in pathologically. During the obser-
vation period, the recurrence was identified only in 7 out
of 151 lesions (4.6%), between 34 and 124 months after
final dredging.
Conclusions: Daughter cyst was found in much
higher rate in multiple cases and multilocular lesions.
The recurrence rate of the KCOT in our division was
4.6%. Long term follow up is essential for dredging
method.
References:
1. Nigel R. Johnson, Martin D. Batstone, Neil W. Savage : Management
and recurrence of keratocystic odontogenic tumor : a systematic review.
Oral Surg Oral Med Oral Pathol Oral Radiol. 116: 271–276, 2013
2. Fadi Titinchi, Christoffel J. Nortje : Keratocystic odontogenic tu-
mor : a recurrence analysis of clinical and radiographic parameters.
Oral Surg Oral Med Oral Pathol Oral Radiol. 114 : 136–142, 2012
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