Tratamento radical de tumor odontogênico ceratocístico em mandíbula com enxerto ósseo vascularizado de fíbula

Abstract

The aim of this study is to present a case report of KCOT, treated by complete mandibularresection (hemimandibulectomy), with immediate reconstruction of the mandible through avascularized bone graft of a fibula, fixed by titanium bar and screws.In 2005, with the WHO’s update of the histological classification of odontogenic tumors, the odontogenic keratocyst (OKC) was reclassified. It is now considered a benign epithelial odontogenic tumor, called Keratocystic odontogenic tumour (KCOT). This is due to its intrinsic characteristics which relate to those of neoplasms, such as rates of cell proliferation not compatible with cystic lesion, that is, abnormal growth, because it is locally aggressive and destructive, and high relapse rates. Although there are many hypotheses for its etiology, the most frequent one, according to the authors, is that it is the result of proliferation and multiplication of epithelial remnants of the dental lamina. The KCOT is considered a lesion of slow and continuous evolution, and it is asymptomatic in most cases, with higher incidence among males aged between 10 and 40. The jaw is affected in most cases, usually in the posterior region. Radiographically, most injuries are unilocular. Depending on the size, characteristics and location of the lesion, several diagnosis hypotheses are possible, such as dentigerous cyst (when associated with an impacted tooth), ameloblastoma, among others. The final diagnosis is obtained by histopathology. There is no consensus among authors on the most effective type of treatment, as several factors should be taken into consideration in such a choice. This paper aims to present a case report of KCOT, treated by complete mandibular resection (hemimandibulectomy), with immediate reconstruction of the mandible through a vascularized bone graft of a fibula, fixed by titanium bar and screws.