Queratoquiste odontogénico. Estudio retrospectivo de 285 casos. (I. Aspectos clínicos)

espanolObjetivo: Analizar retrospectivamente las caracteristicas clinicas de los queratoquistes odontogenicos (QQ) registrados en el I.R.E.P.O. (Facultad de Odontologia - Universidad de Chile) entre los anos 1975-1996. Material y metodo: Se han estudiado 338 casos de QQ diagnosticados en el instituto de referencia de Patologia Oral (Facultad de Odontologia - Universidad de Chile) entre los anos 1975-1996. La muestra final se redujo a 285 casos, ya que se descartaron aquellas lesiones cuyas biopsias fueron insuficientes para establecer el diagnostico. La edad media fue de 33 anos con un rango entre 7 y 77 anos. De estos 285 casos, 223 corresponden a QQ solitarios y 62 a QQ asociados al sindrome nevoide basocelular. Se recogieron en un protocolo las variables de sexo, edad, ubicacion, tiempo transcurrido desde el inicio de la sintomatologia hasta el diagnostico histopatologico, presencia de infeccion, asociacion al sindrome nevoide basocelular y recurrencia. Para el analisis estadistico se utilizaron las pruebas de chi cuadrado, test t no pareado y Mann-Whitney. Resultados: Los 285 casos con diagnostico de QQ representan el 12,8 % de todos los quistes odontogenicos. El QQ solitario (QQS) se presento con mayor frecuencia en los hombres, al igual que los asociados al sindrome nevoide basocelular (QQSNB). Existian dos picos en cuanto a distribucion de la edad: el primero entre la segunda y tercera decadas, y el segundo en la septima decada. Los QQSNB presentaron solo un pico: entre la segunda y tercera decadas. Los QQ se localizan de preferencia en la mandibula, principalmente en el cuerpo, la zona de molares y la rama ascendente, con una tasa de recurrencia para los solitarios de un 22,9 % y de un 31,9 % para los asociados a SNB. Se observo un 23,3 % de QQS infectados y un 8,16 % de QQSNB. Conclusiones: Los QQSNB presentan un comportamiento mas agresivo que los QQS. EnglishObjectives: A retrospective study is made of the clinical features of 338 odontogenic keratocysts recorded in the Instituto de Referencia en Patologia Oral (University of Chile Dental School) in the period 1975- 1996. Material and method: The final study was limited to 285 cysts, following the exclusion of those cases where the biopsy material proved insufficient to establish the diagnosis. The mean patient age was 33 years (range 7-77). Of the total cysts, 233 corresponded to solitary odontogenic keratocysts, while 49 were associated to basal cell nevus syndrome. In 13 cases the association to basal cell nevus syndrome was not established. Patient sex and age were recorded, together with lesion location, the time elapsed from the first presentation of symptoms to the histopathological diagnosis, the presence of infection, association to basal cell nevus syndrome, and recurrence. The statistical analysis was based on the chi-square, non-paired Student t and MannWhitney tests. Results: The 285 odontogenic keratocysts recorded represented 12.8 % of all odontogenic cysts. Solitary odontogenic keratocysts and those associated to basal cell nevus syndrome were more frequent in males. Two peaks in terms of age distribution were observed: one between the second and third decades of life, and another in the seventh decade. In contrast, odontogenic keratocysts associated to basal cell nevus syndrome exhibited a single peak between the second and third decades of life. Odontogenic keratocysts were preferentially located in the lower jaw, particularly the mandibular body, molar zone and ascending ramus - with a recurrence rate of 22.9 % and 31.9 % for solitary lesions and odontogenic keratocysts associated with basal cell nevus syndrome, respectively. The infection rate was 23.3 % and 8.16 %, respectively. Conclusions: It is concluded that odontogenic keratocysts associated with basal cell nevus syndrome exhibit a more aggressive behavior than solitary odontogenic keratocysts.