Research and Scholarshipinsight

Refined Topical 5-Fluorouracil Technique for the Targeted Treatment of Odontogenic Keratocysts

Representative example of odontogenic keratocyst treated with refined topical 5-fluorouracil technique. A, Preoperative Panorex radiograph showing a biopsy-confirmed odontogenic keratocyst involving the right mandibular body, and ramus. B, Six-month postoperative Panorex radiograph showing a well-healed, cystfree right mandible treated with enucleation, peripheral ostectomy, and refined topical 5fluorouracil technique.

What is it?

Odontogenic keratocysts (OKCs) are benign but often aggressive lesions in the jaw. This study represents an investigation of a potentially better way to treat them.

What problem does it aim to solve?

Treatment for OKCs includes application of a drug called 5-fluorouracil (5-FU), which is effective, but the way it is administered, using gauze packing material, is often very uncomfortable/painful for patients, and the gauze may be hard to place correctly if the lesion is too small or in a difficult-to-access location.

How does it work?

Thirteen patients were treated with this new method, in which the surgical cavity was irrigated with saline then covered with topical 5% 5-FU using a cotton swab. The final step was to place absorbable gelatin sponge coated with 5% 5-FU. “This refined technique further increases technical ease, decreases operative time, and precludes the need for packing removal, with similar efficacy as the original approach.