Abstract
BACKGROUND: Odontogenic keratocyst (OKC) and ameloblastoma are benign but locally aggressive jaw lesions that require careful surgical management. While radical resection has traditionally been the preferred treatment, conservative approaches such as surgical excision with peripheral ostectomy have gained interest to prevent significant functional and aesthetic consequences. This study aims to compare the recurrence rates of OKC and ameloblastoma in the maxilla following conservative surgical treatment. METHODS: A retrospective analysis was performed on 31 patients who underwent surgical excision with peripheral ostectomy for OKC (n = 19) or ameloblastoma (n = 12) in the maxilla between 2006 and 2024. Recurrence was monitored through periodic radiographic follow-ups (mean duration: 43 months), including panoramic radiograph and cone-beam computed tomography (CBCT). RESULTS: Among the 19 OKC cases, tumor recurred in two patients (10.5%) at 5, and 14 years post-surgery, while no recurrences were found in the ameloblastoma group. The majority of OKC (95%) were located in the posterior maxilla, whereas ameloblastoma showed an even distribution between the anterior and posterior regions, with 50% in each. Although Fisher's Exact Test did not demonstrate a statistically significant difference in recurrence rates, simple comparison suggests that OKC may have a higher tendency for recurrence than ameloblastoma following conservative treatment. CONCLUSION: Surgical excision with peripheral ostectomy appears to be a viable conservative treatment option for both OKC and ameloblastoma in the maxilla, with a relatively low recurrence rate observed in this study. Notably, recurrences observed even after long-term follow-up indicate the necessity for prolonged monitoring.