Recurrence related to treatment modalities of unicystic ameloblastoma: a systematic review

This systematic review aims to identify all studies pertinent to the clinical question, ‘which treatment for unicystic ameloblastoma results in the lowest recurrence rate?’ A structured systematic search of the literature, with predefined inclusion and exclusion criteria, using computer and manual searches as well as personal communication, was performed. Evaluations and critical appraisal were done separately in 3 rounds. All searches were performed by 2 independent judges and any disagreement was settled by discussion with a third party. Four treatment modalities for unicystic ameloblastomas were identified. The recurrence rates were 3.6% for resection, 30.5% for enucleation alone, 16% for enucleation followed by application of Carnoy's solution and 18% for marsupialization with/without other treatment in a second phase. It was concluded that there is only weak evidence showing that jaw resection resulted in the lowest recurrence rate, followed by enucleation with application of Carnoy's solution. Enucleation alone resulted in the highest recurrence rate and treatment by marsupialization cannot be sufficiently evaluated since most cases were followed by a second stage surgery of some kind.