Palabras clave
Enucleación
Fotobiomodulación láser
Queratoquiste odontogénico
Informe de caso
Cómo citar
Resumen
El queratoquiste odontogénico (QO) es localmente agresivo y con alta recurrencia. Este caso apoya un abordaje conservador multimodal que combina enucleación, 5- fluorouracilo (5-FU) tópico y fotobiomodulación láser para optimizar el control local y la recuperación neurosensorial. Varón en la sexta década con aumento de volumen mandibular derecho de evolución lenta y molestia funcional; asimetría facial y expansión cortical. La radiografía panorámica mostró radiolucidez bien delimitada desde el ángulo hasta la rama ascendente derecha. El QO se confirmó tras enucleación e histopatología. Se realizó enucleación completa con 5-FU intracavitario y fotobiomodulación por paresia leve. A los 12 meses no hubo recidiva ni persistencia, con recuperación funcional y mejoría neurosensorial. Un protocolo conservador y multimodal puede reducir la recidiva del QO con baja morbilidad; se recomienda seguimiento prolongado y estandarizar la dosificación/tiempo de 5-FU y la dosimetría de fotobiomodulación.
Referencias
1. Ledderhof NJ, van den Akker HP, Raghoebar GM, Vissink A, Meijer HJA. Topical 5-fluorouracil as an adjunct after enucleation of keratocystic odontogenic tumours: a pilot study. J Oral Maxillofac Surg. 2017;75(10):2118–26.
2. Lone PA, Guru S, Khanna I. Topical 5-fluorouracil application in management of odontogenic keratocyst: a comparative study. J Clin Exp Dent. 2020;12(9):e835–41.
3. Dashow JE, Pogrel MA, Podlesh S. Significantly decreased recurrence rates in keratocystic odontogenic tumors treated with Carnoy's solution. J Oral Maxillofac Surg. 2015;73(11):2143–9.
4. Al-Moraissi EA, Ellis E 3rd, Vaid NR. What surgical treatment has the lowest recurrence rate for odontogenic keratocyst? A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46(8):942–50.
5. De Freitas Gonçalves TO, et al. Management and recurrence of the odontogenic keratocyst: systematic review (2024). J Cranio-Maxillofac Surg. 2024.
6. Ma Y, et al. Photobiomodulation therapy for nerve injuries: a systematic review and meta-analysis. PLoS One. 2023;18(6):e0287833.
7. Alharbi G, et al. Efficacy of low-level laser therapy and microsurgery on neurosensory recovery: systematic review (2024). J Stomatol Oral Maxillofac Surg. 2024;125:101–9.
8. Eid MK, et al. Conservative enucleation with topical 5-Fluorouracil: a prospective study with 2-year follow-up. Int J Oral Surg. 2024.
9. Reddy GV, et al. Targeting the odontogenic keratocysts: therapeutic potential of 5-fluorouracil through thymidylate synthase inhibition. Cureus. 2025;17(2).
10. Berberi A, et al. Long-term follow-up of recurrent odontogenic keratocyst treated with topical 5-fluorouracil: 18-year case report. J Stomatol. 2023.
11. Dioguardi M, et al. Factors and management techniques in odontogenic keratocysts: systematic review (2024). Eur J Med Res. 2024;29(1):18.
12. Blanas N, et al. A systematic review of treatment and prognosis of odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(5):553–8.
13. Betancourt P, et al. Photobiomodulation therapy in peripheral nerve regeneration: review and applications. Int J Morphol. 2024;42(6):1524–30.
14. Bahrami R, et al. The impact of low-level laser therapy (photobiomodulation) on nerve repair: recent evidence (2025). Photobiomodul Photomed Laser Surg. 2025.
15. Scribante A, et al. A scoping review on laser assisted protocols for nerve sensitivity after surgical trauma (2023). Appl Sci. 2023;13(16):9258.
16. Muret M, et al. Decompression as first-intention treatment for large odontogenic keratocysts. JOMS. 2021.
17. Kaczmarzyk T, et al. A systematic review of recurrence rates for keratocystic odontogenic tumours. J Craniomaxillofac Surg. 2012;40(7).
18. Jacobs T, et al. Comparing 5-fluorouracil versus modified Carnoy's solution after enucleation: a comparative study (2024). J Oral Maxillofac Surg. 2024;82(4).
19. ClinicalTrials.gov. Study: enucleation with 5-FU vs Carnoy's solution in odontogenic cysts. NCT06096220. 2024.
20. ClinicalTrials.gov. Adjunctive methods in treatment of odontogenic keratocyst (5-FU vs MCS). NCT06820229. 2024.
21. Rojas G, Muñoz C. Effects of phototherapy laser in nerve regeneration: narrative review. Rev ADM. 2023;80(2):115–21.
22. Souza PH, Fernandes-Neto AJ, Gasperini G. Low-level laser therapy for treatment of oral nerve injuries: a systematic review. Dent Traumatol. 2024;40(3).
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Derechos de autor 2026 Daniela Alejandra Escobar Garín, Wendy Escobar-González (Autor/a)