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Purpose: The primary aim of this study was to compare time to odontogenic keratocyst (OKC) recurrence with 5-fluorouracil (5-FU) versus modified Carnoy's solution (MCS) following enucleation and curettage and peripheral ostectomy. The secondary aim was to compare the frequency (%) of permanent peripheral nerve injury characterized by hypoesthesia and neuropathic pain present at 12 months or more after surgery with 5-FU versus MCS., Methods: The Cox hazard ratio was calculated to compare time to recurrence between the 2 groups. To compare the frequencies of permanent nerve damage, we fitted a fixed-effects model to the data and calculated the risk ratio. Other variables collected were sex, age, follow-up time, and cyst size., Results: No significant differences in sex, age, follow-up time, and cyst size were found. The median follow-up time for all patients was 60 months (range: 12-180 months, Q 1  = 32 months, Q 3  = 86 months, interquartile range = 54 months). Of the 114 patients treated with MCS, 27 recurrences with a median recurrence time of 42 months (range = 12-108 months, Q 1  = 26.3 months, Q 3  = 54 months, interquartile range = 27.7 months) were recorded; no recurrences were observed among the 99 patients treated with 5-FU (hazard ratio = 0.02, 95% CI = 0.00018-0.16, P = 2.27e-07). Of the 112 patients treated with MCS, there were 20 (17.86%) instances of permanent peripheral nerve injury; of the 98 patients treated with 5-FU, there were 7 (7.14%) instances of permanent peripheral nerve injury (risk ratio = 0.44, 95% CI = 0.20-0.97, P = .04)., Conclusion: The results of this meta-analysis significantly favored 5-FU over MCS for lower OKC recurrence and peripheral nerve injury, supporting the use of 5-FU as the superior adjuvant following enucleation and curettage and peripheral ostectomy for the treatment of OKCs., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Malaria is still one of the most severe public health problems worldwide. The development of treatment, prevention, and control of malaria is one of the substantial problems in the world., Aims: To investigate the in vitro antimalarial activity of Syzygium cumini methanol fruit fraction., Methods: Syzygium cumini L fruit powder was macerated with methanol (PA) and the extract obtained was fractionated using the liquid-liquid partition method with n-hexane, ethyl acetate, butanol, chloroform, methanol, and water solvents. In vitro antimalarial assay was conducted using the culture of Plasmodium falciparum 3D7 strain culture that had reached >5% growth and was examined for IC 50 values using a 24-well microplate in duplicate. Each treatment and control well contained 1,080 μl of complete media. Well, number 1 was added with 120 μl fraction, and then the solution was diluted until it reached 0.01, 0.1, 1, 10, and 100 μg/ml the final concentration in the microtiter well. The control only contained complete media and infected erythrocytes without the addition of anti-malarial drugs. The microplate was incubated for 48 hours. After 48 hours, a thin blood smear was made fixed with methanol and stained with 20% Giemsa for 20 minutes to determine the IC 50 value by plotting sample concentrations and percentage of parasitemia in Excel., Results: The IC 50 values of ethyl acetate fraction, n.hexane fraction, butanol fraction, and water fraction were 1.189, 76.996, 1,769, and 15.058 μg/ml, respectively. Whereases the IC 50 values of C1 fraction (mix fraction from chloroform: methanol 100:0 and 90:10) and C4 fraction (mix fraction from chloroform: methanol 20:80, 10:90, and 0:100) were 100.126 and 1.015 μg/ml, respectively. The results showed that the IC 50 value of ethyl acetate, butanol, and C4 fraction were lower than 10μg/ml and were considered as good activity (strong antimalarial activity)., Conclusion: The ethyl acetate, butanol and C4 subfraction from S. cumini fruit have the potential to be developed as an antimalarial agent., Competing Interests: The authors declare that there is no conflict of interest.

Plants are a significant source for the development of new phytomedicines due to their great clinical benefits, efficiency, cost-effectiveness, fewer side effects, and more affordable therapies. Numerous plants used in traditional treatments, such as Cotinus coggygria Scop., have been effective in the treatment of diabetes mellitus (DM). Therefore, the study is aimed at assessing the phytochemical, antioxidant, and antidiabetic properties of C. coggygria . The hypoglycemic and hypolipidemic activity was evaluated in Swiss male Albino mice by administering an oral dose of 150-250 mg/kg of C. coggygria extracts in alloxan-induced diabetic mice for 15 days. The antioxidant activity and phytochemical composition of the extracts were assessed by using α , α diphenyl- β -picrylhydrazyl (DPPH) and hydrogen peroxide scavenging assays and through standard chemical procedures. The effects of extracts on blood glucose, body weight, lipid profile, and biochemical parameters like total cholesterol (TC), triglyceride (TG), low-density lipids (LDL), high-density lipids (HDL), plasma insulin, liver glycogen, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), urea, and creatinine were determined according to standard procedures. The activities of antioxidant enzymes such as superoxide-dismutase (SOD), peroxidase (POD), and catalase (CAT) were also analyzed spectrophotometrically. The hypoglycemic and hypolipidemic effects with chloroform extracts of 250 mg/kg were found significant in the treatment of diabetes in alloxanised mice compared to the diabetic group. The haematological parameters such as TC, TG, HDL, LDL, creatinine, urea, AST, ALT, and ALP were significantly improved ( p < 0.01) by the chloroform extract of 250 mg/kg compared to the diabetic group. Treatment for 15 days showed significant elevation ( p < 0.01) of antioxidant enzymes. Fourier-transform infrared spectroscopic (FTIR) and gas chromatography-mass spectrometry (GC-MS), column chromatography (CC), and nuclear magnetic resonance (NMR) analyses tentatively identified different phytoconstitutents and metabolites in C. coggygria leaves, which have been reported to possess antihyperglycemic properties. In conclusion, the chloroform extract of 250 mg/kg of C. coggygria possesses significant hypoglycemic and hypolipidemic potential which may prove the claimed use of the plant in amelioration of diabetes and associated complications in folkloric medicine. Additional studies are required for the purification, characterization, and structural elucidation of bioactive compounds., Competing Interests: The authors declare no competing financial interest., (Copyright © 2022 Shahid Rahman et al.)

Plants have profound therapeutic benefits, more economical treatments, fewer side effects, and a relatively cheap cost, making them a source of drugs for protective, preventative, curative, or conducive purposes and creating novel phytomedicines. Plant derived medicines are relatively safe compared to synthetic medicines. Many plants have proved to successfully aid in the treatment of diabetes including Filago hurdwarica (Wall. ex DC.) Wagenitz. The current investigations were therefore designed to assess the phytochemical, antioxidant, antidiabetic, and antihyperlipidemic activities of F. hurdwarica. The phytochemical investigations and antioxidant activities of different extracts were carried out using standard chemical tests, DPPH, and H2O2 scavenging assays. F. hurdwarica plant extract in Hydromethanolic solution were prepared by Soxhletation method and stored in refrigerator at 4°C for two days before use. Swiss Albino mice were made diabetic by a single dose of alloxan (150 mg/kg). Hydromethanolic plant extract and fractions of F. hurdwarica were screened for antidiabetic activity and given to the alloxan-induced diabetic mice at a concentration of 150-250 mg/kg of body weight in different groups of 6 diabetic mice each orally once a day for 15 days. Glibenclamide is also given to another group to as a standard drug to support the result at a dose of 10 mg/kg of body weight orally once a day for 15 days. Blood glucose levels and body weights of mice were measured on 0, 4, 7, 11 and 15th days. The study found that the extract was safe up to the dose level of 2000 mg/kg and the dose response effect of chloroform extract (150-250 mg/kg) of F. hurdwarica showed expressive antihyperglycemic effects and also improved other altered biochemical parameters associated with diabetes. The FTIR and XRD spectra demonstrated the occurrence of phenols, alcohols, alkenes, alkyl halides, ketones, and aromatic compounds and confirmed the amorphous nature of the extract. GC-MS spectral analysis showed the tentative presence of 31 phytochemical constituents in the chloroform extract of F. hurdwarica with different retention time. To conclude, the chloroform extract (250 mg/kg) of F. hurdwarica revealed considerable antioxidant, antihyperglycemic, and antihyperlipidemic potential and is safe for treating diabetes and related complications.

Cancer is one of the most challenging diseases in the modern era for the researchers and investigators. Extensive research worldwide is underway to find novel therapeutics for prevention and treatment of diseases. The extracted natural sources have shown to be one of the best and effective treatments for cell proliferation and angiogenesis. Different approaches including disc potato model, brine shrimp, and chorioallantoic membrane (CAM) assay were adopted to analyze the anticancer effects. Habenaria digitata was also evaluated for MTT activity against NIH/3T3 cell line. The dexamethasone, etoposide, and vincristine sulfate were used as a positive control in these assays. All of the extracts including crude extracts (Hd.Cr), saponin (Hd.Sp), n-hexane (Hd.Hx), chloroform (Hd.Chf), ethyl acetate (Hd.EA), and aqueous fraction (Hd.Aq) were shown excellent results by using various assays. For example, saponin and chloroform have displayed decent antitumor and angiogenic activity by using potato tumor assay. The saponin fraction and chloroform were shown to be the most efficient in potato tumor experiment, demonstrating 87.5 and 93.7% tumor suppression at concentration of 1000  μ g/ml, respectively, with IC 50 values of 25.5 and 18.3  μ g/ml. Additionally, the two samples, chloroform and saponins, outperformed the rest of the test samples in terms of antiangiogenic activity, with IC 50 28.63  μ g/ml and 16.20  μ g/ml, respectively. In characterizing all solvent fractions, the chloroform (Hd.Chf) and saponin (Hd.Sp) appeared to display good effectiveness against tumor and angiogenesis but very minimal activity against A. tumefaciens . The Hd.Chf and Hd.Sp have been prospective candidates in the isolation of natural products with antineoplastic properties., Competing Interests: All authors declare that they have no competing interests that could appear to be affecting the paper., (Copyright © 2022 Osama M. Alshehri et al.)

Men with diabetes have negative effects on reproduction that causes sexual dysfunction. Medicinal plants are non-toxic and much safer than synthetic drugs because regular use of synthetic drugs shows long-term side effects. Curcuma amada (Roxb) is a medicinal plant used in Ayurveda and Unani medicinal systems in India. The goal of this study is to rummage the potential efficiency of the most potent solvent fraction of effective extract of hydro-methanol 60:40 of C. amada rhizome on male gonadal hypofunction in streptozotocin-induced diabetic rat. Diabetes-induced testicular hypofunction was evaluated by glycemic, spermiological, biochemical, genomic, flow cytometric, and histology of testicular tissue. The n-hexane, chloroform, ethyl-acetate, and n-butanol solvent fractions of the said extract were administrated for 4 weeks at 10 mg dose/100 g body weight/day. Among all the used fractions, the ethyl-acetate solvent fraction-treated group showed maximum recovery in serum insulin (177.42%), sperm count (92.84%), sperm motility (97.15%), and serum testosterone (164.33%). The diabetic rats treated with ethyl-acetate solvent fraction also exhibited the maximum resettlement in flow cytometric analysis of sperm viability (55.84%) and sperm mitochondrial integrity (149.79%), gene expression patterns of key markers for androgenesis (Δ5, 3β-HSD 87.50%, and 17β-HSD 74.66%) and apoptosis (Bax 44.63%, Bcl-2 54.03%, and Caspase-3 35.77%) along with testicular histology. The ethyl-acetate fraction contains alkaloids, flavonoids, and polyphenols where all of these components are not present in other fractions, may be the most effective cause for the recovery of diabetes-linked oxidative stress-mediated testicular hypofunctions. PRACTICAL APPLICATIONS: Nowadays worldwide, the use of synthetic drugs are reduced due to their toxic effect. At present, synthetic drugs are replaced by several herbal drugs, the natural source of medicine which has many therapeutic values. C. amada has strong antioxidant activity due to the presence of bio-active compound(s) that can able to manage streptozotocin-induced diabetes linked to oxidative damage of male gonadal organs. Therefore, these bio-active compound(s)-containing said medicinal plant may use as a good source of antioxidative food in the food industry as nutraceuticals and in pharmaceutical industries for the development of the herbal drug to manage diabetes-linked male gonadal hypofunctions. At present, WHO also gives emphasis for developing one drug-multi-disease therapy. From such a viewpoint, this active fraction-containing phytomolecules may have corrective efficacy against diabetes as well as oxidative stress-linked testicular complications., (© 2022 Wiley Periodicals LLC.)

Purpose: The therapeutic use of herbal medicines for the diseases, including cancer, is increasing due to their lower side effects. The present research evaluated the effect of Peucedanum chenur chloroformic extract (PCCE) on cell proliferation against HCT-116 human colorectal cancer cell line., Methods: The cytotoxic effect of PCCE was evaluated by MTT assay. The activity of the Wnt/B-catenin pathway was assayed through measuring the expression of miR-135b, miR-21, and APC genes by real-time PCR. The flow cytometry and scratch tests were used to study the cell cycle and cell migration, respectively. Also, the antioxidant activity of PCCE was measured by DPPH and iron-chelating tests., Results: The results showed the downregulation of miR-135b and miR-21 and overexpression of the APC gene. Furthermore, PCCE decreased the free radicals, cell migration, and cell proliferation. The antioxidant activity of PCCE was confirmed by standard tests., Conclusion: Altogether, our findings suggest that purified compounds of PCCE could be developed as a potent chemo-preventive drug for the treatment of CRC., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

The toxic side effects of doxorubicin in cancer treatment are well established. Here we show that methanolic extract of the fungus Ganoderma applanatum offers protection against cardio- and hepatotoxicity induced by doxorubicin (DOX) in Dalton's Lymphoma Ascites (DLA) bearing mice. Treatment of DLA mice with 20 mg/kg of doxorubicin significantly increased the activities of serum toxicity markers including aspartate amino-transferase (AST), alanine amino-transferase (ALT) and lactate dehydrogenase (LDH). However, co-administration of doxorubicin (20 mg/kg) by intraperitoneal injection and G. applanatum (150 mg/kg) by oral gavage in DLA mice lowered the AST, ALT, and LDH activities when compared to DOX alone treatment. Treatment of DLA mice with DOX alone resulted in reduced GSH contents, and decreased the activities of glutathione-s-transferase (GST), catalase (CAT), and superoxide dismutase (SOD). Treatment of DOX-administered DLA mice with G. applanatum however increased the GSH content and elevated the activities of GST, CAT, and SOD. Among the various solvent extracts of G. applanatum, methanolic extract showed the highest phenolic (376.5 ± 15.24 mg GAE/g) and flavonoid (4717.79 ± 170.22 mg quercetin/g) contents compared to the aqueous (216.3 ± 7.33 mg GAE/g) and chloroform extracts (137.27 ± 1.03 mg GAE/g). Consistently, the methanolic extract was found to possess the highest free radical scavenging activities when compared to the aqueous and chloroform extracts as measured by ABTS and DPPH assays. Our results thus suggest that the protective roles of G. applanatum in DOX-induced toxicity could be an attribute of the antioxidant properties conferred by the high phenolic and flavonoid contents.

Leishmaniasis is a vector-borne disease that is caused by the protozoa of Leishmania genus. Leishmaniasis is endemic in tropical, subtropical, and large areas of the Mediterranean basin, and covers a total of 98 countries worldwide. It is estimated, according to the World Health Organization (WHO) data, that approximately 350 million people are at risk in these areas, and approximately 12 million people are infected. Increased drug resistance has been documented lately, in the treatment of leishmaniasis which causes almost 1.2 million new cases annually. Thus, interest in plant-derived active substances has increased in recent years, and new anti-leishmanial agents are investigated with in vitro studies. The aim of the present study was to investigate the anti-leishmanial effects of Prangos ferulacea and Ferula orientalis plant extracts collected from the rural areas of Şırnak province against Leishmania tropica. The water, chloroform, and ethanol extracts of the roots, stems, and fruits of P.ferulaceae and F.orientalis plants were obtained, and the cytotoxic activity tests of the extracts were performed. L.tropica isolate obtained from the Parasite Bank in Manisa Celal Bayar University in Turkey (MHOM/TR/2012/CBCL-LT) was grown on NNN and RPMI 1640 broth medium. The cytotoxicity of each extract on the L.tropica isolate was evaluated with the XTT test. Amphotericin B (AmpB) was used as the positive control, and the IC50 values were determined. The lowest IC50 values of the plant extracts were found to be as follows: P.ferulaceae root chloroform extract 36 µg/ml and fruit chloroform extract 20 µg/ml, F.orientalis root ethanol extract 2.5 µg/ml, and fruit ethanol extract 48 µg/ml, stem chloroform extract 24 µg/ml, and fruit chloroform extract 3.1 µg/ml. It was also determined in our study that only P.ferulaceae root ethanol extract showed cytotoxic activity on the WI-38 fetal lung fibroblast cell line at 65.19 µg/ml at 72 hours. This is the first study that assessed the anti-leishmanial activities of P.ferulaceae and F.orientalis plants that grow in high altitude areas of our country. It was determined that P.ferulaceae root ethanol extract and fruit chloroform extract had the lowest IC50 values among the 18 plant extracts that we examined for their anti-leishmanial activities. The outcomes of this study will be useful in further studies for the determination of active compounds in P.ferulaceae and F.orientalis plant extracts.

Objective: this study aimed to evaluate the efficacy of local application of Carnoy's solution following the surgical excision of recurrent PGCG., Patients and Methods: 40 patients who sought treatment for recurrent PGCG were included in this study. According to the type of treatment the patients were classified randomly into two equal groups. The lesions in all patients were excised down to the alveolar bone followed by aggressive curettage. Then only in group II, Carnoy's solution was applied for 5 min. Clinical follow-up was done for 1 year to evaluate the tissue healing., Results: patients were 23 females and 17 males, with an average of 35.9years. Recurrent PGCGs occurred most commonly in fifth decade of life (25 %). Maxilla (57.5 %) was involved more than the mandible. The lesions were found posteriorly in 27cases and anteriorly in 13cases. The average size of the lesions was 2.9 cm. Histologically, foci of calcifications occurred in 12cases. Recurrence occurred in 5 cases: 4 in group I and 1 in group II. Bone healing was appropriate in all patients without sequestration., Conclusion: the use of Carnoy's solution following surgical removal of recurrent PGCG decreases their recurrence rates. The technique is safe, and conservative with low tissue morbidity., (Copyright © 2021. Published by Elsevier Masson SAS.)

Irritable bowel syndrome (IBS) is a world-wide disease prevalently in Western nations. It influences about 15% of the western populace, with a negative effect on the quality of life and furthermore on medical services costs. Anticholinergic antispasmodics are first line of treatment for discomfort or abdominal pain, particularly if unrelieved after alleviation of stoppage or antidiarrheal treatment. Otilonium bromide (OTB) is quaternary ammonium compound with action on distal GI tract as antispasmodic. It is utilized in the treatment of patients influenced by Irritable inside disorder (IBS) because of its particular pharmacokinetic and pharmacodynamic properties. OTB is poorly absorbed systematically was viable in contrast with different medications used for same purpose, for example, pinaverium bromide and mebeverine, with a good tolerability profile. The effects are long lasting, even after stopping the dosage regime for reduction of abdominal pain. In this review, an overview of mechanism of action, pharmacologic action, synthesis and particularly various analytical and bioanalytical methods are discussed. The analytical methods discussed are spectrophotometry including Near Infrared Spectroscopy (NIRS), chromatography and capillary electrophoresis methods are described with the range, limit of detection and quantification. The paper also provides details of scope of further extension of analytical methods. It was found that most of the analytical methods involves usage of toxic solvents e.g., methanol, acetonitrile, chloroform etc. posing risk to the analyst as well as environment.

Background and Objective: Medicinal plants represent an important source of alternative medicine for the management of various diseases. The present study was undertaken to assess the potential of Lawsonia inermis ethanol (Li.Et) and chloroform (Li.Chf) extracts as memory-enhancing agents in experimental animals. Materials and Methods: Li.Et and Li.Chf were phytochemically characterized via gas chromatography-mass spectroscopy (GC-MS). Samples were tested for nootropic potentials at doses of 25, 50, 100, 200 mg/kg (per oral in experimental animals (p.o.)). Swiss albino mice of either sex ( n = 210) were divided into 21 × 10 groups for each animal model. Memory-enhancing potentials of the samples were assessed using two methods including "without inducing amnesia" and "induction of amnesia" by administration of diazepam (1 mg/kg, intraperitoneally. Piracetam at 400 mg/kg (i.p.) was used as positive control. Cognitive behavioral models including elevated plus maze (EPM) and the passive shock avoidance (PSA) paradigm were used. Biochemical markers of oxidative stress such as glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) levels were analyzed in the brain tissue of treated mice. Results: In 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals scavenging assay, Li.Et and Li.Chf exhibited 70.98 ± 1.56 and 66.99 ± 1.76% inhibitions respectively at 1.28 mg/mL concentration. GCMS results revealed the presence of important phytochemicals. Both samples (Li.Et and Li.Chf) at 25 mg/kg (p.o.) dose significantly ( p < 0.05) improved learning and memory as indicated by decline in transfer latency and increase in step down latency in EPM and PSA models respectively. Li.Et and Li.Chf at 25 mg/kg (p.o.) showed considerable increase in GSH (2.75 ± 0.018 ***), SOD (2.61 ± 0.059 ***) and CAT (2.71 ± 0.049 ***) levels as compared to positive and negative control groups. Conclusions: This study provides the preliminary clue that L. inermis may be a potential source of memory-enhancing and anti-oxidant compounds and thus warrant further studies.

While cataloguing the historical items in the Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK, we discovered an unusual chloroform inhaler, which incorporated two air-inlet tubes in addition to its main inspiratory valve as well as a funnel on one of its lateral walls. An accompanying card stated that the device was thought to be a modification of Snow's inhaler, by James Robinson. It had been found among some old instruments in a General Practice in Huntingdon, Cambridgeshire, and had probably been acquired by an early practitioner named Dr. Newton, who qualified in 1851 and performed a lot of minor surgery in the practice. Using information published in books, medical journals, instrument catalogues, and other sources available in the public domain, we sought to confirm the identify of this inhaler and further investigate its provenance. Soon after the introduction of chloroform anesthesia in November 1847, James Robinson modified Snow's ether face-piece to produce an ingenious device for administering the vapor of chloroform. However, Robinson's inhaler did not include the air-inlet tubes, or funnels, which are an integral feature of the device found in the Addenbrooke's collection. Following further research, we formally identified our device to be of the type introduced by James Townley in 1862 for use with his "Anodyne mixture." We describe Townley's chloroform inhaler and provide an insight into the life and work of its inventor, as well as Dr. Newton and his son, who may have used the apparatus in the Cambridgeshire area., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12-102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

Introduction and Objective: The keratocystic odontogenic tumor is a benign but aggressive neoplasm. As enucleation alone obtains high recurrence rates, some adjuvant treatments such as Carnoy's solution have been proposed. The aim of this study is to evaluate the reduction of recurrences with the use of Carnoy's solution as adjuvant in the treatment of keratocystic odontogenic tumors., Material and Methods: An electronic search in Pubmed (MEDLINE), ScienceDirect and Cochrane databases was conducted with the key words "odontogenic keratocyst", "keratocystic odontogenic tumor", "carnoy's solution", "treatment" and "enucleation". The inclusion criteria were clinical studies using Carnoy's solution as adjuvant for the treatment of keratocystic odontogenic tumors, published in English, including at least 10 patients. Articles with an unclear reporting of the treatment applied, nonhuman studies, case reports and lesions associated to Gorlin-Goltz syndrome were excluded., Results: All the studies included were case series. The recurrence rate of enucleation ranged from 0% to 58.8%. With the only use of Carnoy's solution as adjuvant treatment to the enucleation, recurrences varied from 0% to 100%. The use of ≥ 2 adjuvant treatments reduced the range between 0% and 7.9%., Conclusions: The use of Carnoy's solution as adjuvant therapy for the treatment of keratocystic odontogenic tumor has a grade C recommendation., Competing Interests: The authors have declared that no conflict of interest exist.

This retrospective study aimed to investigate the recurrence rate of keratocystic odontogenic tumours (KCOTs) treated by enucleation and the application of Carnoy's solution, and to assess the surgical morbidities associated with this treatment. KCOTs treated using a standard protocol of enucleation and the application of Carnoy's solution between 1990 and 2013 were evaluated. One hundred and five KCOTS in 105 patients (54 male, 51 female) were analysed. The mean follow-up period was 86.6 months (range 24-313 months). The recurrence rate was 11.4%. A postoperative inferior alveolar nerve neurosensory deficit occurred in 30.1% of the mandibular cases, with 16% of these being permanent. The postoperative infection and fracture rates were 1.9% and 0.9%, respectively. Younger age, multilocular KCOTs, larger tumour size, and longer antero-posterior lesion length on the radiograph were found to be risk factors for recurrence. It is concluded that enucleation and the application of Carnoy's solution to treat KCOTs results in a relatively low recurrence rate and a low rate of surgical morbidities., (Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: To understand the frequency of use of Carnoy's solution, as a means of chemical curettage, for treating the keratocystic odontogenic tumor (KCOT)., Materials and Methods: A Web-based survey was distributed by e-mail to 6,880 members listed in the 2013 American Association of Oral and Maxillofacial Surgeons directory., Results: Eight hundred nine participants across the United States responded to the survey (12% response rate). The most common procedures performed to definitively treat a KCOT were enucleation plus mechanical curettage (curette with or without peripheral ostectomy; 66%). Of the survey participants, 198 (25%) currently use Carnoy's solution, 111 (56%) of whom are using the solution with chloroform and 83 (42%) are using it without chloroform., Conclusion: Carnoy's solution remains a common method of chemical curettage for the definitive treatment of the KCOT. Carnoy's solution with and without chloroform is being used for chemical cautery., (Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: To determine whether the clinical management of odontogenic keratocysts (OKCs) is more complex in patients who undergo enucleation with or without adjuvant therapy than in patients who undergo decompression with or without residual cystectomy., Materials and Methods: The authors implemented a retrospective cohort study and enrolled a sample composed of patients presenting for the evaluation and management of OKCs. The predictor variable was treatment group, classified as decompression with or without residual cystectomy versus enucleation with or without adjuvant therapy (Carnoy solution, cryotherapy, or peripheral ostectomy). The outcome variables were measurements of complexity of management, including total number of procedures, venue of procedure (operating room vs office), type of anesthesia, hospital admissions, and total number of follow-up visits. Data analyses were performed using univariate and bivariate statistics and a multiple linear regression model., Results: The study sample was composed of 45 patients (66 OKC lesions) with a mean age of 43.3 years. Of the 66 OKCs treated, 34 (51.5%) were treated with decompression with or without residual cystectomy and 32 (48.5%) were treated with enucleation with or without adjunctive therapy. Larger lesions and lesions with radiographic evidence of cortical perforation were treated more often with decompression with or without residual cystectomy. Based on the multiple linear regression model, patients who underwent enucleation with or without adjuvant therapy compared with those who underwent decompression with or without residual cystectomy had on average 1) 1.1 fewer total procedures (P < .01), 2) 0.8 fewer total office procedures (P < .01), 3) 0.6 fewer local anesthesia procedures (P < .01), and 4) 4.8 fewer postoperative visits (P < .01). There was no difference in the number of general anesthesia procedures, office sedation procedures, or hospital admissions., Conclusion: Given comparable recurrence rates, the increased complexity of managing OKCs with decompression with or without residual cystectomy might not be warranted. Enucleation with or without adjunctive therapy could be the more efficient treatment option., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Keratocystic odontogenic tumour is relatively rare benign tumour. It is characterized by its fast aggressive growth and high risk of recurrence. Treatment is always surgical: conservative (enucleation, marsupialization) or aggressive (enucleation followed by application of Carnoy's solution, cryotherapy; peripheral ostectomy or en block resection of the jaw). Authors analysed retrospectively 22 patients who fulfilled inclusion criteria, i.e. had odontogenic keratocystic tumour of mandible, wherein antero-posterior dimension was at least 30 mm, and the tumour penetrated into the surrounding soft tissues. All patients underwent tumour enucleation, in 11 patients Carnoy's solution was given into the bone cavity after enucleation. The recurrence rate in the evaluation at least 36 months after surgery was both patient groups the same: 45.4%.

Objectives: The objective of this study was to evaluate the most up-to-date treatment modalities and respective recurrence rates for keratocystic odontogenic tumor (KCOT)., Study Design: A systematic review of the literature from 1999 to 2010 was undertaken examining treatment and recurrence rates for KCOT. Four inclusion criteria were defined for articles to then be analyzed against 8 standards., Results: Of the 2736 published articles, 8 met the inclusion criteria. When merging the data, enucleation and enucleation with adjunctive measures (other than Carnoy's solution) had recurrence rates of 25.6% and 30.3%, respectively. Marsupialization with adjunctive measures produced a recurrence rate of 15.8%, whereas enucleation with Carnoy's solution presented a recurrence rate of 7.9%. Only one resection case had recurrence (6.3%)., Conclusions: The enucleation technique with the use of adjunctive procedures (other than Carnoy's solution) provides a higher recurrence rate than any other treatment modality., (Copyright © 2013 Elsevier Inc. All rights reserved.)

A small number of medicaments are used in oral and maxillofacial surgery to dress wounds, relieve pain, prevent infection and promote healing. While these materials are routinely used, their constituents, uses and effects on oral tissues are rarely discussed. This literature review provides an overview of the constituents, uses and effects of the common materials--oxidised regenerated cellulose, Whitehead's varnish, Carnoy's solution, bismuth iodoform paraffin paste (BIPP), zinc oxide eugenol (ZOE) and Alvogyl.

Introduction: Odontogenic keratocyst (OKC) is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy's solution, peripheral ostectomy with or without Carnoy's solution, and jaw resection have been discussed in the literature with variable rates of recurrence., Case Report: We presented a 52-year-old male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 x 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy's solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention., Conclusion: Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy's solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS). Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful results.

Introduction: Rotary instruments that are used for retreatment are very effective, but most of them leave root filling residue in the canal. The aim of this study was to evaluate the efficacy of removing gutta-percha-based root fillings with ProTaper retreatment files (Dentsply Maillefer, Ballaigues, Switzerland) followed by F1 and F2 ProTaper instruments and to compare these results with those obtained with a #25 .06 ProFile instrument (Dentsply Maillefer) followed by the Self- Adjusting File (SAF; ReDent, Ra'anana, Israel) using high resolution micro-computed tomography (CT) scanning., Methods: Twenty-eight mandibular molar teeth with oval distal root canals were divided into 2 equal groups of 14 teeth each. The distal root canals were instrumented with ProTaper files up to an F2 instrument, the roots were subsequently filled, and the root filling was allowed to set fully. Removal of the root canal filling was performed with D1-D3 ProTaper retreatment files followed by F1 and F2 ProTaper instruments or with a #25 .06 ProFile followed by SAFs. Chloroform was used in both groups to assist in the removal of the root filling material. High-resolution micro-CT scans were used to measure the residual quantities of the root filling material after completion of the procedures. Statistical analysis was performed using the Wilcoxon test and the Student t test., Results: The median root filling residue in the ProTaper group was 5.39% (interquartile range [IQR] = 4.71) of the original volume of the root canal filling. In the ProFile and SAF group, the median residue was 0.41% (IQR = 1.64, P < .001). An arbitrarily selected threshold of less than 0.5% residue was defined as "effectively cleaned," and 57% of the teeth treated with the ProFile and the SAF met this threshold, whereas none of the cases in the ProTaper group did. The ProFile and SAF procedure required less time than the ProTaper protocol., Conclusions: None of the retreatment methods rendered all of the canals completely free of all root filling residue. Under the conditions of this study, the ProFile and SAF procedure was more effective than the ProTaper procedure and left significantly less root filling residue in the root canal., (Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: Keratocystic odontogenic tumors (KOTs) can be treated with Carnoy's solution, although this treatment modality is not free from complications. It is important to verify the incidence of complications after the use of Carnoy's solution and compare these with the literature., Materials and Methods: This study verified the effects of a complementary treatment for KOTs and assessed the incidence of such complications as recurrence, infection, sequestrum formation, mandibular fracture, dehiscence, and neuropathy., Results: Twenty-two KOTs treated with Carnoy's solution combined with peripheral ostectomy were included, and the follow-up period varied from 12 to 78months with a mean of 42.9months. Complications included recurrence (4.5%), dehiscence (22.7%), infection (4.5%), and paresthesia (18.2%). No difference was found among lesions associated (9.1%) or not (0%) with nevoid basal cell carcinoma syndrome (P>0.05). Dehiscence was influenced by marsupialization (P<0.05), and paresthesia was observed exclusively in cases of mandibular canal fenestration (P<0.01)., Conclusions: Complementary treatment with Carnoy's solution and peripheral ostectomy appear to provide efficient treatment for KOTs. Complications originating from the use of the solution are less frequent and less serious than complications associated with cryotherapy. Neuropathy seems to be related to direct contact between the solution and the epineurium., (© 2012 John Wiley & Sons A/S.)

The keratocystic odontogenic tumour (KCOT) is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. It is aggressive, grows rapidly and invades the surrounding tissues. Various treatment modalities and differing recurrence rates have been reported for KCOT. In order to treat a 24-year-old male patient with KCOT the first stage was marsupialisation. This was followed six months later by enucleation with the application of Carnoy's solution. The defect was filled completely with newly formed bone tissue after two years. This case shows that a large KCOT can be treated with a combination of conservative and aggressive methods.

Aim: The odontogenic keratocyst (KCOT) is a locally aggressive, cystic jaw lesion with a high growth potential and a propensity for recurrence. Considering its neoplastic features, treatments of keratocysts are required and they are generally classified as conservative or aggressive. However, although in literature there are several studies, the choice of treatment strategies remains controversial. We report a two-stage protocol based on initial marsupialization and successive enucleation., Methods: Three cases of large KCOTs have been treated by initial marsupialization and, after a mean period of six months, successive enucleation with peripheral ostectomy and application of Carnoy's solution was performed., Results: All patients were instructed in daily irrigation using chlorhexidine 0.2% during the period of marsupialization. After enucleation, good healing was obtained in all cases and from two up to five years of follow-up, there is no evidence of recurrence., Conclusion: Two-stage surgical treatment protocol of keratocyst leads to complete healing, preservation of important anatomical structures and absence of recurrence.

Studies in the field of forensic pharmacology and toxicology would not be complete without some knowledge of the history of drug discovery, the various personalities involved, and the events leading to the development and introduction of new therapeutic agents. The first medicinal drugs came from natural sources and existed in the form of herbs, plants, roots, vines and fungi. Until the mid-nineteenth century nature's pharmaceuticals were all that were available to relieve man's pain and suffering. The first synthetic drug, chloral hydrate, was discovered in 1869 and introduced as a sedative-hypnotic; it is still available today in some countries. The first pharmaceutical companies were spin-offs from the textiles and synthetic dye industry and owe much to the rich source of organic chemicals derived from the distillation of coal (coal-tar). The first analgesics and antipyretics, exemplified by phenacetin and acetanilide, were simple chemical derivatives of aniline and p-nitrophenol, both of which were byproducts from coal-tar. An extract from the bark of the white willow tree had been used for centuries to treat various fevers and inflammation. The active principle in white willow, salicin or salicylic acid, had a bitter taste and irritated the gastric mucosa, but a simple chemical modification was much more palatable. This was acetylsalicylic acid, better known as Aspirin®, the first blockbuster drug. At the start of the twentieth century, the first of the barbiturate family of drugs entered the pharmacopoeia and the rest, as they say, is history., (Copyright © 2011 John Wiley & Sons, Ltd.)

Aim: Keratocystic odontogenic tumor (KOT) is a benign odontogenic neoplasm with locally aggressive behavior and high recurrence rates. It is associated with nevoid basal cell carcinoma syndrome which usually has a more rapid growth. The aim of the study is to report the experience of our service on diagnosis and treatment of KOT., Materials and Methods: Twenty-five cases of KOT were diagnosed between the years of 1989 and 2006. Demographic data was collected as well as diagnose and treatment., Results: Fifty-six percent were female with a mean age of 33 years old. Seventy percent occurred in mandibula and all received surgical treatment, associate or not with adjuvant therapy, such as cryotherapy and Carnoy's solution. Recidive was observed in 48% of cases with a mean period of time of 18 months., Conclusion: Our data analysis showed the importance of previous diagnosis before enucleation procedure and long-term follow-up for recurrence early detection. Recurrence incidence is more frequent on first year after diagnosis., Clinical Significance: KOT is a benign tumor with local aggressive behavior and therefore its treatment must consider the high index of recidive. Reports of protocol treatment should raise new discussion to decrease recurrence rates.

This retrospective study aimed at evaluating the recurrence rates of keratocystic odontogenic tumors (KCOTs) that were enucleated with and without the application of Carnoy's solution (CS). The study included 36 KCOTs treated between 1996 and 2006. Recurrence rates were investigated in correlation with the respective treatment method applied. Additionally, any damage to the inferior alveolar nerve associated with treatment was analyzed. Treatments consisted of enucleation with (38.9%) or without (61.1%) the application of CS. Median follow-up was 4.5 years. Single enucleation showed a recurrence rate of 50%, but the additional application of CS reduced the recurrence rate to 14.3%. No detrimental effects of CS on the mandibular nerve were detected. Enucleation plus the application of CS reduced the recurrence rate of KCOTs compared with simple enucleation. The application of CS did not cause any damage to the mandibular nerve.

This study aimed to determine the appropriate long-term management for ameloblastoma and the role of enucleation in the management of the subtypes of ameloblastoma (solid ameloblastomas, cystic ameloblastomas and peripheral ameloblastomas). They differ in their degrees of aggressive behavior and recurrence rates. This is an evidence-based study with review of relevant articles from PubMed, EMBASE and the Cochrane Library. Articles were categorized for quality according to the Oxford Center of Evidence-Based Medicine (CEBM). 58 articles met the inclusion criteria; their evidence level varied from IIA to V. No randomized control trials were identified. Solid and multicystic ameloblastomas have a high recurrence rate (60-80%) with simple enucleation and require more aggressive treatment. The treatment of choice is resection with 1-cm margins. This may require segmental resection in the mandible, and partial maxillectomy in the maxilla. For the unicystic ameloblastoma recurrence rates are high for simple enucleation. The intraluminal subtype of unicystic ameloblastoma may do well with enucleation, but the intramural subtype may not, and since these cannot be identified preoperatively more aggressive treatment is recommended, including peripheral ostectomy or enucleation with subsequent treatment of the surrounding bone with liquid nitrogen, Carnoy's solution, or similar physicochemical modality. The peripheral ameloblastoma has a different origin and responds to local excision.

The purpose of this paper is to review the features and behaviour of the odontogenic keratocyst (OKC), now officially known as the keratocystic odontogenic tumour (KCOT); to analyze a series of histologically confirmed KCOT cases; and to review and discuss the redesignation of KCOT and the implications for treatment. Redesignation of the OKC as the KCOT by the World Health Organization (WHO) is based on the well-known aggressive behaviour of this lesion, its histology and new information regarding its genetics. Abnormal function of PTCH, a tumour suppressor gene, is noted to be involved in both nevoid basal cell carcinoma syndrome and sporadic KCOTs. Normally, PTCH forms a receptor complex with the oncogene SMO for the SHH ligand. PTCH binding to SMO inhibits growth-signal transduction. SHH binding to PTCH releases inhibition of the signal transduction pathway. If normal functioning of PTCH is lost, the proliferation-stimulating effects of SMO are permitted to predominate. A review of the literature was conducted and results were tabulated to determine whether treatment modality is related to recurrence rate. More aggressive treatment - resection or enucleation supplemented with Carnoy"s solution with or without peripheral ostectomy - results in a lower recurrence rate than enucleation alone or marsupialization. Notably, the recurrence rate after marsupialization followed by enucleation is not significantly higher than that following the so-called aggressive modalities. Our case series consists of 21 patients treated for KCOTs. Results were organized to demonstrate recurrence as it relates to size of lesion and time since treatment and incidence as it relates to patient age and location in the jaws. In our series, the average KCOT surface area measured radiographically was 14 cm 2 . Most lesions were within the 0-15 cm 2 range and lesions in this range resulted in the greatest number and proportion of recurrences. The recurrence rate of 29% in our case series was consistent with previously established data; all recurrences occurred within 2 years post-intervention. The incidence of primary lesions was highest in the age group 70-79 years; most lesions occurred in the posterior mandible. WHO"s reclassification of the OKC as the KCOT based on behaviour, histology and genetics underscores the aggressive nature of the lesion and should motivate clinicians to manage the disease in a correspondingly aggressive manner. The most effective interventions for the KCOT are either enucleation with Carnoy"s solution, or marsupialization with later cystectomy. Future treatment may involve molecular-based modalities, which may reduce or eliminate the need for aggressive surgical management.

This study compared, by scanning electron microscopy (SEM), the efficacy of three solvents on the removal of filling materials from dentinal tubules during endodontic retreatment. Forty human maxillary canines with straight canals were prepared according to a crown-down technique and enlarged to a#30 apical file size, before obturation with gutta-percha and a zinc-oxide-eugenol based sealer. The samples were stored for 3 months before being randomly assigned to four groups: chloroform (n=10), orange oil (n=10), eucalyptol (n=10) and control (n=10). Solvents were applied to a reservoir created on the coronal root third using Gates Glidden drills. The total time for retreatment using the solvents was 5 minutes per tooth. Following retreatment the roots were split longitudinally for SEM evaluation. SEM images were digitized, analyzed using Image ProPlus 4.5 software, and the number of dentinal tubules free of filling material from the middle and apical thirds was recorded. No significant difference was found among the solvent groups regarding the number of dentinal tubules free of root filling remnants in the middle and apical root thirds (p>0.05). However, the control group had fewer dentinal tubules free of filling material (p<0.05). Under the tested conditions, it may be concluded that there was no significant difference among the solvents used to obtain dentinal tubules free of filling material remnants.

Aim: To assess the efficacy of retreatment of canals filled with the Epiphany System with and without solvent, with particular reference to the extent of canal enlargement during retreatment., Methodology: Sixty roots with canals prepared to apical size 45 were embedded in resin blocks and sectioned vertically. Digital micrographs of canal walls were captured. Roots were re-assembled and filled with Epiphany/Resilon (experimental) or gutta-percha/AH Plus (control). After 8 weeks, canals were retreated to size 45 with or without chloroform, and the time recorded. Roots were split, imaged, re-assembled, retreated to size 55, split and imaged. Root-filling residue, traced at three canal levels, was expressed as percentage of canal surface., Results: Residue percentage was greater (t-test, P < 0.01) in the experimental group than in the control. Most residue in all specimens was in the apical third (ANOVA, P < 0.01). Chloroform and enlargement to size 55 decreased residue in both groups (t-test, P < 0.01). Retreatment time was longer in the experimental group (P < 0.05), and reduced by chloroform in both groups (P < 0.05)., Conclusions: The Epiphany System was retreatable with and without chloroform, with lesser efficacy than gutta-percha and AH Plus sealer.

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.

Recurrence following the surgical treatment of keratocysts of the jaws may present a major problem to the oral surgeon. The surgical treatment of patients with odontogenic keratocysts is concerning the high recurrence rate demanding and difficult. It has been suggested that recurrence is a consequence of technical of microcysts in the mucosa overlying the recurrent lesions. Attemps have been made to reduce this high recurrence rate by improved surgical techniques, such as removal of superadjacent mucosa, smoothing of the osseous wall of the cystic cavity, resection of neighboring parts of the mandible, tanning of the epithelial lining of the cyst with Carnoy's solution and marsupialisation. On the basis of a case report it was the aim of the authors to present the surgical treatment of odontogenic, recurrent keratocysts at the Clinic for Maxillo-Facial Surgery, University Hospital Zurich, from the primary operation following the Brosch-procedure in 1971 up to the latest cystectomy in 2004.

We present decision trees on the treatment of cystic lesions of the jaws based on their location. We give special consideration to the treatment of potentially aggressive lesions such as odontogenic keratocysts and cystic ameloblastomas. The treatment plan is based on a retrospective study of 19 ameloblastomas and similar published studies combined with a prospective study of keratocysts.

Effective removal of gutta-percha (GP) in endodontic retreatment is a significant factor in creating successful outcomes from failed procedures. Ideally, gutta-percha removal must be efficient, not predispose the tooth to subsequent failure through iatrogenic events, and clean the existing canals so that subsequent irrigants can effectively and biomechanically cleanse the root canal system. All things being equal, it is recommended that GP be removed without solvents in the coronal two-thirds of canals as much as possible and with solvents in the apical third. Rotary nickel titanium files and the SystemB heat source (SybronEndo, Orange, CA) are significant adjuncts in effective GP removal.

A retrospective analysis of 29 patients with a histologically confirmed diagnosis of unicystic ameloblastoma is reported with special emphasis on a treatment regime employing enucleation and application of Carnoy's solution. Despite the finding that 93% of lesions exhibited mural invasion, a recurrence rate of 10% after treatment is reported, suggesting a possible benefit of Carnoy's solution against recurrence.

Objective: The purpose of this study was to report our experience in the surgical treatment of 484 Chinese patients with follow-up in 255 cases., Methods: A retrospective analysis was conducted of all odontogenic keratocysts that were surgically treated and histopathologically diagnosed between 1962 and 1998. The odontogenic keratocysts were surgically treated with enucleation, marsupialization followed by secondary enucleation, and resection with or without continuity defects. The recurrence rate was evaluated for the patients followed more than 3 years., Results: Of a total of 489 odontogenic keratocysts, 327 (66.87%) were found in the mandible and 162 (33.13%) in the maxilla. Follow-up data were obtained in 255 patients. Recurrence was found in 31 cases (15.27%) in 203 patients treated with enucleation after an observation period of 3 to 29 years. Twenty-nine recurrences (17.79%) were found in 163 patients treated with enucleation alone, two recurrences (6.70%) were seen in 29 patients who received Carnoy's solution fixation of the cyst wall before enucleation, and no recurrence was found in 11 cases treated with marsupialization in combination with secondary enucleation. No recurrence was seen in 52 patients treated with resection., Conclusion: Odontogenic keratocysts treated with enucleation alone have a higher recurrence rate. Enucleation with adjunctive treatment can decrease recurrence rate. Radical excision has no recurrence but does have the highest morbidity rate and should be reserved for multiple recurrent cysts after conservative means.

Objectives: To clarify the natural history of the odontogenic keratocyst (OKC) and to evaluate treatments with respect to the likelihood of recurrence., Study Design: A systematic review of the literature was completed pertaining to the treatment and prognosis of the OKC. Each investigation was evaluated based on 4 inclusion criteria. Each study that met the 4 inclusion criteria was then evaluated based on 8 standards., Results: Of 2290 citations reviewed pertaining to the OKC, 14 investigations were found to meet the 4 inclusion criteria. Resection was found to have the lowest recurrence rate (0%) but the highest morbidity rate. Simple enucleation was reported to have a recurrence rate of 17% to 56%. Simple enucleation combined with adjunctive therapy, such as the application of Carnoy's solution or decompression before enucleation, was reported to have recurrence rates of 1% to 8.7%., Conclusions: Although the existing literature consists of retrospective consecutive case series, it appears that resection or enucleation with adjunctive therapy is associated with recurrence rates that are lower than those associated with enucleation alone.

Objective: To evaluate the effectiveness of topical application of aspirin in chloroform as an adjuvant in the management of chronic neurogenic pain., Design: Intervention study, nonrandomized before-and-after trial., Setting: A department of physical medicine and rehabilitation in a tertiary-care university teaching hospital., Participants: Fifteen adults who presented with severe, chronic neurogenic pain in whom, conventional methods of treatment were unsuccessful in alleviating the pain., Intervention: A solution of aspirin (acetyl salicylic acid) in chloroform was applied over the painful areas., Main Outcome Measures: A numerical scale from 0 to 100 was used to measure the severity of pain., Results: Seventy-four percent of patients showed a good response, 13% had fair response, and in 13% there was no response., Conclusion: Aspirin in chloroform solution is a simple and effective adjuvant in the management of chronic neurogenic pain.