Odontogenic myxoma: An updated analysis of 1,692 cases reported in the literature

Abstract

Objective To integrate the available data published on odontogenic myxoma (OM) into a comprehensive analysis of its clinical/radiologic features. Methods Electronic search undertaken in January/2018, looking for publications reporting cases of OM. Results 377 publications included. We identified 1692 lesions and 695 were used for analysis of recurrence. There is predominance of OMs in females and in mandibles. OMs usually present with bone expansion, asymptomatic cortical perforation, multilocular. Lesion location (maxilla/mandible), bone expansion, cortical bone perforation, locular radiological appearance, tooth resorption, odontogenic epithelial rests or angular septa are not associated with recurrence. While curettage (31.3%) showed the highest recurrence rate, marginal resection (1.3%) and segmental resection (3.1%) showed the lowest values. Enucleation + peripheral osteotomy (6.7%) showed better results than enucleation (13.1%) or enucleation + curettage (12.7%). In comparison to unilocular lesions, multilocular ones were significantly more prevalent in mandibles, more often presented expansion and cortical bone perforation, had larger mean size, and were more often treated by segmental resection. Conclusion Conservative surgical procedures are associated with higher probability of recurrence of OM. Taking into consideration the recurrence rate and morbidity associated with different surgical treatments, tumor enucleation followed by peripheral osteotomy should be considered as the first therapeutic choice.