Transformation of Odontogenic Cysts to Neoplasms - A Systematic Review

BACKGROUND: Odontogenic cysts have the potential to transform into neoplasms. However, the characteristics of those which transformed to neoplastic tissues have not been well described and the exact causes of that phenomenon are not yet clear. OBJECTIVES: This study aims to describe characteristics of odontogenic cysts that transformed into neoplasms and to look for their potential etiologies. DATA SOURCES: English-written studies indexed in PubMed, Science Direct, and Proquest were assessed using keywords verified by Medical Subject Headings: ‘Odontogenic Cyst’ and ‘Neoplastic Cell Transformation’. STUDY ELIGIBILITY CRITERIA: Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were used as guidance. PARTICIPANTS: Following steps in PRISMA guidelines, 19 articles were fully reviewed (three case series and 16 case reports) with 27 subjects of 16 males (59%) and 11 females (41%) from 15 to 86 years old. RESULTS: Cystic origins were eight dentigerous cysts, four odontogenic keratocysts, two residual cysts, one radicular cyst, one calcifying odontogenic cyst, one follicular cyst, one glandular odontogenic cyst, and nine unspecified odontogenic cysts that transformed to ameloblastoma (3 cases) and carcinoma (24 cases). LIMITATIONS: Neoplastic transformations of odontogenic cysts arose from epithelial remnants of inadequate odontogenic cyst removal and chronic inflammation due to infection. However, the exact causes of their transformations remain unclear. CONCLUSIONS: Therefore, careful removal of odontogenic cysts and regular postoperative follow-ups are key to prevent recurrence and neoplastic transformation. Future studies are needed to investigate potential causes of neoplastic transformation of odontogenic cysts.