Non-Cochrane · intervention · PM41454329
Exploring the use and efficacy of 5-fluorouracil in the management of odontogenic keratocysts: a systematic review and meta-analysis.
Mahmoud Reema, Kleinman Shlomi, Shuster Amir, et al. · BMC oral health · 2025 · PubMed · doi:10.1186/s12903-025-07567-x
Findings
6 findings
| Population | ||||
|---|---|---|---|---|
| Patients with odontogenic keratocyst (OKC) | 5-FU (5% topical) after enucleation and peripheral ostectomy | Modified Carnoy's solution (MCS) after enucleation and peripheral ostectomy | Recurrence Follow-up 12 to 108 months across studies · Not specified · Overall | RD -0.199 [-0.283, -0.114] 23/95 (24.21%) vs 0/86 (0%) Moderate 5 studies · 181 participants |
| Patients with odontogenic keratocyst (OKC) | 5-FU (5% topical) after enucleation and peripheral ostectomy | Modified Carnoy's solution (MCS) after enucleation and peripheral ostectomy | Permanent paresthesia Follow-up 12 to 108 months across studies · Not specified · Overall | RD -0.061 [-0.14, 0.018] 15/95 (15.79%) vs 7/86 (8.14%) GRADE not reported 5 studies · 181 participants |
| Patients with odontogenic keratocyst (OKC) | 5-FU (5% topical) after enucleation and peripheral ostectomy | Modified Carnoy's solution (MCS) after enucleation and peripheral ostectomy | Postoperative paresthesia (any) Follow-up 12 to 108 months across studies · Not specified · Overall | RD -0.158 [-0.281, -0.035] 36/95 (37.89%) vs 16/86 (18.82%) Moderate 5 studies · 181 participants |
| Patients with odontogenic keratocyst (46 lesions in 43 patients) in uncontrolled studies | 5-FU (5% topical) after enucleation and peripheral ostectomy | None (single-arm, no control group) | Recurrence Mean follow-up 27.16 months (SD 18.1) · Not specified · Uncontrolled studies | Proportion (%) 0 GRADE not reported 8 studies · 46 participants |
| Patients with odontogenic keratocyst (46 lesions in 43 patients) in uncontrolled studies | 5-FU (5% topical) after enucleation and peripheral ostectomy | None (single-arm, no control group) | Permanent paresthesia Mean follow-up 27.16 months (SD 18.1) · Not specified · Uncontrolled studies | Proportion (%) 2.17 GRADE not reported 8 studies · 46 participants |
| Patients with odontogenic keratocyst (46 lesions in 43 patients) in uncontrolled studies | 5-FU (5% topical) after enucleation and peripheral ostectomy | None (single-arm, no control group) | Postoperative paresthesia (any) Mean follow-up 27.16 months (SD 18.1) · Not specified · Uncontrolled studies | Proportion (%) 13.04 GRADE not reported 8 studies · 46 participants |
Included primary studies 15
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Banala 2023 Antimetabolite in the Management of Odontogenic Keratocyst-A Case Report. PMID:36703675 | 2023 | this review only | Recurrence | not extracted yet |
| Barua 2023 The Role of 5-Fluorouracil in Preventing Recurrence After Enucleation of Odontogenic Keratocyst: A Case Report. PMID:37809265 | 2023 | this review only | Recurrence | not extracted yet |
| Berberi 2023 Combined conservative treatment of a recurrent mandibular keratocyst by enucleation, diode laser, 5-Fluorouracil and dental implants: a… PMID:36818317 | 2023 | this review only | Recurrence | not extracted yet |
| Caminiti 2021 5-Fluorouracil Is Associated With a Decreased Recurrence Risk in Odontogenic Keratocyst Management: A Retrospective Cohort Study. PMID:32866486 | 2021 | this review only | Recurrence; Postoperative paresthesia (any); Permanent paresthesia | not extracted yet |
| Casino 2023 Refined Topical 5-Fluorouracil Technique for the Targeted Treatment of Odontogenic Keratocysts. PMID:36270385 | 2023 | this review only | Recurrence | not extracted yet |
| Eid 2024 Application of topical 5-Fluorouracil to reduce the recurrence of odontogenic keratocyst: A prospective study with 2-year follow-up. PMID:39168535 | 2024 | this review only | not stated | not extracted yet |
| Essa 2023 Efficacy of adjunct topical application of 5-Fluorouracil in reducing the recurrence of odontogenic keratocyst DOI:10.4103/tdj.tdj_27_23 | 2023 | this review only | Recurrence | not extracted yet |
| Hernandez-Ortega 2021 matched by author and year (probable) | NR | this review only | Recurrence | not extracted yet |
| Hernandez-Ortega 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hidalgo 2024 Uso de 5-fluorouracilo en el manejo del queratoquiste odontogénico. Reporte de caso DOI:10.35366/115901 | 2024 | this review only | Recurrence | not extracted yet |
| Ledderhof 2017 Topical 5-Fluorouracil is a Novel Targeted Therapy for the Keratocystic Odontogenic Tumor. PMID:27789270 | 2017 | this review only | Recurrence; Postoperative paresthesia (any); Permanent paresthesia | not extracted yet |
| Lone 2020 Topical 5-fluorouracil application in management of odontogenic keratocysts. PMID:32775182 | 2020 | this review only | Recurrence; Postoperative paresthesia (any); Permanent paresthesia | not extracted yet |
| Mishra 2023 Comparative Evaluation of Topical Application of 5-Fluorouracil and Modified Carnoy’s Solution in Management of Odontogenic… DOI:10.51847/exyxyn3qwb | 2023 | this review only | Recurrence; Postoperative paresthesia (any); Permanent paresthesia | not extracted yet |
| Shiran 2019 Use of Topical 5-Fluorouracil for Keratocystic Odontogenic Tumors of Gorlin-Goltz Syndrome as a New Targeted Therapy: A Case Report and… DOI:10.29252/jrdms.4.4.43 | 2019 | this review only | Recurrence | not extracted yet |
| Wanve 2023 Comparison of the effectiveness of 5-Fluorouracil and modified Carnoy's solution in reducing the recurrence of odontogenic keratocyst. PMID:37207018 | 2023 | this review only | Recurrence; Postoperative paresthesia (any); Permanent paresthesia | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients diagnosed with odontogenic keratocyst (OKC) | OKC patients (282 lesions in 14 studies) |
| Intervention | 5-fluorouracil as adjunctive treatment, alone or combined with surgery | Enucleation and peripheral ostectomy plus topical 5% 5-FU (n=156 lesions) |
| Comparison | Not specified | Modified Carnoy's solution (n=95); segmental resection (n=7); enucleation and peripheral ostectomy alone (n=24); no control in uncontrolled studies |
| Outcomes | Recurrence, nerve injury, postoperative complications | Recurrence; paresthesia; permanent paresthesia; bone density; adverse effects |
| Study designs | RCTs, cohort studies, case reports | 4 RCTs, 5 retrospective cohorts, 5 case reports (5 studies in meta-analysis) |
| Timing | Not specified | Follow-up 6 to 144 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Partial Yes · RCT: Yes | NRSI: Partial Yes · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: No · RCT: No | NRSI: No · RCT: No | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |