Analysis of Tissue Staining With 1% Methylene Blue Solution After Enucleation of Odontogenic Keratocyst

Abstract

Background

Odontogenic keratocyst (OKC) treatment often involves enucleation followed by peripheral ostectomy to reduce recurrence. However, identifying bone areas containing epithelial remnants remains a surgical challenge. The intraoperative use of 1% methylene blue solution has been proposed to delineate residual epithelial tissue. This study aimed to evaluate the presence of epithelial structures in both OKC surgical specimens and bone tissue stained with 1% methylene blue solution following enucleation.

Methods

A retrospective analysis was conducted on histological records from OKC cases treated between August 2022 and December 2023. The primary variable was the presence of epithelial structures, including daughter cysts, microcysts, and epithelial remnants. Data were analyzed descriptively.

Results

Twelve patients (mean age: 40.8 years) were included. Most lesions were located in the posterior mandible (50%) and exhibited a unilocular radiographic pattern (91.7%), with a mean lesion size of 25 mm. Epithelial structures were identified in 75% of OKC surgical specimens and in 16.7% of the stained bone tissues. The mean follow-up period was 26.5 months, with no recurrences observed.

Conclusions

The use of 1% methylene blue solution may aid in the intraoperative identification of residual epithelial tissue, potentially contributing to more precise and conservative OKC management.