本研究旨在鉴定文献中关于切除牙源性角化囊肿（OKC）的临床病理指征，并基于这些发现制定OKC管理的临床指南。于2021年9月在PubMed/Medline、Scopus、Web of Science、Google Scholar和Cochrane数据库进行了系统综述。在搜索策略中使用以下MeSH关键词：（odontogenic keratocyst）或（keratocystic odontogenic tumor）或（primordial cyst）和（treatment）或（Radical resection）或（Resection of OKC）或（Treatment methods）。符合以下条件的文献被纳入资格标准：临床研究中经过组织学确认的OKC接受了根治切除。排除少于5个OKC的研究、实验研究、流行病学研究、包括正角化牙源性囊肿的研究以及综述文章。共鉴定并定性分析了10项关于OKC的研究，这些研究报告了分段或外周切除。共对221个OKC进行了根治切除，其中67个是原发性OKC，30个是复发性OKC，其余不清楚是原发性还是复发性。131个OKC进行了分段下颌骨切除术，87个OKC进行了外周下颌骨切除术，3个OKC接受了部分上颌骨切除术。进行根治切除的主要指征是多房外观、大型OKC（>5 cm）、多发性复发OKC伴有或不伴有骨质穿孔以及恶性转化。总而言之，根治切除在OKC的管理中具有一定的地位。当存在侵蚀性病变、骨质穿孔、腭肌或颅底受累以及恶性转化时，根治切除被推荐使用。外科医生应努力识别这些特征，以适当管理OKC和预防多次复发。本文提出了OKC管理的临床指南。版权：©2023国家口腔颌面外科杂志。

The aim of this study was to identify clinico pathological indications for radical resection of odontogenic keratocysts (OKCs) in the literature and formulate clinical guidelines for the management of OKCs based on these findings. A systematic review of the literature was undertaken in September 2021 in PubMed/Medline, Scopus, Web of Science, Google Scholar, and Cochrane databases. The following MeSH Keywords terms were used in the search strategies: (odontogenic keratocyst) OR (keratocystic odontogenic tumor) OR (primordial cyst) AND (treatment) OR (Radical resection) OR (Resection of OKC) OR (Treatment methods). Eligibility criteria included publications of clinical studies on histologically confirmed OKCs which underwent radical resection. Studies with less than 5 OKCs, experimental studies, epidemiological studies, studies that included orthokeratinized odontogenic cyst, and review papers were excluded. Ten studies on OKCs reporting on segmental or marginal resections were identified and analyzed qualitatively. Of the total of 221 OKCs that underwent radical resection, 67 OKCs were primary, 30 were recurrent, and the remaining were unclear whether they were primary or recurrent. Segmental mandibulectomy was performed in 131 OKCs, marginal mandibulectomy in 87 OKCs, and 3 OKCs were treated by partial maxillectomy. The main indications for radical resection were multilocular appearance, large OKCs (> 5 cm), multiple recurrent OKCs with or without cortical perforation, and malignant transformation. In conclusion, radical resection has its place in the management of OKC. It is indicated when there is an aggressive lesion with bony perforation, involvement of the pterygoid musculature or skull base, and malignant transformation. The surgeon should aim to identify these features to manage OKC appropriately and to prevent multiple recurrences. Clinical guidelines for the management of OKCs are proposed.Copyright: © 2023 National Journal of Maxillofacial Surgery.