Trends in the presentation, investigation and management of paediatric jaw lesions: A systematic review.

Paediatric odontogenic jaw lesions aren’t extensively researched and have no recognised treatment guidelines. The WHO 2022 classification groups lesions into benign tumours, malignant lesions and cysts with subdivisions based on histological, immunochemical and genetic profiles. This is useful for novel molecular-targeted therapies however, it is unclear whether these are used in children. We reviewed existing literature on management of paediatric odontogenic lesions. Secondary outcomes included patient demographics and diagnostic work up. Ovidsp search engine including 14 databases was used for our selection process. 292 papers were selected and 23 met criteria for review. Data is organised in figures, tables according to the WHO 2022 classification. Only data involving patients from birth to 18 years were extracted. Odontomas were the commonest benign tumour in North America and Europe and exhibited no recurrences following enucleation. Ameloblastoma had a higher prevalence in Asia and Africa with both the unicystic and multicystic forms contributing significant morbidity due to aggressive subtypes. 4 cases of malignant odontogenic lesions were reported (100% ameloblastic carcinomas) with osteosarcomas the commonest bone-derived malignant lesion. OKCs had a 12-33% prevalence rate amongst all cystic lesions with recurrence rate 17-57%. One study commented on adjuvant carnoy solution or cryotherapy in children which lowered recurrence to 1-8%. We designed a treatment algorithm using our results following the WHO 2022 classification and identified areas requiring further collaborative research to develop strong evidence-based treatment guidelines.