Odontogenic Keratocyst (OKC)
Exodontia.Info
What is the Odontogenic Keratocyst (OKC)?

The
odontogenic keratocyst (OKC) is the most important of
the tooth-derived cysts.

This cyst may have any clinical appearance; it is a great
mimic and the diagnosis is made after microscopic analysis.

This is the third most common tooth-derived cyst.

These cysts also are found as part of the
Basal Cell Nevus
Syndrome
, also known as Gorlin syndrome.

What are the causes of Odontogenic Keratocysts?

Their cause is controversial.

One theory is that the
cyst develops instead of a tooth.  
Presumably, the cells that would form the tooth undergo
cystic degeneration without ever completing tooth formation
and develop into the
OKC.
Radiographs of Odontogenic Keratocysts present in the
lower jaw
The OKC has a number of 'compartments' and has
connecting smaller
cysts that extend into the surrounding
bone.  Because of this, there is frequent tendency for the
condition to recur, particularly if the original surgical
treatment does not result in complete removal of the cyst.

Removal of the
cyst with removal of surrounding bone and /
or
cryosurgery (intense cold is applied to the cyst and bone)
are the most common forms of treatment.

Long-term follow-up with monitoring by X-ray is important,
as if these
cysts are left untreated, they can become quite
large and locally destructive.
Useful Articles:

J American Dent Association 2003.  Maxillary Odontogenic
Keratocyst.  A common and serious clinical mis-diagnosis.

J Oral Maxillofac Surg 2005.  Treatment of Keratocysts.
The Case for Decompression and Marsupialization

Mandible

Chapter 12.  Cysts of the Jaws

Power Point Presentation about the Origin of Odontogenic
Cysts & Tumours
Odontogenic Keratocysts - Key Features

  • Usually, multi-locular (many compartments)
  • Form intra-osseously (within bone), most frequently in
    the posterior (back) alveolar ridge or angle of the
    mandible (lower jaw)
  • May grow around a tooth
  • Spreads extensively along marrow spaces before
    expanding the jaw
  • Frequently recurs after enucleation
  • Does not respond to marsupialisation
  • Definitive diagnosis only by histo-pathology, although
    clinical & radiographic features may allow fairly
    accurate pre-operative diagnosis
  • May be easily confused with ameloblastoma or, less
    likely, with dentigerous cysts
  • May be part of the jaw cyst / basal cell naevus
    syndrome
Last Updated 23rd November 2010