Odontogenic Keratocyst (OKC) /
Keratocystic Odontogenic Tumour
Exodontia.Info
What is an 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 did 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
J Oral Maxillofac Surg 2005.  Treatment of Keratocysts. The Case for
Decompression and Marsupialization

JOMS 2005. The Treatment of Odontogenic Keratocysts by Excision of the
Overlying, Attached Mucosa, Enucleation & Treatment of the Bony Defect With
Carnoy Solution

JOMS 2006.  A Retrospective Review of Treatment of the Odontogenic Keratocyst

JOMS 2006.  Conservative Treatment Protocol of Odontogenic Keratocyst - A
Preliminary Study

JOMS 2006. Conservative Management of a Large Odontogenic Keratocyst -
Report of a Case & Review of the Literature

JCDA 2008.  Clinical Practice.  Keratocystic Odontogenic Tumour -
Reclassification of the Odontogenic Keratocyst from Cyst to Tumour

Head & Neck Pathol 2010.  Keratocystic Odontogenic Tumor

JOMS 2010.  Keratocystic Odontogenic Tumor vs Odontogenic Keratocyst – The
Issue Of Adequate Nomenclature

Contemporary Clin Dent 2010.  Surgical Treatment of Odontogenic Keratocyst by
Enucleation

J Oral & Maxillofacial Res 2010.  Conservative Treatment Protocol for Keratocystic
Odontogenic Tumour - A Follow-up Study of 3 Cases

The Saudi Dental Journal 2011.  Surgical Treatment of Keratocystic Odontogenic
Tumour - A Review Article

BJOMS 2011. Technical Note.  Use of Methylene Blue for Precise Peripheral
Ostectomy of Keratocystic Odontogenic Tumour

Oral Surgery 2012.  Treatment of a Patient with Large Keratocystic Odontogenic
Tumour in the Mandible. Case Report with Literature Review

Stomatos 2012.  Diagnostic & treatment features of keratocystic odontogenic
tumors

JOMS 2013.  Keratocystic Odontogenic Tumor Recurrence Rates With Enucleation
& Curettage Using Carnoy’s Versus Modified Carnoy’s Solution

JOMS 2013.  How Well Do We Manage the Odontogenic Keratocyst

Dental Update 2015.  Odontogenic Cysts - An Overview





Cysts & Cystic Lesions of the 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 into 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 13th June 2017
Radiograph of the above patient, 1 year post-op
Radiograph of the above patient, 2 years post-op
Radiograph of the above patient, 3 years post-op
Radiograph of the above patient, 4 years post-op