On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency dark area. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Subjects and methods the case files of all patients who had histological confirmation of the diagnosis of odontogenic keratocyst from 19801995, at both the cornwall regional hospital and. A large extragnathic keratocystic odontogenic tumour. Combined treatment of odontogenic keratocyst and mandibular defect with marsupialization, enucleation, iliac crest bone graft, and dental implants. Cysts and tumors of the jaws treated by marsupialization. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. Multiple cystic spaces similar to those seen in botryoid odontogenic cysts. It is characterized by its fast aggressive growth and high risk of recurrence. Pdf conservative treatment protocol for keratocystic.
Resolution of odontogenic keratocysts of the jaw in basal. It is important to understand that these odontogenic keratocysts can be quite aggressive, destroying the local tissues. Growth of cysts is believed to occur by a combination of osmotic pressure and pressure resorption,1 coupled with release of pros. In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. They present more commonly in the posterior mandible of young adults than the maxilla. Here we report a case of a recurrent buccal lesion in a 62yearold. Odontogenic keratocyst okc is a locally aggressive odontogenic cyst with a high recurrence rate after treatment. Treatment of an odontogenic keratocyst although there are promising new techniques to treat an odontogenic keratocyst, the most common method of treatment is simply going into the jawbone and removing the odontogenic keratocyst. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Treatment options for keratocyst odontogenic tumour kcot.
We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. The most effective treatments are enucleation supplemented with carnoys solution, or marsupial. Abstract the keratocystic odontogenic tumour kcot is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. Identical to structures present in lateral periodontal cysts or botryoid odontogenic cysts or soft tissue odontogenic cyst, gingival cyst of adult multiple cyst compartments. Surgical treatment of keratocystic odontogenic tumour. The wide surgical excision is often performed in patients who have multiple keratocysts present.
Keratocystic odontogenic tumour kcot misdiagnosed as a. Okc received its new title as keratocystic odontogenic tumour kcot by the who 2005 in order to. Clinical consideration of a keratocystic odontogenic tumor in the differential diagnoses of the maxillary sinus lesions can affect the modality of treatment being used. Reclassification and treatment of odontogenic keratocysts scielo. Conservative surgical removal and longterm followup is the treatment of choice by most clinicians. Case report a 28year old man was referred to the department of oral surgery complaining of painless swelling in the. The terms keratocyst or keratocystic odontogenic tumor were searched for and the. Management of keratocystic odontogenic tumour with. Optimal treatment of odontogenic keratocysts okc remains a matter of debate in the literature. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour. Odontogenic keratocyst in the mandible, surgical treatment. The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. Report of a case a 55yearold man with a strong family history of basal cell nevus syndrome bcns had numerous basal cell carcinomas bccs and multiple associated odontogenic keratocysts. Reclassification and treatment of odontogenic keratocysts.
Although odontogenic keratocysts okcs are benign, they are often locally destructive and tend to recur after conservative surgical treatment. Ppt odontogenic cysts and tumors powerpoint presentation. Anthony pogrel, dds, md decompression of a cyst involves any technique that relieves the pressure within the cyst that causes it to grow. Treatment of mandibular odontogenic keratocyst by decompression with a customized removable device. Introduction the keratocystic odontogenic tumor kcot is defined, according to the world health organization who as a benign tumor uni or multicystic, intraosseous tumor of odontogenicorigin, with a characteristic lining of pa. It is aggressive, grows rapidly and invades the surrounding tissues. Volume change pattern of decompression of mandibular odontogenic keratocyst volume change pattern of decompression of mandibular odontogenic keratocyst. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. Reports of bone erosion, 1 orbital invasion, 2 skull base extension, 3 and temporal fossa violation 4 show the aggressive nature of this lesion.
Topical 5fluorouracil is a novel targeted therapy for the. Clinically, the kot is manifested by an asymptomatic growth. Keratocystic odontogenic tumors kots are benign lesions occurring in the maxilla or mandible with potential for serious morbidity. There is no uniform agreement as to the most appropriate method of treatment of odontogenic keratocysts. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium. Keratocystic odontogenic tumor in the maxillary sinus. Presentation of a keratocystic odontogenic tumor with. Pdf keratocystic odontogenic tumour with extraosseal.
It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Keratocystic odontogenic tumors, keratocyst, odontogenic keratocyst, iodine tincture 1. A conservative surgical treatment was performed assuming a less aggressive clinical course for the peripheral odontogenic keratocyst. Recommendations vary from enucleation, with or without adjunctive therapy such as application of carnoy solution, to marsupialization or decompression, to marginal or segmental resection. Odontogenic keratocysts okcs are developmental cysts which occur typically in the jawbones. Surgical treatment of odontogenic keratocyst by enucleation. The cyst ruptured during excisional biopsy revealing contents typical of an odontogenic keratocyst okc. Coelho1 1oral surgery department, school of dentistry, university of lisbon, lisbon, portugal 2improvement in teaching methods in conservative dentistry, school of dentistry, university of lisbon, lisbon, portugal key words. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Keratocystic odontogenic tumour is relatively rare benign tumour.
The aim of the present study was to investigate its treatment and address. The present study reported the clinical outcomes of 35 patients with mandibular odontogenic keratocysts okcs following treatment by radical resection and immediate defect reconstruction. Pdf orofacial cysts at komfo anokye teaching hospital, ghana. This novel drug, useful for the treatment of bcc, also appears to be effective for treatment of odontogenic keratocysts. Surgical treatment of odontogenic keratocyst by enucleation ncbi. Variable amounts of keratin were seen in the cystic lumen. It is most common in people in their second to third decades but can be seen at almost any age. A case series juan gonzalez, dmd, omfs1 david malave, dmd, omfs1 dan holtzclaw, dds, ms2 1. In onethird of cases, an impacted tooth is involved.
Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. Histology of odontogenic keratocyst and ameloblastoma histological examination of the odontogenic keratocysts showed palisading of the basal cell layer with nuclear polarization and a corrugated keratinized layer with alternating areas of orthokeratosis and parakeratosis. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. It most often affects the posterior mandible and most commonly presents in the third decade of life. Pdf the authors suggest a method for preoperative determination of bone cavity volume v in radicular cysts of the jaws by measurement of. Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis.
Locally, radicular periapical cysts were the most common odontogenic cyst 65. A free powerpoint ppt presentation displayed as a flash slide show on id. Nonetheless, odontogenic keratocyst presents a single form of developed odontogenic cyst and deserves special attention due to its pathological characteristics and specific clinical behavior. For these health concerns, these are the most common treatment approaches. It seems that odontogenic keratocysts come back for one of two reasons. Okcs have been reclassified under odontogenic tumours in 2005 by the who and have since been termed as keratocystic odontogenic tumours kcots. The keratocystic odontogenic tumour kcot is a benign intraosseous odontogenic lesion relatively frequent in the oral cavity. Conservative treatment protocol for keratocystic odontogenic. Surgical treatment algorithm for odontogenic keratocyst.
They must therefore be distinguished from other cysts of the jaw. Endoscopic removal of an odontogenic keratocyst in the. Calcifying odotogenic cyst is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. It has a locally aggressive behaviour and exhibits a high propensity to recur after treatment. Odontogenic keratocyst symptoms, treatment, pictures. Keratocystic odontogenic tumour canadian dental association. When the cyst is multilocular and located at the molar ramus area, it may be. Risk factors for postoperative infection of odontogenic. The aggressive mode of treatment involves treating the okc as a neoplasm and includes en bloc resection and peripheral.
The okc is classified as a developmental epithelial cyst and comprises approximately 11% of all cysts of jaws. Investigations continue into the lesions pathologic classification, diagnosis and. Pdf the keratocystic odontogenic tumour is classified as a developmental cyst derived. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. The word odontogenic keratocyst okc was coined by phillipsen in 1956 cakur et al, 2008. It was formerly known as odontogenic keratocyst okc. Odontogenic keratocyst looks can be deceptive, causing. Conservative treatment of primary and nonsyndromic odontogenic. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Pdf a method for calculation of bone socket volume in. Odontogenic keratocysts make up around 19% of jaw cysts. In various studies odontogenic keratocysts ranged from 2. Odontogenic keratocyst treatment with marsupialization and decompression.
Keratocystic odontogenic tumour of lesions treated in our clinic. Pdf reclassification and treatment of odontogenic keratocysts. As far we know this is the first case of the odontogenic keratocyst originating from the. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance.
Depending on the size of the cyst, its location and the patients age, several treatment options are available. Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. The odontogenic keratocyst okc is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. Original article treatment options for keratocyst odontogenic tumour kcot. Odontogenic keratocyst marsupialization and decompression. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of malassez or the remnants of the dental lamina. Odontogenic cysts and tumors michael underbrink, md anna pou, md february, 2002 introduction variety of cysts and tumors uniquely derived from tissues of. Case report keratocystic odontogenic tumor simulating. Previously known as odontogenic keratocysts okcs, kots were subsequently reclassified as a tumor by the world health. Pdf the odontogenic keratocyst okc is a recurrent cyst that has. Approximately 50% of cases of nbccs are associated with allelic losses at. A 14yearold caucasian girl presented for observation of bilateral.
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