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COMMENTARY
Year : 2014  |  Volume : 7  |  Issue : 3  |  Page : 353-354  

Odontogenic keratocyst: Diagnosis and management


Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur, Karnataka, India

Date of Web Publication18-Mar-2014

Correspondence Address:
Yadavalli Guruprasad
Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur - 584 103, Karnataka
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Guruprasad Y. Odontogenic keratocyst: Diagnosis and management. Med J DY Patil Univ 2014;7:353-4

How to cite this URL:
Guruprasad Y. Odontogenic keratocyst: Diagnosis and management. Med J DY Patil Univ [serial online] 2014 [cited 2021 Jan 25];7:353-4. Available from: https://www.mjdrdypu.org/text.asp?2014/7/3/353/128981

The publishing of the article "Orthokeratinized odontogenic keratocyst crossing mandibular midline - A diagnostic dilemma" brings into focus several factors like proper diagnosis and early management to prevent morbidity resulting from aggressive surgical procedures like resection.

Odontogenic keratocyst (OKC) is classified as a developmental cyst originating from remnants of dental lamina, occurring between second and third decades of life, which affects the mandible at a proportion of 2:1 in relation to the maxilla. [1] OKCs grow through medullary spaces, rarely deforming cortical plates. They may reach large dimensions without causing any symptoms and are usually discovered during routine radiographic examination. The main radiographic characteristics of OKC are unilocular radiolucent area, with scalloped borders, surrounded by a fine sclerotic line and with little or no expansion of cortical bones. [2,3] They can be located at the periapical region of teeth, thus resembling periapical cysts; or they may envelope the crowns of unerupted teeth, mimicking dentigerous cysts; or they can be sited between the roots of the teeth, simulating lateral periodontal cysts or lateral radicular cysts; or they can be located at the maxillary midline, suggestive of a nasopalatine duct cyst. [3,4] Radiographically, large OKCs in the mandible can be indistinguishable from cystic ameloblastomas especially when they involve anterior mandible crossing the midline. Conventional radiographic imaging, such as panoramic views and intraoral periapical films, are usually adequate to determine the location and estimate the size of an OKC and CT scan for multiple cystic lesions or syndromic cases. [5]

Management includes surgical enucleation with curettage small cysts and marsupialization for large cysts and surgical resection if the cyst is extensive with perforation of the cortical plate. Good results can be achieved in the treatment of large cystic lesions using marsupialization in the modern era of more aggressive surgical procedures and reconstructive techniques. none Marsupialization revealed to be more advantageous in many respects and is therefore considered a worthwhile procedure in large unicystic lesions. Due to the high recurrence rate of OKCs following enucleation, the use of Carnoy's solution to fix the surrounding tissue and any cystic remnants has been recommended. The potential for recurrence of OKC relates to the high proliferative activity of the keratocystic epithelium. Due to the high recurrence rate and aggressive behavior of OKCs early diagnosis and proper choice of surgical procedure plays a vital role.

 
  References Top

1.Myoung H, Hong SP, Hong SD, Lee JI, Lim CY, Choung PH, et al. Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:328-33.  Back to cited text no. 1
    
2.Koseoglu BG, Atalay B, Erdem MA. Odontogenic cysts: A clinical study of 90 cases. J Oral Sci 2004;46:253-7.  Back to cited text no. 2
    
3.Michelle G, Giovanni BG, Lajolo C, Bisceglia M, Herb KE. Conservative management of a large Odontogenic Keratocyst: Report of a case and Review of Literature. J Oral Maxillofac Surg 2006;64:308-16.   Back to cited text no. 3
    
4.Guruprasad Y, Prabhu PR. Gorlin-Goltz syndrome with situs oppositus. Natl J Maxillofac Surg 2010;1:58-62.   Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.Guruprasad Y, Chauhan DS. Multiple odontogenic keratocysts in a nonsyndromic patient. J Cranio Max Dis 2012;1:36-40.  Back to cited text no. 5
  Medknow Journal  




 

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