Surgical treatment of odontogenic keratocyst tumour. Odontogenic keratocyst okc is a common developmental odontogenic cyst affecting the maxillofacial region that arises from the dental lamina. They are characterised by an aggressive behaviour with a relatively high recurrence rate. Odontogenic keratocysts okcs, first described by philipsen in 1956, are benign intraosseous lesions of odontogenic origin that account for about 10% of jaw cysts. Mcdonald, in mcdonald and averys dentistry for the child and adolescent tenth edition, 2016. An odontogenic keratocyst can develop at virtually any site in the jaws and is of concern because of its aggressive clinical behavior. Selfretained voice prosthesis in the decompression of the. A case report of odontogenic keratocyst in anterior. This lesion was first described in 1956 by phillipsen. Pogrel, in current therapy in oral and maxillofacial surgery, 2012.
Odontogenic keratocyst keratocystic odontogenic tumor the odontogenic keratocyst is a distinct clinicopathologic entity with a clearly identifiable histologic appearance. Pdf treatment modalities of odontogenic keratocyst of maxilla. Chapter 21 odontogenic and nonodontogenic tumors of the jaws introduction. A case of an okc treated with 5fu is presented in this study.
Cureus management of the odontogenic keratocyst six. Conservative management of odontogenic keratocyst with longterm. Giant keratocystic odontogenic tumor of the maxillary. The odontogenic keratocyst is a very well known odontogenic cyst.
Odontogenic keratocyst an overview sciencedirect topics. Odontogenic infections, consisting primarily of dental caries and periodontal disease gingivitis and periodontitis, are common and have local eg, tooth loss and, in some cases, systemic implications. Odontogenic keratocysts okcs, first described by philipsen in 1956 1, are benign intraosseous lesions of odontogenic origin that account for about 10% of jaw cysts. Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Present study is a case report of a 22 year old man presenting with a symptomatic swelling on the gingiva between. The odontogenic keratocyst okc is an enigmatic developmental cyst that deserves special attention. Basal cell nevus gorlin syndrome bcns omim 109400 is a rare autosomal dominant disease in which affected individuals can develop a panoply of phenotypic abnormalities, the most prominent of which are basal cell carcinomas bccs of the skin and keratocystic odontogenic tumors kcots of the jaw. The presence of bcl2 and cytokeratin 10 along with interleukins in the basal and suprabasal layers led to the inhibition of apoptosis of the surface epithelium and hence the high rate of recurrence. A dentigerous cyst dc and odontogenic keratocyst okc are known as common odontogenic cyst in the mandibular third molar region 2,3,4. It may be unilocular or mulilocular and thus making a total of 31. Odontogenic keratocyst okc has been the subject of great interest since philipsen introduced the term in 1956. Management of keratocystic odontogenic tumour with. Following a 7 month period of decompression with the voice prosthesis, a reduction in size of the cystic lesions, peripheral bone deposition, and superior migration of tooth 27 was observed figure 5, figure 6. It is aggressive, grows rapidly and invades the surrounding tissues.
The okc is distinctive among jaw cysts given its tendency toward recurrence and aggressive clinical. Clinically, the kot is manifested by an asymptomatic growth. The keratocystic odontogenic tumour kcot is a benign intraosseous odontogenic lesion relatively frequent in the oral cavity. The following series presents two cases in which conservative treatment of odontogenic keratocysts resulted in lesion. Odontogenic keratocyst okc is a cyst of tooth origin with an aggressive clinical behavior, including a high recurrence rate. The odontogenic keratocyst is a keratinizing squamous epitheliumlined cyst that occurs in the mandible and maxilla. Surgical treatment of odontogenic keratocyst by enucleation. The odontogenic keratocyst okc is a jaw cyst with a proclivity for local invasion and recurrence. Envelopmental this is an odontogenic keratocyst which embraces or envelopes an adjacent unerupted tooth.
The odontogenic keratocyst okc is a recurrent cyst that has been recently. Odontogenic keratocysts okc are keratinizing, epitheliallined cysts of the jaw. Volume change pattern of decompression of mandibular odontogenic keratocyst volume change pattern of decompression of mandibular odontogenic keratocyst. The okc is well known for its tendency to recur, potential aggressive behavior and defined histopathological feature. Dentigerous cyst associated with adenomatoid odontogenic. Treatment options for keratocyst odontogenic tumour kcot. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Thus, it has been the subject of much research over the last 40 years.
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. Today, it is known that 311% of all the diagnosed cysts at the level of the jaw are actually odontogenic keratocysts. Risk factors for postoperative infection of odontogenic. Odontogenic keratocyst is one of the most aggressive odontogenic cysts with a high. Surgical treatment algorithm for odontogenic keratocyst. Topical 5fluorouracil a novel therapeutic treatment. The odontogenic keratocyst okc is a cystic lesion of odontogenic origin, which is classified as a developmental cyst derived from the dental lamina. Presentation of a keratocystic odontogenic tumor with. In this report, a 35yearold male patient was admitted to our clinic with numbness in the left mandible. The odontogenic keratocyst okc is a commonly encountered developmental cyst table 1 of considerable importance because of its.
In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Odontogenic keratocyst okc is a benign lesion recently considered an. The aim of the present study was to investigate its treatment and address. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. In case of unilocular lucencies dentigerous cyst, eruption cyst, coc, aot, unicystic ameloblastoma etc. The aim of our study is to report the outcome of conservative treatment protocol for okc. Odontogenic keratocysts make up around 19% of jaw cysts. Pdf odontogenic keratocyst treatment with marsupialization and. It most often affects the posterior mandible and most commonly presents in the third decade of life. 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. This paper describes the rare peripheral presentation of an odontogenic keratocyst localized to the maxillary anterior gingiva and its differential diagnosis. The use of vismodegib to shrink keratocystic odontogenic. Dentigerous cyst associated with adenomatoid odontogenic tumour sumit majumdar1, divya uppala2, ayyagari kameswara rao3, sunil talasila4, mahesh babu5 abstract adenomatoid odontogenic tumour aot, a tumour composed of odontogenic epithelium, is an uncommon tumour of odontogenic origin that accounts for only 2.
Fivefluorouracil 5fu is an antimetabolite drug used in the treatment of various cancers, including basal cell carcinomas bcc. It has characteristic histopathological and clinical features. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. Keratocystic odontogenic tumour kcot misdiagnosed as a. 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. Odontogenic and nonodontogenic 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. Reclassification and treatment of odontogenic keratocysts scielo. Pathologic evaluation confirmed the lesions to be odontogenic keratocysts. Marsupialization as a definitive treatment for the. Odontogenic keratocysts appear distinct from other jaw cysts. Topical 5fu may be a novel therapeutic option for kots and may provide a targeted molecular approach to treatment. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to be known as a primordial cyst.
Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. Odontogenic keratocyst is a common type of tooth derived cyst due to presence of odontogenic epithelium remnant in different regions of jaw. The approaches taken to the surgical treatment of kcot involved since conservative choice to the more aggressive. Odontogenic keratocyst looks can be deceptive, causing. It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Surgical treatment is considered, for several years as the gold standard treatment. The term odontogenic keratocyst was first used by philipsen in 1956. Pdf odontogenic cysts such as the odontogenic keratocyst are benign. Histologically, okcs arise from the dental lamina and are constituted by a cystic space containing desquamated keratin. It was formerly known as odontogenic keratocyst okc.
Odontogenic keratocyst free download as powerpoint presentation. Keratocystic odontogenic tumour canadian dental association. The odontogenic keratocyst okc, currently designated by the world health organization as a keratocystic odontogenic tumor is a locally aggressive, cystic jaw lesion with a putative high growth potential and a propensity for recurrence. When the cyst is multilocular and located at the molar ramus area, it may be. They are characterised by an aggressive behaviour with a relatively high recurrence rate 2. Odontogenic keratocyst okc is classified as a developmental cyst originating from remnants of dental lamina, occurring between second and third decades of life, which.
Okc received its new title as keratocystic odontogenic tumour kcot by the who 2005 in order to. The treatment of cystic lesions associated with mandibular third molar has relatively favorable prognosis. It is one of the most aggressive odontogenic cysts of the oral cavity. The odontogenic keratocyst was described for the first time in 1876 and it was later 1956 characterized in detail, by philipsen. Oral surg oral med oral pathol oral radiol endod 1998. Odontogenic cysts, odontogenic tumors, fibroosseous, and. Before i get started, let me say that in 2005, the world health organization actually changed the name of odontogenic keratocyst to keratocystic odontogenic tumor. In 5% to 10% of patients the keratocysts may be a manifestation of the basal cell nevus syndrome. Surgical treatment of odontogenic keratocyst by enucleation medind. Abstract the keratocystic odontogenic tumour kcot is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. Treatment of mandibular odontogenic keratocyst by decompression with a customized removable device. This paper describes the rare peripheral presentation of an odontogenic keratocyst localized to the maxillary anterior gingiva and its differential.
In case which the lesions are similar in size and location, the treatment is similar. In the united states, it is estimated that 25 percent of adults over the age of 60 have lost all their teeth edentulism, approximately one. It had been known as odontogenic keratocyst for nearly 50 years, since its discovery in 1956. Odontogenic keratocyst okc has a special mention in the field of oral and maxillofacial surgery due to its varied presentation and high recurrence rate. Marsupialization as a definitive treatment for the odontogenic keratocyst. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Odontogenic keratocysts are aggressive lesions characterised by a high recurrence risk ratio due to dental lamina residues in mandibular and maxillary regions. Treatment of a large odontogenic keratocyst using the brosch.
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