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. Clinically, the kot is manifested by an asymptomatic growth. Surgical treatment of odontogenic keratocyst by enucleation. 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.
Transnasal marsupialization using endoscopic sinus surgery. Histologic examination revealed an odontogenic keratocyst with no evidence of mineralization or calcification within the lesion. Surgical treatment of keratocystic odontogenic tumour. In case of unilocular lucencies dentigerous cyst, eruption cyst, coc, aot, unicystic ameloblastoma etc. Odontogenic keratocyst marsupialization and decompression. Odontogenic keratocyst in the mandible, surgical treatment and reconstruction. Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis. 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. When the cyst is multilocular and located at the molar ramus area, it. Recurrent glandular odontogenic cyst additional references mervyn shear and paul speight. Odontogenic keratocysts potentially behave aggressively, and the rate of recurrence is high, varying from 0 to 62% according to the various treatments.
Okc received its new title as keratocystic odontogenic tumour. Odontogenic keratocysts appear distinct from other jaw cysts. Odontogenic keratocysts were first reported by philipsen in 1956. Combined treatment of odontogenic keratocyst and mandibular defect with marsupialization, enucleation, iliac crest bone graft, and dental implants. Odontogenic keratocysts are aggressive lesions characterised by a high recurrence risk ratio due to dental lamina residues in mandibular and maxillary regions. The odontogenic keratocyst arises by proliferation of the residues of the dental lamina, possibly as a hamartomatous abnormality. Unusual ct appearance in an odontogenic keratocyst of the. The odontogenic keratocyst is a very well known odontogenic cyst. 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. The odontogenic keratocyst okc is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. Odontogenic keratocysts are dentigerous cysts derived from the proliferation of residues of the dental lamina.
This lesion was first described in 1956 by phillipsen. Surgical treatment of odontogenic keratocyst tumour. The odontogenic keratocyst thus appeared in both the 1st 1971 and 2nd 1992 editions of the who classifications. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. An expansile lesion in the body of the left mandible had high attenuation 225 hu on nonenhanced ct scans. The radiographic odonogenic of aot frequently resemble other odontogenic lesions such as dentigerous cysts, calcifying odontogenic cysts, calcifying odontogenic tumors, globulemaxillary cysts, ameloblastomas, odontogenic keratocysts and periapical disease 10. Presentation of a keratocystic odontogenic tumor with. Upon the establishment of intravenous sedation and local anesthesia, the. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. In a case, toward enucleation with complication, other case toward resection. Recommendations vary from enucleation, with or without adjunctive therapy such as application of carnoy solution, to marsupialization or decompression, to marginal or segmental resection. 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. These lesions are fairly aggressive locally and they have a high.
It enlarges by both multicentric expansion due to the proliferation of localized groups of epithelial cells in the lining and by unicentric expansion from the hydrostatic pressure of its contents. Immunohistochemical demonstration of bone morphogenic protein in odontogenic tumors. It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Surgical management of dentigerous cyst and keratocystic. It is characterized by its fast aggressive growth and high risk of recurrence. The term odontogenic keratocyst was first used by philipsen in 1956.
The odontogenic keratocyst okc is a cystic lesion of odontogenic origin, which is classified as a developmental cyst derived from the dental lamina. It was formerly known as odontogenic keratocyst okc. The patient accepted the treatment plan and following a standard history and physical examination, the patient was consented for surgery. Odontogenic keratocyst looks can be deceptive, causing. Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. Odontogenic keratocysts okcs are benign, developmental cystic lesions of epithelial origin and involve the maxilla or mandible. The odontogenic keratocyst okc has been a controversial entity with regard to its terminology, recurrence tendency, and varied treatment options. Odontogenic keratocyst is a locally aggressive and highly recurrent lesion, which occurs mostly on the posterior mandible with a slightly higher rate in males. Half the cysts were histologically proven odontogenic keratocysttumor okc. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. 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. 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. Orthokeratinized odontogenic keratocyst is a lessaggressive nonsyndromic variant of odontogenic keratocyst okc. 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.
Updates in the surgical management of odontogenic keratocyst. Glandular odontogenic cyst, calcifying epithelial odontogenic. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Surgical treatment algorithm for odontogenic keratocyst. 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 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. Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. It is thought to originate from dental laminae residues.
The high attenuation was considered to be due to highly concentrated protein of thick, viscous keratin in the lumen of the. Thus, it has been the subject of much research over the last 40 years. Pdf keratocystic odontogenic tumour with extraosseal. The word odontogenic keratocyst okc was coined by phillipsen in 1956 cakur et al, 2008. The aim of the present study was to investigate its treatment and address. Enucleation of a multilocular odontogenic keratocyst using. Keratocystic odontogenic tumour kcot misdiagnosed as a. There is no uniform agreement as to the most appropriate method of treatment of odontogenic keratocysts.
Envelopmental this is an odontogenic keratocyst which embraces or envelopes an adjacent unerupted tooth. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. Conservative treatment protocol of odontogenic keratocyst. It is one of the most aggressive odontogenic cysts of the oral cavity. Cysts of the oral and maxillofacial regions, 4th edition, 2007, head neck pathol 2011. Radiographically, it may appear unilocular or multilocular, with or without defined borders. The odontogenic keratocyst okc is a jaw cyst with a proclivity for local invasion and recurrence. Conservative surgical removal and longterm followup is the treatment of choice by most clinicians. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. The okc is classified as a developmental epithelial cyst and comprises approximately 11% of all cysts of jaws. 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.
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