Odontogenic Keratocyst (OKC) / Keratocystic Odontogenic Tumour
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.
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.
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 dentigerouscysts
- May be part of the jaw cyst / basal cell naevus syndrome
Useful Articles & Websites
JOMS 2006. A Retrospective Review of Treatment of the Odontogenic Keratocyst
JOMS 2006. Conservative Treatment Protocol of Odontogenic Keratocyst – A Preliminary Study
JOMS 2009. Keratocystic Odontogenic Tumor – A Review
Head & Neck Pathol 2010. Keratocystic Odontogenic Tumor
Contemporary Clin Dent 2010. Surgical Treatment of Odontogenic Keratocyst by Enucleation
Stomatos 2012. Diagnostic & treatment features of keratocystic odontogenic tumors
J Nat Sci Bio Med 2013. Odontogenic Keratocyst – What is in the name?
JOMS 2013. How Well Do We Manage the Odontogenic Keratocyst
Biomed & Pharmacol J 2014. Surgical Treatment of Odontogenic Keratocyst Tumour – A Review Article
Dental Update 2015. Odontogenic Cysts – An Overview
JOMS 2015. Keratocystic Odontogenic Tumours – Etiology, Pathogenesis & Treatment Revisited
Braz Oral Res 2017. Reclassification & Treatment of Odontogenic Keratocysts – A Cohort Study
J Adv Med & Med Res 2019. A Review of the Odontogenic Keratocyst & Report of a Case
Dental Update 2019. The Bigger Picture – a Gorlin-Goltz Case Report
Cysts & Cystic Lesions of the Mandible
Power Point Presentation about the Origin of Odontogenic Cysts & Tumours