|Odontogenic Keratocyst (OKC)
What is the 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.
|Radiographs of Odontogenic Keratocysts present in the
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 does 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 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 dentigerous cysts
- May be part of the jaw cyst / basal cell naevus
|Last Updated 23rd November 2010