• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.279-285
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• 1996

The odontogenic keratocyst(OKC) was used of term and described some of clinical, radiological and microscopic features by Philipsen 1956. The microscopic finding of OKC is characterized by the production of keratin, Which sometimes fills the lumen and thinning of epithelium of cyst. The most clinical importance of OKC is its extraordinary recurrence rate owing to the incomplete removal of the cyst wall. The final diagnosis of OKC should be evaluated by histologic findings and follow-up of any case of OKC with annual roentgenograms and clinical evaluations is essential for at least five years after surgery. This article is report of 2 cases of large OKC involved both molar portion and symphysis of mandible with facial asymmetry, severe bone destruction and paresthesia of lower lip on clinically, roentgenographically. By the postoperative findings the patients showed normal regeneration of bone defect area without recurrence signs by panorama films after surgery.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.37-41
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• 2022

Odontogenic keratocyst (OKC) accounts for 3-11% of all odontogenic cysts. OKC is a benign intra-osseous odontogenic tumor, but what makes this cyst special is its aggressive behavior and high recurrence rate. OKC is relatively aggressive compared to other odontogenic cysts, but its malignant transformation is considered extremely rare. Squamous cell carcinoma associated with odontogenic keratocysts have rarely been reported in the medical literature. We recently experienced a case of a 63-year-old man finally confirmed with squamous cell carcinoma of the mandible, which was initially diagnosed as a benign odontogenic keratocyst. Surgical resection was performed as definitive treatment. Therefore, we present this unique case with a review of the literature.

• Imaging Science in Dentistry
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• v.40 no.2
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• pp.99-101
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• 2010

Odontogenic keratocyst (OKC) with secondary inflammation involving the maxillary sinus was presented. Radiological diagnosis of this case was made based on the various findings from the cone-beam computed tomography, computed tomography and magnetic resonance images. There were calcified materials and impacted tooth within the lumen of the lesion, which is not uncommon in OKC. Histopathologic findings confirmed this lesion as OKC with secondary inflammation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.2.1-2.6
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• 2019

Objectives: This study was aimed to analyze the reducing pattern of decompression on mandibular odontogenic keratocyst and to determine the proper time for secondary enucleation. Materials and methods: Seventeen patients with OKC of the mandible were treated by decompression. Forty-five series of CT data were taken during decompression and measured by using InVivo software (Anatomage, San Jose, Calif) and were analyzed. Results: The expected relative volume during decompression is calculated using the following formula: V(t) = V_initial × exp.(at + 1/2bt²) (t = duration after decompression (day)). There was no significant directional indicator in the rate of reduction between buccolingual and mesiodistal widths. Conclusion: The volume reduction rate gradually decreased, and 270 days were required for 50% volume reduction following decompression of OKC. The surgeon should be aware of this pattern to determine the timing for definitive enucleation. Clinical relevance: The volume reduction rate and pattern of decompression of the OKC can be predicted and clinicians should be considered when treating OKC via decompression.

• Imaging Science in Dentistry
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• v.47 no.2
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• pp.135-140
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• 2017

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.

• Imaging Science in Dentistry
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• v.38 no.2
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• pp.117-120
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• 2008

The odontogenic keratocyst (OKC) is a developmental odontogenic cyst typically occurring in the jaws. Since the first description of OKC was published in 1956, the lesion has been of particular interest because of its specific histopathologic features, high recurrence rate, and aggressive behavior. Recurrences most commonly arise within bone at the site of the original cyst. However, as lining cells may find their way into surrounding tissues either from implantation during surgery or from cortical perforation recurrences may arise at a distance from the original cyst. Here, we report a rare case of recurrent OKC which was first developed in mandible and recurred within the masticatory space.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.2
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• pp.89-93
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• 2009

Purpose: The purpose of this study is to investigate the clinical and histological features of odontogenic keratocyst Patients and Methods: A retrosective review of 100 patients who were diagnosed as odontogenic keratocyst by hitological findings during the period of January 2000 and December 2005 in the Dept. of Oral and Maxillofacial surgery Pusan National University was consecuted. For each patient, age, sex, location of lesion, initial diagnosis by radiographic features, treatment procedure, hitologic findings and recurrance rate were evaluated. Results: In this study, OKC has male prevalance to female by 1.38:1, and most likely occurs during third decade. The most common site of lesion was mandibular ramus region(34.6%) and the most common symptom was swelling(50%). The most common initial diagnosis by radiographic findings was OKC and cyst enucleation was the most common treatment method. The recurrance rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. Conclusion: In this study, total recurrence rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. But, since 97% of patients were treated by enucleation and adjuntive excision, further styudy is need about concordance of recurrence rate with surgical method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.150-160
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• 2005

Background: For normalization of displaced anatomical structure by large cyst, two-step procedure (decompression and enucleation afterward) has been recommended. However, the histological transformation after cystotomy for decompression was shown frequently in secondary enucleation. Therefore, analyses about effects and histological changes after decompression have been necessary. Methods: 48 cases diagnosed as large odontogenic cyst in the jaw and treated by decompression and secondary enucleation were retrospectively analyzed in clinical, rediographical, and histological aspects. Results: In dentigerous cyst, decompression was much useful. Impacted permanent teeth were erupted and reduction rate was higher than that of odontogenic keratocyst (OKC) and apical periodontal cyst. In OKC, among the 29 cases, 11 cases showed no-keratosis, proliferation and rete-ridge elongation after decompression. 4 cases showed no-keratosis, only. 7 cases showed orthokeratosis and rete-ridge elongation and 6 cases showed reteridge elongation, only. 1 case had no change. And the recurrence rate for OKCs was 10.3%. For all odontogenic cysts in this study, dysplasia was not found in cystic lining after decompression. Conclusions: This study implied that decompression for large odontogenic cyst was useful treatment modality because it was conservative treatment and recurrence rate was low although long treatment period was required.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.167-173
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• 2002

Purpose : To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. Materials and Methods: 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (LIS) ratio of the lesion, and expansion angle of the cortex. Results: Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1 %), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The LIS ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8°) and OKC (31.5°). Conclusion : The numeric morphology (LIS ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.456-459
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• 2008

Post-operative recurrence of cystic lesion is a great concern for clinician, patients, and their family, especially in case of odontogenic keratocyst, which has aggressive behavior and high recurrence rate. The purpose of this study was to evaluation clinical characters of OKC, focusing of the recurrence rate and proposed critical follow-up period. 58 cases (aged 9 to 66, 33 males and 25 females) of OKC were reviewed for sex of patients, location, size, operative procedure type, radiographic findings, histopathologic findings, post-operative recurrence time, from 2000 to 2005 at Yonsei Medical Center, were selected. The computerized statistical analysis was carried out with SAS system. 18 of 58 cases (31.03%) were recurred and this study revealed no statistically significant difference in recurrence rate for sex, location, size, radiographic findings, histopatologic findings, operative procedure type, recurrence timing. 3 out of 18 cases (16.7%) showed one or more recurrence. This was statistically significant difference (P=.0264). In this study, 15 of 18 cases (83.3%) were observed recurrence during 4 years after removal of the OKCs, we suggest critical follow-up period during 4 years after operation.