• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.24-32
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• 2007

The odontogenic keratocyst(OKC) is a common developmental odontogenic cyst and represents approximately 11% of odontogenic cysts. It is decided by microscopic and histopathologic determinant rather than by clinical appearance. In this study, expression of RANKL and OPG in OKC in relation to age and gender of patient and recurrence, location of lesion were examined through immuno- histochemical study. The RANKL and OPG antibody staining were used. The obtained result were as follow. 1. Positive immunoreactivity to RANKL/OPG in all specimens was found. 2. There was no significant difference in immunohistochemical expression of RANKL relating to recurrence, location of OKCs and age, gender of patients. 3. There was no significant difference in immunohistochemical expression of OPG relating to recurrence, location of OKCs and age, gender of patients. From above results, it is suggested that activation of osteoclasts by RANKL is an important mechanism by which OKCs cause bone destruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.127-134
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• 1990

NBCCS is a hereditary disorder characterized by multiple defects of ectodermal and mesodermal structure, which is chiefly affected on skin, jaws & skeleton, CNS, eye and sexual organ. It is well associated with multiple odontogenic keratocyst on the jaws. Thus, we intended to investigate other anomalies presenting on NBCCS in cases of multiple odontogenic keratocyst which were treated in our hospital from 1980 to 1989. Here we reported 6 cases of NBCCS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.311-323
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• 1999

The osteonectin is a sort of glycoprotein which is secreted in human tissues. The osteonectin is generally detected in number of normal or neoplastic human tissues in vivo, but hasn't been studied the role of osteonectin in developing human teeth and odontogenic tumors. We evaluated degree of the expression of osteonectin immunohistochemically in 20 cases of developing tooth germ which growth from fetus 5 to 38 weeks, and total 51 odontogenic tumors whitch has taken from routine biopsy, such as 10 ameloblastomas, 5 cases of adenomatoid odontogenic tumors and odontomas and odontogenic fibromas, 4 cases of cementomas and calcifying epithelial odontogenic cyst and odontogenic keratocyst and dentigerous cysts and periapical cysts, and 3 cases of ameloblastic fibromas and myxomas. The results were as follows: 1. The osteonectin on the bud stage of tooth germ was strongly expressed in the epithelial dental lamina and in the outer dental epithelium on the early bell stage, and also strongly expressed in the inner dental epithelium on the late bell stage of tooth germs. 2. In ameloblastoma, the osteonectin was strongly expressed in the epithelial tumor component and especially in the acanthomatous types. 3. In both of calcifying epithelial odontogenic tumor and adenomatoid odontogenic tumors, the osteonectin was moderately expressed on the duct like spindle cells and epithelial tumor cells around calcification areas. 4. In odontogenic tumors originated from epithelial-mesenchymal tissues, the osteonectin was moderately expressed on the epithelial tumor components and in odontogenic cysts, it was expressed in ghost cells and calcification areas only. These were summaried the osteonectin may be strongly related to the developing tooth germ and odontogenic tumors and could be regulated hard tissue of human tooth in morphogenesis and involved with calcification mechanism in development odontogenic tumors.

• 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.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.49-54
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• 1999

Ko, Lim found some differences in the concentrations of bone resorptive cytokines, especially IL-$1{\alpha}$ and IL-$1{\beta}$ in periapical lesions and inflamed pulps. And they suppose that these differences may be due to the type of cells which produce each cytokine. The purpose of this study was to analyze the human odontogenic cysts & cystic fluid for their contents of IL-$1{\alpha}$, IL-$1{\beta}$ and TNF-$1{\alpha}$ and to compare the concentrations of each cytokine according to the cytokine producing cells. The cystic tissues used in this experiment, were obtained from periapical surgery or cyst enucleation surgery. Cystic fluid was obtained from root canal during routine endodontic therapy(n=5). Cystic tissues were subdivided into two groups, inflammatory radicular cyst group(n=15) and developmental odontogenic keratocyst group(n=3). Normal periapical tissues of extracted third molar(n=5) were also obtained to be used as control group. Each specimen was incubated in 0.5ml homogenizing buffer (0.1mol/L potassium chloride, 0.02mol/L TRIS;pH=7.6) for two hours and then homogenized with glass homogenizer. Each specimen was centrifuged in a microcentrifuge for 3 minutes, and supernatants were extracted. The concentrations of cytokines were measured with R&D ELISA kit. The data were analyzed by Mann-Whitney U test for the differences among the diseases and t test for the correlations among each cytokine. Following results were obtained ; 1. For IL-$1{\alpha}$ and IL-$1{\beta}$, all experimental groups showed significantly higher concentrations of each cytokine than the control group (p<0.05). 2. In radicular cysts, the concentrations of IL-$1{\alpha}$ were higher than IL-$1{\beta}$, but not stastically significant (p>0.05). In odontogenic keratocysts, the concentrations of IL-$1{\alpha}$ were significantly higher than IL-$1{\beta}$ (p<0.05). In cystic fluid, the concentration of IL-$1{\beta}$ was significantly higher than IL-$1{\alpha}$ (p<0.05). 3. Between odontogenic keratocysts and radicular cysts, the concentrations of IL-$1{\alpha}$ were significantly higher in odontogenic keratocysts than in radicular cysts (p<0.05). 4. For TNF-${\alpha}$, only cystic fluid group showed significantly higher concentrations than the control group (p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.78-83
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• 2015

Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity, and it accounts for about 90% of all oral cancers. Several risk factors for oral SCC have been identified; however, SCC associated with odontogenic keratocysts have rarely been reported. The present study describes the case of a 36-year-old man with SCC of the right ramus of the mandible, which was initially diagnosed as a benign odontogenic cyst. He underwent enucleation at another hospital followed by segmental mandibulectomy and fibular free flap reconstruction at our institution. In this case, we introduce a patient with oral cancer associated with odontogenic cyst on the mandible and report a satisfactory outcome with wide resection and immediate free flap reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.74-80
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• 1999

A family is presented in which multiple odontogenic keratocysts have been expressed. 3 members of the two generations of family with features of multiple keratocysts, suspected basal cell nevus syndrome have been investigated. The proband, 19-year-old woman and her mother, and her brother suffered from these cysts and two female patients' disease have been recurred multiply though careful treatments. Close attention to the family and routine follow up will alert the clinician to its recurrences and genetic counseling and serial screening for the development of other symptoms, that is malignant skin carcinoma etc.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.172-177
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• 2008

Basal cell nevus syndrome, also known as Gorlin-Goltz syndrome, is a hereditary condition transmitted as an autosomal dominant trait that exhibits high penetrance and variable expressivity. It is an ecto-mesodermal polydysplasia with numerous manifestations that affect multiple organs. Odontogenic keratocysts, palmar and plantar pits, and hypertelorism are the most frequently observed anomalies. Currently there are new lines of investigation based on biomolecular studies, which aim at identifying the molecules responsible for these cysts and thus early allowing an early diagnosis of these patients. We report two cases of multiple odontogenic keratocysts associated with basal cell nevus syndrome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.4
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• pp.312-315
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• 2005

A squamous odontogenic tumor (SOT) is rare disease and it is believed to originate from epithelial rests of Malassez of the periodontal membrane. Neither sex nor site predilection in either jaw has been established. Some lesion can be shown in juxtaposition in tooth roots. Although most lesions remain smaller than 2 cm, our cases involved a half of left mandibular ramus. The exact pathogenesis is still unknown. We report a case of SOT including the results of immunohistochemical study of pancytokeratin and p53.