Odontogenic Keratocyst

The Odontogenic Keratocyst (Okc) Is A Developmental Odontogenic Cyst That Exhibits Specific Histopathologic Features And Clinical Behavior. Investigators Believe That Okc’s Develop From Cell Rests Of The Dental Lamina.

Okc’s Exhibit A Different Growth Mechanism Than Other Odontogenic Cysts (Osmotic Pressure).

Okc’s Behave More Like Cystic Neoplasms And Their Behavior May Be Due To Proliferative Capability Of The Epithelial Lining. Several Studies Of Large Numbers Of Odontogenic Cysts Indicate That The Okc Makes Up 3% To 11% Of All Odontogenic Cysts.

Okc’s Exhibit A Range From Childhood To Old Age But ~60% Occur In People Between 10 And 40 Years Of Age.

There Is A Slight Male Predilection And 60% To 80% Of Cases Involve The Mandible (Posterior Body And Ramus).

Keratocyst has peculiar features: unusual growth pattern, tendency to recur, ameloblastomatous and malignant transformation.

It is usually asymptomatic and May Grow To Large Size And Cause Expansion And Pain and if infected may evoke pain.

Growth pattern is antero-posterior direction.



Radiographically It may be in close association of the crown of unerupted tooth.
or may be in between roots (scalloped outline).
Demonstrate Well-Corticated Borders And Large Lesions May Appear Multilocular.


Microscopic Examination

Reveals An Epithelial Lining Of Parakeratinized Stratified Squamous Epithelium Approximately 6 To 8 Cells In Thickness. The Basal Cells Are Either Cuboidal Or Columnar And The Basal Cell Nuclei Are Hyperchromatic And Arranged In A “Picket Fence” Configuration. The Parakeratinized Layer May Appear Corrugated.


Treatment Of Okc’s Is Variable Depending On The Size And Location Of The Lesion. Small, Unilocular Okc’s May Be Treated By Enucleation And Curettage. Large, Multilocular Okc’s Have Been Treated With Resection, Marsupialization Or Carnoy’s Solution Prior To Removal Of The Cyst. Recurrences Have Been Reported To Range From 5% To 62% this high recurrence rate is related to presence of microcysts and its difficult to remove with a more conservative treatmnt