Recurrence and Prognosticators of Recurrence in Odontogenic Keratocyst of the Jaws.

Introduction: The incidence of recurrence of OKC varied from 2.5 to 62%. Studies have linked recurrence to treatment methods and also clinical and pathological features. The aim of this study was to evaluate the 5-year recurrence and the factors associated with recurrence in odontogenic keratocysts of the jaws. Methods: A retrospective review of records was done from the Institute's Medical Records Directory from 2010 to 2021. The following data were obtained of the lesion; age at presentation, gender, site, subsite, radiographic presentation (locularity), radiographic borders, presence or absence of satellite cysts, inflammatory infiltrate, and treatment rendered presence or absence of cortical perforation and soft-tissue extension and presence or absence of recurrence. Kaplan Meir estimator was used to evaluate recurrence rate and log rank test was used to compare the survival amongst groups. Cox regression analysis was used to evaluate the odds ratio to find out the possible factors influencing risk of recurrence. A p value of < 0.05 was considered statistically significant at 95% confidence interval. Results: In our study cohort, 27.2% of patients had recurrence. Posterior maxillary lesions, multilocular lesions, lesions with scalloped borders, presence of soft-tissue extension and cortical perforation, presence of satellite cysts and inflammatory infiltrate and enucleation with peripheral ostectomy were significantly associated with recurrence. However, soft-tissue extension, cortical perforation, multilocular lesions and presence of satellite cysts were independent risk factors. Conclusion: There is still debate on the best treatment modality for the management of OKCs. More studies are required to quantify the results.

Immunohistochemical Analysis of CD117 in the Mast Cells of Odontogenic Keratocysts.

BACKGROUND: Odontogenic lesions contain mast cells (MCs), particularly those with a cystic appearance. Because of their high recurrence rates and aggressive clinical behaviour, odontogenic keratocysts (OKCs) require special treatment. A particular kind of protein called cluster of differentiation (CD) 117/ receptor tyrosine kinase (c-KIT) is present on the surface of many cells. Most hematopoietic cells lose their expression of KIT during the differentiation process, with the exception of MCs, which continue to express KIT throughout their lifetime. AIM: Using the CD117 immunomarker, this immunohistochemical investigation sought to assess the presence and location of MCs in OKCs and examine the relationship between MC numbers in sporadic, syndromic, and recurrent OKCs. METHODS: The study comprised 30 paraffin-embedded tissue specimens, and a histopathological diagnosis was made from hematoxylin and eosin-stained sections with a thickness of 4-5 µ. Out of 30 specimens, 21 were sporadic, six were recurrent OKCs, and three were syndrome-associated OKCs. CD-117/c-kit rabbit polyclonal primary antibody was used to stain the sections for observing MCs, which were then viewed under a light microscope with a digital camera and a desktop computer with MICAPS software for viewing images. RESULT: To compare the number of MCs among OKCs, a one-way ANOVA test was used. Our study revealed that a statistically significant increase in MCs has been observed in the subepithelial and deep connective tissue of recurrent OKC (p < 0.05). However, a comparison of the mean MC value among three OKC subtypes did not reveal any statistically significant differences. An increased mast count was observed in the deep connective tissue layer of syndromic OKC under multiple comparisons. CONCLUSION: Our study concluded that MCs were present in increased numbers both in the superficial and deep connective tissue of recurrent OKCs, indicative of their aggressive clinical behaviour. Increased mean MC counts observed in some of the sporadic cases may be an indicator of their chances of recurrence in the future.

Calcifying Odontogenic Cyst Presenting Odontogenic Keratocyst-Like Areas: A Rare Case Report.

An 81-year-old male patient presented with a well-demarcated, unilocular radiolucent lesion in the right mandibular body, identified during a routine radiographic examination. Based on the clinical hypothesis of a residual cyst, enucleation with curettage was performed, and the specimen was submitted for histopathological analysis. Microscopically, the cystic lesion was predominantly lined by ameloblastomatous epithelium with numerous ghost cells and dentinoid. Additionally, other cystic cavities lined by stratified squamous epithelium with corrugated parakeratin were observed in the fibrous capsule. Based on these features, a final diagnosis of a calcifying odontogenic cyst with odontogenic keratocyst-like areas was established. No recurrence was observed over a 9-year follow-up period. The association of a calcifying odontogenic cyst with odontogenic keratocyst or odontogenic keratocyst-like areas is very rare. To date, this is the second case report in the literature presenting these findings.

Differentially expressed extracellular matrix genes functionally separate ameloblastoma from odontogenic keratocyst.

BACKGROUND: Ameloblastoma and odontogenic keratocyst (OKC) are odontogenic tumors that develop from remnants of odontogenic epithelium. Both display locally invasive growth characteristics and high predilection for recurrence after surgical removal. Most ameloblastomas harbor BRAFV600E mutation while OKCs are associated with PATCH1 gene mutation but distinctive indicators of ameloblastoma growth characteristics relative to OKC are still unclear. The aim of this study was to assess hub genes that underlie ameloblastoma growth characteristics using bioinformatic analysis, ameloblastoma samples and mouse xenografts of human epithelial-derived ameloblastoma cells. METHODS: RNA expression profiles were extracted from GSE186489 gene expression dataset acquired from Gene Expression Ominibus (GEO) database. Galaxy and iDEP online analysis tools were used to identify differentially expressed genes that were further characterized by gene ontology (GO) and pathway analysis using ShineyGO. The protein-protein interaction (PPI) network was constructed for significantly upregulated differentially expressed genes using online database STRING. The PPI network visualization was performed using Cytoscape and hub gene identification with cytoHubba. Top ten nodes were selected using maximum neighborhood component, degree and closeness algorithms and analysis of overlap was performed to confirm the hub genes. Epithelial-derived ameloblastoma cells from conventional ameloblastoma were transplanted into immunocompromised mice to recreate ameloblastoma in vivo based on the mouse xenograft model. The top 3 hub genes FN1, COL I and IGF-1 were validated by immunostaining and quantitative analysis of staining intensities to ameloblastoma, OKC samples and mouse ameloblastoma xenografts tissues. RESULTS: Seven hub genes were identified among which FN1, COL1A1/COL1A2 and IGF-1 are associated with extracellular matrix organization, collagen binding, cell adhesion and cell surface interaction. These were further validated by positive immunoreactivity within the stroma of ameloblastoma samples but both ameloblastoma xenograft and OKC displayed only FN1 and IGF-1 immunoreactivity while COL 1 was unreactive. The expression levels of both FN1 and IGF-1 were much lower in OKC relative to ameloblastoma. CONCLUSION: This study further validates a differentially upregulated expression of matrix proteins FN1, COL I and IGF-1 in ameloblastoma relative to OKC. It suggests that differential stromal architecture and growth characteristics of ameloblastoma relative to OKC could be an interplay of differentially upregulated genes in ameloblastoma.

Multilocular Radiolucent Pathology in the Body and Ramus of the Mandible: A Case Report.

Odontogenic keratocyst (OKC), a type of epithelial developmental cyst, is frequently found in the jaw region. It has invasive characteristics such as satellite cysts, rapid progression, and tissue expansion. The OKC often favors the mandibular angle and ascending ramus. OKC symptoms include pain, swelling, displacement or malpositioning of adjacent teeth, and erosion or thinning of the limited or no bucco-lingual cortical expansion. There is radiographic evidence of a distinct, often scalloped, radiolucent lesion with a characteristic "soap bubble" or "honeycomb" appearance. This article reports a female patient, aged 40 years, with the main concern of unilateral pain and swelling of the mandibular left side and the provisional diagnosis of ameloblastoma. After histopathological examination, the final diagnosis of the patient was OKC. This article also includes previously published literature on OKC with differential diagnosis and relevant clinical and radiologic findings of the case.

Epidemiology of odontogenic tumours and selected cysts diagnosed at a single New Zealand oral pathology centre- A 15-year retrospective study.

PURPOSE: This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023. METHODS: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS. RESULTS: Of the 34,225 biopsies over the 15-year period, 1.8% were identified as OTs, COC and OKCs and accounted for 47%, 1.5% and 51.5% respectively. The most prevalent OT types were odontoma (43.7%), ameloblastoma (27%) and cemento-ossifying fibroma (7.5%). Malignant OT, ameloblastic carcinoma, constituted 1.4% of OT. The average age at diagnosis for OKC, COC and OT patients were 48.2 ± 20.9, 33.7 ± 23.3 and 28.9 ± 19.3 years. Overall, male and mandibular site predilections were observed. Recurrence of OKC and ameloblastoma occurred in 15.2% and 13.7% of patients. The time for recurrence for OKC and Ameloblastoma were 61.7 ± 56.5 months and 122 ± 152 months respectively. CONCLUSION: The demographic features and range of OT, COC and OKC in New Zealand align with those of other western countries. The study also confirms need for long term follow up for patient with OKC and ameloblastoma.

Queratoquiste: Expresión clínica mandibular atípica en un caso clínico

El queratoquiste odontogénico constituye del 3 a 11% de los quistes odontogénicos. Se presenta desde la infancia hasta la vejez con mayor incidencia en hombres. La mandíbula está involucrada en el 60% al 80% de los casos, con una frecuencia en cuerpo y rama. Las lesiones de menor tamaño suelen ser asintomáticos, diagnosticados por examen radiográfico, no obstante, las lesiones más grandes pueden estar asociadas con dolor y aumento de volumen. Radiográficamente se observan lesiones uniloculares o multiloculares radiolúcidas de bordes nítidos, corticalizados, asociado a un diente retenido. Se presenta caso clínico de paciente género masculino de 30 años de edad, que exhibe una expresión atípica. Manifestándose como una doble lesión de queratoquistes odontogénicos independientes entre sí, localizados en rama y cuerpo mandibular derecha, tratado en el Servicio de Cirugía Maxilofacial del Hospital San José, Santiago de Chile. Se describe diagnóstico y tratamiento quirúrgico realizado. El interés clínico del caso es la presencia de dos lesiones independientes entre sí, con el mismo diagnóstico. Presentación que nos parece fundamental reportar en la literatura científica debido a su alto alcance e impacto.

The odontogenic keratocyst represents 3 to 11% of all odontogenic cysts. It occurs from childhood to old age with a higher incidence in men. The mandible is involved in 60% to 80% of cases, with a frequency in the body and ramus. Smaller lesions are usually asymptomatic and diagnosed by radiographic examination. However, larger lesions may be associated with pain and increased volume. Radiographically, radiolucent unilocular or multilocular lesions with sharp, corticalized edges are observed, associated with an impacted tooth. A clinical case of a 30-year-old male patient, who exhibits an atypical expression, is presented. A double lesion of odontogenic keratocysts independent of each other appears, located in the right mandibular ramus and body, treated in the Maxillofacial Surgery Service of the San José Hospital, Santiago de Chile. Diagnosis and surgical treatment performed are described. The clinical interest of the case is the presence of two lesions independent of each other, with the same diagnosis. It seems fundamental to us to report it in the scientific literature due to its high scope and impact.

Management and recurrence of the odontogenic keratocyst: an overview of systematic reviews.

MATERIALS AND METHODS: An extensive literature search among six eletronic databases and Grey Literature was used to identify systematic reviews (S) that could respond if: in individuals diagnosed with OKC (P), is there any influence of the treatment method (I/C) on the recurrence rate of the lesion (O)? After evaluating all titles and abstracts and then applying the eligibility criteria, the included studies were read in full, and data were extracted based on a standardized sheet ordered in the PICO sequence. The assessment of the quality of the systematic reviews included, was determined by AMSTAR2, and final synthesis were descriptively made based on the results and quality of the systematic reviews. RESULTS: From a total of 19 included systematic reviews, it was observed that the most used treatment for OKC was enucleation, followed by enucleation with adjuvant techniques and marsupialization. The mean percentage of recurrence was 16,2%, and the highest OKC recurrence rate was 43.2% after simple enucleation. The use of adjuvant techniques promoted reductions in OKC recurrence rates. The overall methodological quality of systematic reviews was critically low, and this parameter demonstrate the need for more studies to facilitate the choose of the treatment. CONCLUSION: Despite being the most used treatment, simple enucleation is related to the highest rate of recurrence, except when performed after marsupialization/decompression. In addition, the use of adjuvant techniques has a strong impact on reducing the likelihood of recurrence. However, these findings are not conclusive because of the critically low quality of the systematic reviews.

Concordance of clinician, Chat-GPT4, and ORAD diagnoses against histopathology in Odontogenic Keratocysts and tumours: a 15-Year New Zealand retrospective study.

BACKGROUND: This research aimed to investigate the concordance between clinical impressions and histopathologic diagnoses made by clinicians and artificial intelligence tools for odontogenic keratocyst (OKC) and Odontogenic tumours (OT) in a New Zealand population from 2008 to 2023. METHODS: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OKCs and OT. Specimen referral details, histopathologic reports, and clinician differential diagnoses, as well as those provided by ORAD and Chat-GPT4, were documented. Data were analyzed using SPSS, and concordance between provisional and histopathologic diagnoses was ascertained. RESULTS: Of the 34,225 biopsies, 302 and 321 samples were identified as OTs and OKCs. Concordance rates were 43.2% for clinicians, 45.6% for ORAD, and 41.4% for Chat-GPT4. Corresponding Kappa value against histological diagnosis were 0.23, 0.13 and 0.14. Surgeons achieved a higher concordance rate (47.7%) compared to non-surgeons (29.82%). Odds ratio of having concordant diagnosis using Chat-GPT4 and ORAD were between 1.4 and 2.8 (p < 0.05). ROC-AUC and PR-AUC were similar between the groups (Clinician 0.62/0.42, ORAD 0.58/0.28, Char-GPT4 0.63/0.37) for ameloblastoma and for OKC (Clinician 0.64/0.78, ORAD 0.66/0.77, Char-GPT4 0.60/0.71). CONCLUSION: Clinicians with surgical training achieved higher concordance rate when it comes to OT and OKC. Chat-GPT4 and Bayesian approach (ORAD) have shown potential in enhancing diagnostic capabilities.

Lymphangiogenesis in Odontogenic Keratocysts Compared with Dentigerous Cysts.

Statment of the Problem: Podoplanin can indicate the lymphangiogenesis. On the other hand, lymphangiogenesis affects the biological behavior of lesions. The clinical behavior of odontogenic keratocysts (OKC) and dentigerous cysts (DC) is different. Purpose: This study aimed to evaluate the immunohistochemical expression of podoplanin and to investigate lymphangiogenesis in OKCs as compared to DCs. Materials and Method: In this experimental laboratory study, sixty paraffined blocks, including 30 OKC and 30 DC samples, were examined in this study, all of which were histopathologically non-inflamed. To evaluate lymphangiogenesis, the immunohistochemical reaction of D2-40 was evaluated via cytoplasmic and membrane staining of lymphatic endothelial cells. The expression of podoplanin in the epithelial cells of two cyst groups was also examined. To analyze the collected data and compare the results between the two groups of cysts, independent samples t-test, Mann-Whitney U test, and Chi-square test were performed in SPSS version 22. The significance level was set at 0.05. Results: The mean lymph node count and podoplanin expression were significantly higher in the OKC epithelium as compared to DC (p< 0.001). Based on the results, 90% of OKC samples and 43.3% of DC samples showed grade 3 staining. Conclusion: The rate of lymphangiogenesis and podoplanin expression in the epithelium were higher in OKCs compared to DCs. According to the results, the expression of podoplanin may be a useful marker for determining the invasiveness and proliferation of OKC.

Evaluation of Paxillin Expression in Odontogenic Cysts and Tumors.

Statement of the Problem: Paxillin (PXN) is one of the proteins involved in cell adhesion. PXN and integrins constitute a key site for the focal adhesion between the cell and extracellular matrix. Several studies have shown that PXN is a factor in tumor formation, progression, invasion, and metastasis. Purpose: This study evaluated PXN expression in four types of odontogenic lesions with different aggressive behaviors. Materials and Method: In this retrospective cross-sectional study, PXN expression was immunohistochemically assessed in 68 paraffin-embedded tissue samples from patients with the confirmed diagnosis of four types of odontogenic lesions, including 14 dentigerous cysts (DC), 20 odontogenic keratocyst (OKC), 16 unicystic ameloblastoma, and 18 solid ameloblastoma. The PXN expression in these samples were scored based on the percentage and intensity of immunoreactivity, and compared among the groups by Chi-square test. Results: The PXN marker was detected in the cytoplasm of tumor cells (unicystic and solid ameloblastoma) and the epithelial layer of cysts (DC and OKC). The intensively stained marker of PXN was observed in 9 cases (64.3%) of the DC, 14 cases (70%) of OKC, 12 cases (75%) of unicystic ameloblastoma, and 13 cases (72.2%) of solid ameloblastoma. However, there was not statistical difference of PXN protein expression between DC and OKC (p Value = 0.51) and unicystic and solid ameloblastoma (p = 0.58), also the same was true for cysts and tumors (p = 0.37). Conclusion: The expression of PXN is not related to the biological behaviors of odontogenic lesions.

Endodontic microsurgery and prosthodontic treatment of a permanent anterior concrescence: A case report.

Concrescence is a rare dental anomaly in which two adjacent teeth are united only by their cementum. Concrescence most frequently occurs in molars, especially a third mandibular molar and a supernumerary tooth. It is rarely seen in the maxillary anterior teeth. This case report is the first in the literature which details the successful treatment of a concrescence between the maxillary central incisor and a supernumerary tooth through multidisciplinary therapy. The treatment plan included root canal treatment, endodontic microsurgery, and prosthodontic treatment.

Characterization of stromal calcifications in odontogenic keratocyst: a multicentric study.

Odontogenic keratocysts (OKCs) are locally aggressive cysts that exhibit typical histopathological features and have a propensity for recurrence. Though histological variations are observed in OKCs, hard tissue formation and metaplastic changes are rare, and the underlying pathogenesis is not well understood. This study aimed to characterize stromal calcifications and analyze their association with odontogenic components in non-syndromic and syndrome-associated cases of OKCs. We analyzed 153 cases of OKCs from healthcare institutes in India and Japan. The epithelial and stromal features were evaluated, and the relationship of calcifications with odontogenic rests was determined. Immunohistochemistry for cytokeratin-19 and special stains including Masson Trichrome and Van Gieson, were used for identification of odontogenic rests and calcifications respectively. Stromal calcifications were observed in 29.41% OKCs. The calcification patterns included irregular dystrophic, dentinoid with linear or calcospherite-type mineralization, and psammoma calcifications. Psammoma and dentinoid calcifications were found in the proximity of cytokeratin-19-positive odontogenic rests or satellite cysts, whereas majority cases with dystrophic calcifications did not exhibit co-localization with stromal odontogenic components. Distinct patterns of calcifications were observed in OKCs. Calcifications found in proximity of the odontogenic rests were possibly indicative of an inductive or host-mediated response.

Differential Diagnosis of OKC and SBC on Panoramic Radiographs: Leveraging Deep Learning Algorithms.

This study aims to determine whether it can distinguish odontogenic keratocyst (OKC) and simple bone cyst (SBC) based solely on preoperative panoramic radiographs through a deep learning algorithm. (1) Methods: We conducted a retrospective analysis of patient data from January 2018 to December 2022 at Pusan National University Dental Hospital. This study included 63 cases of OKC confirmed by histological examination after surgical excision and 125 cases of SBC that underwent surgical curettage. All panoramic radiographs were obtained utilizing the Proline XC system (Planmeca Co., Helsinki, Finland), which already had diagnostic data on them. The panoramic images were cut into 299 × 299 cropped sizes and divided into 80% training and 20% validation data sets for 5-fold cross-validation. Inception-ResNet-V2 system was adopted to train for OKC and SBC discrimination. (2) Results: The classification network for diagnostic performance evaluation achieved 0.829 accuracy, 0.800 precision, 0.615 recall, and a 0.695 F1 score. (4) Conclusions: The deep learning algorithm demonstrated notable accuracy in distinguishing OKC from SBC, facilitated by CAM visualization. This progress is expected to become an essential resource for clinicians, improving diagnostic and treatment outcomes.

Further Expanding the Mutational Spectrum of Gorlin Syndrome in Three Unrelated Families.

Introduction: Gorlin syndrome is a rare, autosomal dominant multi-systemic disorder with a predisposition to the development of cancers such as medulloblastoma and nevoid basal cell carcinoma. Heterozygous pathogenic variants in PTCH1 are responsible for 90% of Gorlin syndrome cases. Pathogenic variants in PTCH1 cause overstimulation of the sonic hedgehog signaling pathway, which plays a role in the development of embryonic structures and tumorigenesis. Clinical major and minor diagnostic criteria for Gorlin syndrome have been determined. Odontogenic keratocyst (OKC) is the most common reason for medical admission in Gorlin syndrome. In this article, it is aimed to draw attention to the fact that patients with Gorlin syndrome are not very rare in our country and the variability in phenotypic and dysmorphic findings may be a clue for the diagnosis. Methods: Exome sequencing was performed on the Illumina NextSeq550 System platform by using the Ion Ampliseq exome RDY kit for Illumina. Sanger sequencing was performed accordingly for the other affected individuals in both families. Results: In this study, the clinical and molecular findings of 9 Gorlin syndrome patients from three unrelated families are presented. Macrocephaly, calcification of falx cerebri, palmar-plantar pits, rib anomalies, and OKC were detected in decreasing order in more than half of the patients. A novel heterozygous frameshift PTCH1 variant in family 1, a nonsense previously reported PTCH1 variant in family 2, and a novel heterozygous splice-site PTCH1 variant in family 3 were detected. Conclusion: Gorlin syndrome should be kept in mind in patients presenting with macrocephaly, palmoplantar pits, and OKC history. Careful examination of all family members is essential in the timely diagnosis of other affected individuals with minor phenotypic findings.

2-Staged Surgical Protocol for Management of Large Odontogenic Keratocyst.

The World Health Organisation classification and the treatment protocol for the odontogenic keratocyst (OKC), previously referred to as the keratocystic odontogenic tumour, were examined based on a study of the literature. Because not all OKCs have an identifiable protein patched homolog mutation, the idea of changing the management protocol for OKC in response to this shift in tumour category was met with scepticism and was not widely adopted. This study's objective was to outline a successful management plan for an odontogenic keratocyst in a patient who was 23 years old. The procedure for therapy involved marsupialisation, which was followed by enucleation, peripheral osteotomy, and the injection of 5 FFU. Following a 2-year observation period (clinical and radiological monitoring), it was found that bone regeneration was normal and there was no sign of a recurrence.

Wnt/ß-catenin-YAP axis in the pathogenesis of primary intraosseous carcinoma NOS, deriving from odontogenic keratocyst.

Odontogenic tumors (OGTs), which originate from cells of odontogenic apparatus and their remnants, are rare entities. Primary intraosseous carcinoma NOS (PIOC), is one of the OGTs, but it is even rarer and has a worse prognosis. The precise characteristics of PIOC, especially in immunohistochemical features and its pathogenesis, remain unclear. We characterized a case of PIOC arising from the left mandible, in which histopathological findings showed a transition from the odontogenic keratocyst to the carcinoma. Remarkably, the tumor lesion of this PIOC prominently exhibits malignant attributes, including invasive growth of carcinoma cell infiltration into the bone tissue, an elevated Ki-67 index, and lower signal for CK13 and higher signal for CK17 compared with the non-tumor region, histopathologically and immunohistopathologically. Further immunohistochemical analyses demonstrated increased expression of ADP-ribosylation factor (ARF)-like 4c (ARL4C) (accompanying expression of ß-catenin in the nucleus) and yes-associated protein (YAP) in the tumor lesion. On the other hand, YAP was expressed and the expression of ARL4C was hardly detected in the non-tumor region. In addition, quantitative RT-PCR analysis using RNAs and dot blot analysis using genomic DNA showed the activation of Wnt/ß-catenin signaling and epigenetic alterations, such as an increase of 5mC levels and a decrease of 5hmC levels, in the tumor lesion. A DNA microarray and a gene set enrichment analysis demonstrated that various types of intracellular signaling would be activated and several kinds of cellular functions would be altered in the pathogenesis of PIOC. Experiments with the GSK-3 inhibitor revealed that ß-catenin pathway increased not only mRNA levels of ankyrin repeat domain1 (ANKRD1) but also protein levels of YAP and transcriptional co-activator with PDZ-binding motif (TAZ) in oral squamous cell carcinoma cell lines. These results suggested that further activation of YAP signaling by Wnt/ß-catenin signaling may be associated with the pathogenesis of PIOC deriving from odontogenic keratocyst in which YAP signaling is activated.

Assessing Conservative Treatment Options for Odontogenic Keratocyst in a 12-Year-Old Patient, with 1-Year Follow-up.

The odontogenic keratocyst (OKC) is a frequently developing odontogenic cyst that accounts for 10%-14% of all jaw cysts. Due to the high recurrence rate, aggressive therapeutic techniques such as jaw resection and marsupialization are indicated. Following a conservative marsupialization procedure in which Carnoy's solution and an iodoform packing were used, the clinical, radiological, and histological evaluation of OKC in a 12-year-old female patient revealed no evidence of recurrence over the subsequent year of follow-up.

Odontogenic Keratocyst With Moderate Epithelial Dysplasia: A Rare Entity.

We present a rare case of odontogenic keratocyst (OKC) with moderate epithelial dysplasia in a 47-year-old male patient. He presented with a history of pain and swelling on the right side of his face for the past three months. The radiograph revealed multi-locular radiolucency involving the ramus, coronoid process, and condylar process of the right mandible. We have discussed the cytology, incisional biopsy, radiological investigations, surgical management, reconstruction, excisional biopsy report, and follow-up of this rare entity.

Management regulations for odontogenic keratocyst: a case report and review of the literature.

BACKGROUND: Reconstruction of the entire dentition with odontogenic keratocyst is a very challenging quandary. Most cases of odontogenic keratocyst are often reported to be benign, resulting in severe occlusal discrepancies with the maxillary and mandibular dentition. Dental radiographs occasionally reveal an uncommon, locally aggressive developing cyst termed as odontogenic keratocyst, which is typically located in the posterior jaw. When this cyst occurs in the anterior region, it is often misdiagnosed with other periapical lesions due to its lack of response to pulp vitality tests. CASE PRESENTATION: This clinical case scenario demarcates the endodontic management of a patient diagnosed with odontogenic keratocyst. A 37-year-old Indian male patient reported to the department with throbbing pain in the lower left posterior tooth requiring endodontic therapy. This patient also presented with odontogenic keratocyst in the anterior region of the jaw, for which he had undergone surgical rehabilitation. This case report highlights the clinical protocol for the endodontic therapy in patient diagnosed with ododntogenic keratocyst. Masticatory impairment was not visible after the follow-up period and the treatment outcome was successful. CONCLUSION: This case report details the presentation, characteristic radiographic findings, and endodontic management of a patient with an extremely rare condition of odontogenic keratocyst. The management involves multidisciplinary approach for the rehabilitation.