In the united states, it is estimated that 25 percent of adults over the age of 60 have lost all their teeth edentulism, approximately one. J aw cysts are very common due to the presence of odontogenic epithelium remnants. Due to its neoplastic nature, the odontogenic keratocyst, which was previously classified as a cyst, had its name changed to keratocystic odontogenic tumor kcot. Comparison of components of cystic fluid in odontogenic keratocyst, dentigerous cyst, and radicular cyst type of cystsalbumin globulin total protein odontogenic keratocyst between 2 and 4 gdl between 0. Odontogenic cysts were not considered in the new 2005 classification, which means that the previous 1992 classification is still relevant for cysts of the jaws and maxillofacial region, with one notable exception. The odontogenic keratocyst is a very well known odontogenic cyst. Upon confirmation of an odontogenic keratocyst diagnosis, the gorlingoltz syndrome should be suspected and investigated. A case report of odontogenic keratocyst in anterior mandibule.
Developmental odontogenic cysts flashcards quizlet. Induced proliferation of epithelial cell rests rests of serres or malassez in the jaw region plays an important role in the pathogenesis of odontogenic cysts. Has many features of odontogenic tumor, therefore it is placed in the category of tumors in the latest who classification of odontogenic cysts and tumors. Cyst formation, like the development of neoplasms, involves a dysregulation of the balance between cell proliferation and cell death. Odontogenic keratocyst radiology reference article. Histologic examination revealed an odontogenic keratocyst with no evidence of mineralization or calcification within the lesion. The first description of an okc was by philipsen in 1956. Odontogenic keratocysts in nevoid basal cell carcinoma. The keratocyst odontogenic tumor has characteristics, with slow development, does not cause metastases and.
Odontogenic keratocysts make up around 19% of jaw cysts. The odontogenic keratocyst, especially the parakeratinized type, is one of bestknown jaw cysts for its aggressive behavior and high recurrence rate. Introduction a cyst is an epithelium lined sac containing fluid or semifluid material the epithelial cells first proliferate and later undergo degeneration and liquefaction grow by. Presentation of a keratocystic odontogenic tumor with. Odontogenic keratocyst okc is an odontogenic cyst and because of its ability in growth and creation tumoral lesions is placed in odontogenic tumor okt. Okcs have been reclassified under odontogenic tumours in 2005 by the who and have since been termed as keratocystic odontogenic tumours kcots.
Odontogenic keratocyst looks can be deceptive, causing. Keratocystic odontogenic tumour canadian dental association. The odontogenic keratocyst is an important part in the clinical features of basal cell nevus syndrome or gorlin and goltz syndrome. Review of the molecular pathogenesis of the odontogenic keratocyst. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development.
Shawneen gonzalez post author august 14, 2015 at 1. Odontogenic keratocyst okc has been the subject of great interest since philipsen introduced the term in 1956. A 14yearold caucasian girl presented for observation of bilateral. The odontogenic keratocyst thus appeared in both the 1st 1971 and 2nd 1992 editions of the who classifications. An odontogenic keratocyst okc is an epithelial cyst lesion commonly located in the maxilla and mandible with a significant potential for growth, expansion and local invasion. Since its initial description, a number of studies have focused on different aspects of this lesion, attempting to explain its distinctive biological behaviour. When the cyst is multilocular and located at the molar ramus area, it may be. The authors conducted a search in english literature using the following keywords. It is the most agre ssive and recurrent of all the odontogenic cysts and shows characteristics resembling both a cyst and a benign tumor 10.
It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Today, it is known that 311% of all the diagnosed cysts at the level of the jaw are actually odontogenic keratocysts. In the past, odontogenic keratocysts okcs were considered to originate from the primordium of a tooth before mineralization had taken place. It may be unilocular or mulilocular and thus making a total of 31. Present study is a case report of a 22 year old man presenting with a symptomatic swelling on the gingiva between. Also called as odontogenic ghost cell cyst or gorlin cyst. The odontogenic keratocyst is a histopathologically and behaviorally unique, specific entity. The odontogenic keratocyst keratocystic odontogenic tumour okc is one of the most prevalent odontogenic tumours.
The odontogenic keratocyst arises by proliferation of the residues of the dental lamina, possibly as a hamartomatous abnormality. A case report on surgical management of odontogenic. Odontogenic keratocyst okc is a developmental cyst of tooth origin with an aggressive behaviour including high recurrence rate. Okcs account for 1214% of all odontogenic cysts of the jaws, with a predilection for.
Considering the rarity of this syndrome, we present a 12yearold boy affected by this syndrome. Odontogenic keratocyst okc is so named because keratin is. Odontogenic cysts and tumors ppt linkedin slideshare. The odontogenic keratocyst okc was first introduced as separate pathologic entity by philipsen in 1956. Reclassification of the odontogenic keratocyst from cyst to tumour jonathan madras, bsc hons, dds. Orthokeratinized odontogenic cyst ooc is also a developmental cyst occurring in the tooth bearing regions of jaws and is defined by the world health organisation as the uncommon orthokeratinized type of odontogenic keratocyst okc. Unusual ct appearance in an odontogenic keratocyst of the. It had been known as odontogenic keratocyst for nearly 50 years, since its discovery in 1956. Factors such as inflammation or trauma stimulate epithelial rests to proliferate sealing off the.
The odontogenic keratocyst was described for the first time in 1876 and it was later 1956 characterized in detail, by philipsen. The odontogenic keratocyst okc is a cystic expand bone. Keratocystic odontogenic tumor in the maxillary sinus. The odontogenic keratocyst okc was first described in 1876 1 and named by phillipsen in 1956. Odontogenic infections, consisting primarily of dental caries and periodontal disease gingivitis and periodontitis, are common and have local eg, tooth loss and, in some cases, systemic implications. One manifestation of the basal cell nevus syndrome. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Review of molecular pathogenesis of odontogenic keratocyst. Ameloblastoma tends to cause more resorption of teeth and expansion of bone first. In 2005, the world health organization revised and updated the classification of odontogenic tumor, and some terminologies were modified. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. The odontogenic keratocyst okc is regarded as an aggressive lesion due to its characteristic high tendency to recur,and to invade adjacent tissues 15 singh m, gupta kc.
There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Summary a 39yearold female complaining of swelling and pain in the left mandibular. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Aug 11, 2009 the odontogenic keratocyst is a very well known odontogenic cyst. Clinical, radiological and therapeutic features of. Review of the molecular pathogenesis of the odontogenic.
Dentigerous cysts, also called follicular cysts, are slowgrowing benign and noninflammatory odontogenic cysts that are thought to be developmental in origin on imaging, they usually present as a welldefined and unilocular radiolucency surrounding the crown of an unerupted or impacted tooth within the mandible. Okc is known for its rapid growth 35 and its tendency to invade the adjacent tissues including bone. Etiology and pathogenesis of keratocysts oral and maxillofacial. Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis. No difference in site distribution was lesion of odontogenic origin, which is classified as a seen between unilocular and multilocular cysts 3. Pdf the odontogenic ke maxillofacial region which has gained very special attention since last two characteristic. Envelopmental this is an odontogenic keratocyst which embraces or envelopes an adjacent unerupted tooth. The aim of this study was to discuss the aspects regarding the diagnosis, prognosis and treatment of odontogenic keratocyst. Infrequent clinicopathologic features of keratocystic odontogenic tumour. It most often affects the posterior mandible and most commonly presents in the third decade of life. Whether these lesions are developmental or neoplastic is controversial, with the 2017 who classification placing it back into the development lesion category. This reflects the dearth of information concerning the behavior and management of odontogenic keratocyst. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Odontogenic keratocyst symptoms, treatment, pictures.
It enlarges by both multicentric expansion due to the proliferation of localized groups of epithelial cells in the lining and by unicentric. In case of unilocular lucencies dentigerous cyst, eruption cyst, coc, aot, unicystic ameloblastoma etc. Odontogenic keratocysts are benign lesions of the maxillomandibular region with high growth. Aim to present a clinical case of odontogenic keratocyst okc simulating a lateral periodontal cyst. If one removes such an okc some of these epithelial residues may be left behind which may later give rise to a new keratocyst.
Keratocystic odontogenic tumour kcota cyst to a tumour. An expansile lesion in the body of the left mandible had high attenuation 225 hu on nonenhanced ct scans. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. Currently, this tumour is classified as a benign neoplasm of odontogenic origin and not as a cyst. Odontogenic keratocyst dr henry knipe and assoc prof frank gaillard et al. Keratocystic odontogenic tumor grows along jaws first. Most odontogenic keratocyst 60% arise from dental lamina rests or from the basal cells of oral epithelium and are thus primordialorigin odontogenic keratocysts figure 7a 10. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. They present more commonly in the posterior mandible of young adults than the maxilla. Present study is a case report of a 22 year old man presenting with a symptomatic swelling on the gingiva between the mandibular right premolars and canine. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. Epithelial islands andor microcysts are found in approximately 50% of the cases in the overlying, attached mucosa.
Odontogenic keratocyst is a common type of tooth derived cyst due to presence of odontogenic epithelium remnant in different regions of jaw. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Maxillary odontogenic keratocyst a common and serious clinical misdiagnosis mohammad ali, d. Nevoid basal cell carcinoma syndrome, a rare autosomal dominant disorder, comprises a number of abnormalities such as multiple nevoid basal cell carcinomas, skeletal abnormalities and multiple odontogenic keratocysts. Clinically, the kot is manifested by an asymptomatic growth. The etiology of odontogenic keratocyst tumor kcot consists of the remnants of dental lamina philipsen, 1956. Treatment consisted of enucleation and curettage for 22 of the lesions, resection for 2 and marsupialization for 3. The remaining 40% arise from the reduced enamel epithelium of the dental follicle and are thus dentigerousorigin odontogenic keratocysts figure 7 b as we. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Apr, 2016 odontogenic keratocyst or keratocystic odontogengic tumor.
It enlarges by both multicentric expansion due to the proliferation of localized groups of epithelial cells in the lining and by unicentric expansion from the hydrostatic pressure of its contents. The diagnosis of kcot is based on its characteristic histological features 8 ide f, horie n, shimoyama t, saito i, tanaka a, kusama k. A keratocyst in the buccal mucosa with the features of. Nov 11, 2011 the world health organization who has reclassified odontogenic keratocyst okc to keratocystic odontogenic tumour kcot in 2005. Odontogenic keratocysts okcs are developmental cysts which occur typically in the jawbones. Odontogenic keratocyst and keratocystic odontogenic tumour.
In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. He had multiple okcs, calcification of falx cerebri, bifid ribs, frontal bossing. The keratocyst odontogenic tumor has characteristics, with slow development, does not cause metastases and provides great bone destruction. International endodontic journal, 41, 800806, 2008. A 14yearold caucasian girl presented for observation of bilateral agenesis. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. New tumour entities in the 4th edition of the world health. Evidence has shown that the pathogenesis of nbccs and sporadic.
Investigations continue into the lesions pathologic classification, diagnosis and. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Reclassification of the odontogenic keratocyst from cyst to tumour. A large extragnathic keratocystic odontogenic tumour. Developmental odontogenic cysts tissues left behind in the affected area. Keratocystic odontogenic tumour of lesions treated in our clinic. Comparison of components of odontogenic cyst fluids. Odontogenic keratocyst parakeratinized versus orthokeratinized. The odontogenic keratocyst, one of the most studied odontogenic lesions, usually affects males in the second, third, or fourth decades of life, and posterior mandible involvement is particularly. A case report of odontogenic keratocyst in anterior. Odontogenic keratocyst of the maxilla 2 the most striking feature is the cysts capacity for recurrence. In 2005, odontogenic cyst was classified as keratocyst odontogenic tumor due to being aggressive and recurrent. The high attenuation was considered to be due to highly concentrated protein of thick, viscous keratin in the lumen of the keratocyst.
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