Odontogenic keratocysts/keratocystic odontogenic tumours: biological characteristics, clinical manifestation and treatment.
BACKGROUND
Odontogenic keratocysts (OKCs) now reclassified as Keratocystic odontogenic tumours (KCOTs) are a clinical entity with a characteristic microscopic picture, kinetic growth and biological behaviour. They arise from the proliferation of the epithelial dental lamina in both maxilla and mandible and occur in patients of all ages. 70-80% of keratocysts are found in the mandible commonly in the angle between the jaw and mandibular branch and maxillary region of the third molar. The cysts are long latent, often symptomless and may attain remarkable dimensions without significant deformation of the jaw bones. They are often found during routine dental X-ray examination. Compared to other types of jaw cyst, odontogenic cysts have a striking tendency to rapid growth and re-occurrence.


OBJECTIVE
This review focuses on the biological characteristics, clinical behaviour and treatment of KCOTs.


METHODS
The databases searched were the PubMed interface of MEDLINE and LILACS.


CONCLUSIONS
Ondontogenic keratinocysts are not currently a diagnostic problem. Orthopantomograms which are today ordinary tools of dental investigation enable diagnosis of clinically asymptomatic cystic lesions. The problem remains the optimal therapeutic approach to reduce the still high likelihood of postoperative recurrence. There is no complete consensus on the ideal operating procedure but cystectomy with delayed extirpation is favoured. An open question also remains the timeliness of screening for postoperative recurrences. Given that the first clinical manifestation of Nevoid Basal Cell Carcioma Syndome (NBCCS) may be lesions of this type, routine histopathological classification supplemented by analysis of immunophenotype should be done. Patients with proven sporadic and especially syndromic OKC should be long term screened. In patients with NBCC preventive X ray examination is recommended only once a year.
Department of Oral and Maxillofacial Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Jindrich
J
Pazdera
Zdenek
Z
Kolar
Vitezslav
V
Zboril
Peter
P
Tvrdy
Richard
R
Pink
D014408:Biomarkers, Tumor / Q000032:analysis*; D006801:Humans; D007573:Jaw Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000601:surgery*; D009807:Odontogenic Cysts / Q000737:chemistry / Q000175:diagnosis / Q000601:surgery*; D009808:Odontogenic Tumors / Q000737:chemistry / Q000175:diagnosis / Q000601:surgery*
D014408:Biomarkers, Tumor