Keratocystic odontogenic tumor: Clinicopathological aspects and treatment

Odontogenic keratocyst with granular cell changes: A distinctive finding

Odontogenic keratocyst (OKC) originates from the dental lamina and is more commonly seen in the posterior mandible than in the maxilla. OKC is the most aggressive cyst of the oral cavity and is known for its rapid growth and its tendency to invade bone of the adjacent tissues. The recurrence rate of OKC is very high due to various reasons debated upon. Cases of OKC have shown the presence of calcifications, dentinoid formation and ossification. Here, we report the first case of OKC in a 27-year-old male showing granular cell changes.

Application of endoscopy to treat mandibular keratocystic odontogenic tumors

The aim of this study was to evaluate the feasibility of endoscopy to remove keratocystic odontogenic tumors (KCOTs) with virtual 3D mandibular images. Fifteen patients (mean age, 40.27±14.58 years) who underwent endoscopic mandibular KCOT enucleation between May 2009 and October 2009 were included. Virtual 3D mandibular reconstructions derived from computed tomography (CT) imaging were generated for all patients. Recurrence and pathological fracture were evaluated as the primary outcome variables at 1 and 12 months after operation. Secondary infection and inferior alveolar nerve injury were evaluated as the secondary outcome variables at 1 and 6 months after operation. None of the 15 patients exhibited signs of recurrence or pathological fracture after operation. During long-term follow-up, no symptoms of inferior alveolar nerve injury or secondary infection were observed and no signs of recurrence were found in any of the patients. Endoscopy helps surgeons to remove mandibular KCOTs with small incisions. Moreover, endoscopy can provide clear and magnified views and help to avoid damage to the inferior alveolar neurovascular bundle. Therefore, under the support of preoperative virtual 3D mandibular images, the application of endoscopy to remove the tumors should be considered to be a treatment option for KCOTs.