Etiology:The odontogenic keratocyst (OKC) develops from the dental lamina or its remnants. It is a developmental cyst and very aggressive
Transmission: na
Characteristics: OKCs occur most often in the posterior mandibular region and can occupy most of the ramus in some cases. In late stages of development, the cyst may become large enough to displace teeth and extend through the cancellous bone into the oral cavityAs the jaw becomes weakened, a fracture is more likely to occur. Radiographically , the lesions can be multilocular or unilocular , well circumscribed on the radiograph , and radiolucent, with a scalloped appearance. The radiographic appearance closely resembles that of an ameloblastoma in certain cases . They can also be round and ovoid and appear laterally to the tooth, making them appear as a lateral periodontal cyst
Dental Implications : Although the OKC can radiographically resemble other cysts , the microscopic interpretation is unique once a specimen is submitted . The association with nevoid BCC syndrome is especially important in a diagnosis , and the cysts have very aggressive behavior. Therefore , prompt treatment is required . Multiple OKCs should alert the practitioner to the possibility of nevoid basal cell carcinoma
Treatment and Prognosis: Since recurrence is high, but varied (from 5 to 62 %), careful removal of the entire cyst is crucial, and the capsule must be removed intact so that daughter cells do not remain . Many OKCs today are treated by decompression (marsupialization ), allowing the cyst to shrink before definitive surgical removal . The thin wall is often difficult to separate from bone and remove in one piece, often allowing daughter cells to remain and increase in occurrence.