• Imaging Science in Dentistry
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• 제42권1호
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• pp.61-64
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• 2012

Keratocystic odontogenic tumor (KCOT) is a benign odontogenic tumor with a potentially aggressive and infiltrative behavior. KCOT is most commonly occurred in mandible and demonstrate a unilocular, round, oval, scalloped radiolucent area, while large lesions may appear multilocular. An important characteristic of KCOT is its propensity to grow in an antero-posterior direction within medullary cavity of bone causing minimal expansion. Definitive diagnosis relies on histological examination. In this report, a KCOT that had an expansion both buccal and lingual cortical bone is described including its features in computed tomography and ultrasonographic exams. The lesion was removed surgically via an intraoral approach under local anesthesia and histologically reported as a KCOT.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권2호
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• pp.73-77
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• 2014

Keratocystic odontogenic tumor (KCOT) is a benign cystic intraosseous tumor of odontogenic origin. An infection of a KCOT is not common because KCOT is a benign developmental neoplasm. Moreover, a severe deep neck space infection with compromised airway caused by infected KCOT is rare. This report presents a 60-year-old male patient with a severe deep neck space infection related to an infected KCOT due to cortical bone perforation and rupture of the exudate. Treatment of the deep neck space infection and KCOT are reported.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.182-187
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• 2013

Keratocystic odontogenic tumors (KCOT) - previously termed odontogenic keratocysts (OKC) - are characterized by aggressive behavior and a high rate of recurrence. Histopathologically, the basal layer of KCOT shows a higher cell proliferation rate and increased expression of anti-apoptosis genes. Clinically, KCOT is frequently involved in the mandibular posterior region but is not common in the posterior maxilla. However, it should be noted that due to its expansive characteristics, KCOT involved near the maxillary sinus could easily expand to an enormous size and occupy the entire maxilla. To achieve total excision of these expanded cystic tumors in the maxilla, a more aggressive approach would be needed. In this report, we describe two cases of expansile KCOT involving the entire unilateral maxilla and maxillary sinus; they were completely excised using the Weber-Ferguson approach, showing no evidence of recurrence during the follow-up period of more than two years. In immunohistochemical analyses of the tumor specimens, p53 and p63 showed strong expression, and B-cell lymphoma 2 (BCL2) and MKI67 (Ki-67) showed moderate or weak expression, however, detection of BCL2-associated X protein (BAX) was almost negative. These data indicate that expansile KCOT possesses increased anti-apoptotic activity and cell proliferation rate but decreased apoptosis. These properties of KCOT may contribute to tumor enlargement, aggressive behavior, and high recurrence rate.

• 한국치위생학회지
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• 제15권6호
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• pp.941-946
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• 2015

Objectives: Since World Health Organization reclassified the odontogenic keratocyst as a keratocystic odontogenic tumor(KCOT) in 2005, management of KCOT remains controversial. The purpose of the this study is to present a current concept of the treatment of the KCOT. Methods: Recent articles were focused on the method of the surgical therapy and the recurrence rate of KCOT. Results: The treatment modality is divided into conservative treatment-such as simple enucleation with or without curettage or marsupialization-and aggressive treatment including peripheral ostectomy, chemical curettage with Carnoy's solution, and resection. Conclusions: Keratocystic odontogenic tumors have higher recurrence rates than other odontogenic lesions; thus, the selected type of treatment is very important.

• Imaging Science in Dentistry
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• 제43권2호
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• pp.91-98
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• 2013

Purpose: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. Materials and Methods: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. Results: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. Conclusion: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1997-2001
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• 2015

Objective: To clarify the association between the p53 polymorphism at codon 72 and susceptibility to the sporadic keratocystic odontogenic tumor (KCOT). Design: One hundred KCOTs and 160 match-group healthy controls were genotyped to ascertain the frequency of the p53 codon 72 polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), confirmed by direct sequencing. Results: The frequencies of the Pro/Pro, Arg/Pro, and Arg/Arg genotypes were 23.8%, 49.4%, and 26.9%, respectively, in the controls, while the KCOT cohort demonstrated 43.0%, 39.0%, and 18.0%, respectively. Further analysis suggested that p53 Pro could be a KCOT-susceptible allele (OR (95%CI)=1.77 (1.22 to 2.59), p=0.0024), with a sex-adjusted OR (95%CI) of 1.71 (1.17-2.50), p=0.0046. Moreover, the results indicated that p53 codon 72 Pro homozygous was associated with a two-fold risk of developing KCOT (adjusted OR (95%CI) =2.17(1.23-3.84), p=0.0062). Conclusions: The C/C genotype of P53 gene codon 72 increases the risk of developing sporadic KCOT and may be a useful tool for screening and diagnostic purposes.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.498-504
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKC is histologically divided into orthokeratic and parakeratic types. According to revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term, keratocystic odontogenic tumor (KCOT) has been adopted to describe parakeratic OKC. The KCOT is noted for its capacity to recur after treatment. The aggressive, or potentially aggressive, nature of KCOT has led to alternative treatments. Among the treatments is noted the use of Carnoy's solution as adjunctive intralesional therapy having a low rate of recurrence. This study suggests a possible benefit of Carnoy's solution against recurrence of KCOT.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권4호
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• pp.208-212
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• 2015

Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible.

• 대한소아치과학회지
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• 제36권3호
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• pp.489-497
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• 2009

악골에서 다수로 발생하는 낭은, 단독으로 발생하는 낭에 비해 매우 드물게 나타난다. 증후군을 동반하지는 않고, 악골 내에 다수의 낭이 발생한 경우를 다발성 악골낭 이라고 하는데, 소아에서 발생하는 다발성 악골 낭의 대부분은 각화낭성 치성종양(Keratocystic odontogenic tumor, KCOT)이다. 소아에서 나타나는 악골의 다발성 각화낭성 치성종양은, 기저세포모반증후군의 한 증상으로 발생할 수 있으므로, 악골의 방사선 사진에서 다발성 낭이 발견되면, 증후군을 의심해보고 임상 및 병리 검사를 하게 된다. 본 증례는, 다발성 악골 낭을 주소로 내원한 소아환자들로, 기저세포모반증후군을 의심하였으나 현재까지 증후군의 다른 증상들은 보이고 있지 않으며, 단지 수년간에 걸쳐서 종양의 재발과 수술을 반복하고 있는 경우이다. 악골의 다발성 낭 이외의 기저세포모반증후군의 증상들이 나타나지 않더라도, 나이가 들면 증후군의 다른 증상들이 나타난 경우의 보고도 있으므로, 소아에서 이러한 다발성 치성종양이 관찰되면, 지속적으로 방사선 및 임상 검사를 시행하여 증후군으로의 진행 여부를 관찰하는 것이 중요한 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권4호
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• pp.332-336
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• 2010

We reviewed 30 cases of keratocystic odontogenic tumor (KCOT) managed during the 8-year period between 2001 and 2008. This case report described the clinical, radiographic and histopathologic features of these KCOT. Of the 30 patients in whom KCOTs were diagnosed, 18 (60%) of the patients were male and 12 (40%) were female. The mean age of these patients was 34.2 years, with peak incidence occurring in the third decade of life. The lesions were mostly located in the mandible (74.2%) and in the maxilla (25.8%). There was a marked predilection to occur in the posterior mandible. Radiographically, 19 (63%) out of the 30 cases were unilocular type with a well demarcated border, while 11 cases (37%) were multilocularin appearance. Histopathologically, 73% of the cysts were lined with parakeratinized stratified squamous epithelium, while only 3% of the cysts were lined with mixed parakeratinized of orthokeratinized epithelium. 22 cases (73%) contained keratin in the lumen. A satellite cyst was observed in 14 cases (47%). All cysts were treated by enucleation. The recurrence rate was shown as 10% for 3 patients with a follow up period and recurred lesions were treated by re-enucleation.