• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.408-413
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• 2009

Odontogenic keratocyst (OKC) is a epithelial developmental cyst which were first described by Phillipsen in 1956. The frequency of OKC has been reported to vary from 3% to 11% of odontogenic cysts. The most characteristic clinical aspect of OKC is the high frequency of recurrence. The mechanism of recurrence is thought to be related to residues of cyst epithelium and an intrinsic growth potential following excision. And since the lining of the OKC is thin and friable, removal of the cyst in one piece may sometimes be difficult. Complete removal of the cyst lining without leaving behind remnants attached to the soft tissue or bone is necessary to avoid recurrence. Therapeutic approaches vary in different studies from marsupialization and enucleation, which may be combined with adjuvant therapy such as cryotherapy or Carnoy's solution, to marginal or radical resection. The recurrent rate varies from approximately 20% to 62%. And OKC in the angle-ramus region of the mandible had a higher tendency to recur, because of the difficulty in accessing and removing OKC from the ramus. By employing a sagittal splitting of the mandible a good surgical access was provided and cyst could be removed completely. We present an illustrative case of a small, lobulated OKC that involved ramus on mandible, and a review of the contemporary literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.173-179
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• 2009

Dentigerous cyst is an odontogenic cyst which occurs in unerupted tooth crown. After the crown formation, enamel epithelium remnants surrounded continuously proliferates and it forms effusionfluid cyst and expands due to increased internal osmotic pressure. Treatments of cysts are mainly enucleation, marsupialization and de-compression. When deciding the way of treatment, the age of a patient, the anatomical circumstances, the region of lesion and the size of cyst should be considered. Marsupialization is that some parts of internal cystic wall would be converted into oral mucosa if the cyst is large size and is concerned about neighboring anatomic structure. It can be accompanied by enucleation later and eruption of related tooth can be possible. If there is a limitation of spontaneous tooth eruption, eruption of tooth can be induced by orthodontic apparatus. There were 3 patients had dentigerous cyst and underwent marsupialization, their impacted teeth had preserved and had induced eruption, all showing satisfactory results.

• Imaging Science in Dentistry
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• v.40 no.1
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• pp.53-58
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• 2010

Common radiographic appearances of ossifying fibroma (OF) are well demarcated margin, radiolucent or mixed lesion. Lesions for the radiographic differential diagnosis with OF include fibrous dysplasia, focal cemento-osseous dysplasia. Other confusing lesions might be the mixed lesions such as calcifying odontogenic cyst, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, and benign cementoblastoma. We reported three cases of OF in posterior mandible. These cases showed a little distinguished radiographic features of OF and diagnosed from a combination of clinical, radiographic, and histopathologic information. We need to further refine radiographic and histopathological features of OF and other confusing lesions with literatures review because some cases of these lesions are not easily differentiated radiographically and histopathologically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.358-360
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• 2020

The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy's solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.1
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• pp.59-62
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• 2007

A squamous odontogenic tumor (SOT) is an epithelial originated benign tumor. It has been rarely reported and most was intramural type. We observed a case of SOT in the mandible. It was associated with the odontogenic cyst. It was shown positive to pancytokeratin and p53. Considering that the case was free from recurrence for 5 years after surgery, p53 positive did not seem to be related to the prognosis of the disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.176-179
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• 2011

Adenomatoid odontogenic tumors represent 3 to 7 percent of all odontogenic tumors. These tumors are more common in the maxilla than the mandible and usually include the anterior region. Clinically, the most common symptom is painless swelling and the tumor is associated with an unerupted tooth, typically a maxillary or mandibular cuspid. The adenomatoid odontogenic tumor appears radiographically as a unilocular radiolucency around the crown of an impacted tooth, resembling a dentigerous cyst. More often, it contains fine calcifications. Histopathologically, there is a thick wall cystic structure with a prominent intraluminal proliferation of the odontogenic epithelium. The most striking pattern is varying-sized solid nodules of spindle-shaped or cuboidal epithelial cells forming nests or rosette-like structures with minimal stromal connective tissues. Conspicuous within the cellular areas are structures of tubular or duct-like appearance. The duct-like spaces are lined with a single row of cuboidal or low columnar epithelial cells, of which the ovoid nuclei are polarized away from the luminal surface. Small foci of calcification may also be scattered throughout the tumor. These have been interpreted as abortive enamel formations. In some adenomatoid odontogenic tumors, the material has been interpreted as dentoid or cementum.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.161-168
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• 2011

Purpose: The odontogenic keratocysts demonstrated a high recurrence rate and a biologically aggressive nature. This might be due to unknown factors inherent in the epithelium or enzymatic activity in the fibrous wall. Bcl-2 protein is characterized by its ability to inhibit apoptosis. The aim of this study was to evaluate the expression and distribution of bcl-2 in the OKCs, its possible relationship with the tumorous characteristics, such as the aggressive nature and high recurrence rate, and its usefulness to differentiate OKCs from dentigerous cysts. Materials and Methods: Formalin fixed paraffin-embedded tissue sections of 53 OKCs, and 44 dentigerous cyst were immunohistochemically analyzed quantitatively for the immunoreactivity of the bcl-2 protein with i-solution. Results: More Bcl-2 expression was observed in the OKCs (mean34.387%) than dentigerous cyst (mean11.144%) with statistical significance (P<0.001). Seventeen and 15 of the 32 OKCs in this study showed positivity in the basal layer and basal/suprabasal layers, respectively. In dentigerous cyst, 2 of 3 showed positivity in the basal cell layer. Conclusion: Considering that bcl-2 over expression may lead to the increased survival of epithelial cells, this study demonstrated a possible relationship between the aggressive nature of OKC and the intrinsic growth potential of its lining epithelium. Furthermore, the basal/suprabasal distribution of bcl-2 positive cells was observed in some OKCs, which might have a significant impact on the behavior of cysts. The bcl-2 expression of OKCs can be useful for differentiating OKCs from dentigerous cysts.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.139-140
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• 2015

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.163-171
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• 1987

The author has clinically and radiologically investigated 57 cases of odontogenic keratocyst in 47 patients consisted of 26 males and 21 females aged from.2 to 63 years, who were pathologically diagnosed as odontogenic keratocyst at infirmaries of dental colleges, Yonsei University and Seoul national university during 1965-1986. The results were as follows: 1. The peak incidence of the disease was on their teenagers (29.8%). The ratio of Male/Female was 1.23:1 and incidence rate of males showed higher than their counterpart. 2. The most frequent complaints were swelling in (65.9%) followed by pus discharge, unknown mass, pain, residual root. 3. The most common site was mandibular third molar and mandibular ramus region (15.8%) followed by mandibular body and ramus, mandibular third molar, mandibular anterior teeth. Incidence of this disease in mandible was higher than in maxilla. 4. The lesions not associated with adjacent teeth were (14.0%) and in the lesions associated with adjacent teeth (35.1%) showed root resorption, (50.9%) were without root resorption, (35.1%) showed tooth migration and (50.9%) were without tooth migration. 5. The border types of the lesions were scalloped type in (52.6%), smooth type in (47.4%) and morphological type were unilocular in (50.9%), multilocular in (49.1%). 6. The radiologic cyst type of the lesions were follicular type (42.1%) followed by primordial, unclassified odontogenic, residual, lateral periodontal, median mandibular, globulomaxillary type.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.3
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• pp.263-267
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• 2007

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and probably developing from residues of the odontogenic epithelium. PIOC appears more common in male than female, especially at posterior portion of the mandible. Radiographic features of PIOC show irregular patterns of bone destruction with ill defined margins. It could be sometimes misdiagnosed as the cyst or benign tumor because it shows well defined margins. If it couldn't be done appropriate treatment initially, PIOC shows extremely aggressive involvement, extensive local destruction and spreads to the overlying soft tissue. Therefore accurate diagnosis in early state is necessary. The diagnosis criteria proposed for PIOC are : (1) absence of ulcer formation, except when caused by other factors, (2) histologic evidence of squamous cell carcinoma without a cystic component or other odontogenic tumor cell, and (3) absence of another primary tumor on chest radiograph obtained at the time of diagnosis and during a follow-up period of more than 6 month(Suei et al., 1994).