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

• 대한치과교정학회지
• /
• 제50권1호
• /
• pp.63-71
• /
• 2020

Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제29권1호
• /
• pp.24-32
• /
• 2007

The odontogenic keratocyst(OKC) is a common developmental odontogenic cyst and represents approximately 11% of odontogenic cysts. It is decided by microscopic and histopathologic determinant rather than by clinical appearance. In this study, expression of RANKL and OPG in OKC in relation to age and gender of patient and recurrence, location of lesion were examined through immuno- histochemical study. The RANKL and OPG antibody staining were used. The obtained result were as follow. 1. Positive immunoreactivity to RANKL/OPG in all specimens was found. 2. There was no significant difference in immunohistochemical expression of RANKL relating to recurrence, location of OKCs and age, gender of patients. 3. There was no significant difference in immunohistochemical expression of OPG relating to recurrence, location of OKCs and age, gender of patients. From above results, it is suggested that activation of osteoclasts by RANKL is an important mechanism by which OKCs cause bone destruction.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권15호
• /
• pp.6289-6292
• /
• 2015

Purpose: To determine the biological behaviour of common odontogenic cystic lesions by analysing and comparing bcl-2 expression amongst them. Materials and Methods: Our study covered 90 formalin fixed paraffin embedded tissue samples: 26 primary cases each of radicular cysts (RC), dentigerous cysts (DC) and odontogenic keratocysts (OKC) and 12 of recurrent OKCs. Bcl-2 expression was analysed immunohistochemically and data analysis was accomplished using SPSS version 17.0. Means were taken for age while for gender and site of the lesions frequencies and percentages were determined. The Chi-square test was applied to evaluate any statistically significant difference of bcl-2 expression in these lesions and p value of ${\leq}0.05$ was taken as significant. Results: All the recurrent OKCs showed a strong positivity for bcl-2 that was absent in all of its primary cases (p value<0.05). Although variation in expression of bcl-2 was not found to be statistically significant between RC and DC, however, it became significant when all primary cases of these common odontogenic lesions were compared. Conclusions: Recurrent OKC showed comparatively a more aggressive behaviour than their primary counterparts and also from RC and DC. Bcl-2 proved to be a valuable adjunct in determining aggressive biological behaviour of odontogenic lesions.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권5호
• /
• pp.431-436
• /
• 2010

Purpose: It is estimated that the odontogenic keratocyst (OKC) makes up 10% to 12% of all developmen-tal odontogenic cysts. The lesion has been of particular interest because of its specific histopathologic fea-ture, high recurrence rate, and aggressive behavior. Materials and Methods: We investigated 266 OKCs of Korean patients for the sex of patient, the age of the patient, the location of OKC, the recurrence rate related to radiographic impression. Results: The male-to-female ratio was 1.47:1, showing a slight male predilection. Odontogenic keratocysts had a peak of occurrence in the third decade of life. The mandibular angle and ascending ramus area (49.6%) is the most frequent site of OKCs in the jaws. Fourteen cases of unilocular (12%) and 5 cases of multilocular (20%) OKCs recurred. Thirteen cases of smooth (12.9%) and 6 cases of lobulated (14.6%) OKCs recurred. Seventeen cases of OKCs without perforation of cortical bone (12.5%) and 2 cases of OKCs with perforation of cortical bone (33.3%) recurred. Fifteen people of patients with single lesion (12.2%) and 4 people of patients with multiple lesions (66.7%) recurred. Conclusion: In this resul, we consider multiple odontogenic keratocysts can recur more easily. So we have to treat them more carefully and need long-time follow-ups.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권5호
• /
• pp.408-413
• /
• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권5호
• /
• pp.287-291
• /
• 2023

Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, suchas resection. As an alternative, this report introduces a modified Carnoy's solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy's solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy's solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy's solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

• Imaging Science in Dentistry
• /
• 제34권2호
• /
• pp.75-79
• /
• 2004

Purpose: To compare the proliferation potential of the epithelial cells between unicystic ameloblastoma (UA), dentigerous cyst (DC), and odontogenic keratocyst (OKC) and to correlate this proliferation potential with the radiographic features of these three pathoses. Materials and Methods: Immunohistochemical expression of PCNA, Ki-67, and cytokeratin as a proliferation marker were assessed for 15 cases of UA, 15 cases of DC, and 15 cases of OKC. The degree of immunochemical expression of three proliferation markers were correlated with the radiographic features, especially cortical expansion (negative and positive) and shape of border (scalloped and round). Results: Using PCNA and Ki-67, OKC showed the highest proliferation potential and UA the lowest. Statistically significant differences were found between the OKC and the UA (p < 0.05). However, no statistically significant difference was present according to the radiographic features in all pathoses. Using cytokeratin, there was no significant differences of proliferation potential among three pathoses. Conclusions : OKC epithelium has the most intense proliferation potential, followed by the dentigeous cyst and then unicystic ameloblastoma. There is no significant relation between the radiographic features and the proliferation potential of epithelium of these three pathoses.

• 대한치과의사협회지
• /
• 제55권7호
• /
• pp.481-488
• /
• 2017

The aim of this study is to examine the incidence of odontogenic tumors and to review the clinical and radiological findings for the most frequent three types in Korea. Odontoma, ameloblastoma and keratocystic odontogenic tumors are the most frequent odontogenic tumors in Korea. We provide an overview of these tumors based on clinical and radiographic findings.

• 대한소아치과학회지
• /
• 제35권4호
• /
• pp.731-736
• /
• 2008

치성각화성낭종(Odontogenic keratocyst, OKC)은 치체(dental lamina)로부터 발생하는데, 모든 악골 낭의 $5{\sim}17$% 정도를 차지하며 낭의 내부는 이장상피로부터 유래한 점액성이나 치즈양 물질인 케라틴(keratin)으로 채워져 있다. 치성낭 중 가장 높은 재발률을 보인다는 것이 이 낭의 중요한 특징이다. 간혹 기저층에서 인접 결체조직 벽으로 돌기가 증식하기도 하며 결체조직 벽 내에 존재하는 치성 상피조직 섬의 증식이 위성 소낭을 발생시키기도 한다. 이들 소낭들이 치성각화성낭종의 높은 재발률의 원인으로 여겨진다. 치성각화성낭종은 다양한 연령층에서 발견되나, 20대와 30대에서 호발한다. 남성에서 다소 호발하며 하악, 특히 제3대구 치와 하악지 부위에서 자주 발생한다. 대개 피질골의 팽융에 의해 처음 발견되며 매복치와 관련되어 있고 일반적으로는 증상이 없지만 동통과 감염이 나타날 수도 있다. 흡인시 걸쭉한 노란 치즈양 물질인 케라틴이 관찰되며 특히 재발이 잘 된다. 치성 각화낭의 중요한 특징 중의 하나는 병소가 피질골의 팽창을 많이 유발시키지 않으면서 악골의 내면을 따라 성장한다 는 것이다. 치성각화성낭종화낭은 인접 치아를 변위시키고 흡수시킬 수 있으나 함치성낭보다는 정도가 심하지 않다. 하악관을 하방으로 변위시키기도 하며 상악 병소의 경우는 상악동을 침범해서 상악동 전체를 차지하기도 한다. 본 증례는 7세 10개월 된 여아의 하악 우측 제2유구치 부위에 발생한 치성각화성낭종에 대한 증례로써 전신마취하 낭종적 출술을 시행하였다. 낭종에 포함된 제1,2유구치, 유견치 및 제1소구치 치배를 발거하였으며, 현재 공간유지장치를 장착후 주기적으로 내원중이다.