Maxillary odontogenic keratocyst: a clinical case report

Daniel Antunes Freitas,Alisson Luís D'Afonseca Santos,Daniela Araújo Veloso,Vinícius Antunes Freitas

doi:10.1590/1981-86372015000300017576

Daniel Antunes Freitas, Alisson Luís D'Afonseca Santos + Show 2 more

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https://doi.org/10.1590/1981-86372015000300017576

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Abstract

Odontogenic keratocysts are benign lesions of the maxillomandibular region with high growth potential resulting in huge bone destruction. The presence of multiple Odontogenic keratocysts can be associated with the Gorlin-Goltz syndrome. There are two accepted theories of their origin: remnants of dental lamina and proliferation of cells from the basal layer of oral epithelium into the mandible or maxilla. Odontogenic keratocysts are usually asymptomatic and are diagnosed incidentally on routine periapical or panoramic radiographs. The type of treatment is related to their high recurrence rate. The objective of the present study is to report a clinical case of a surgical treatment of a parakeratinized odontogenic keratocyst by enucleation in a fourteen-year old girl. This technique was used since the complete removal of the cyst posed no risks of complications from a dental and/or anatomical point of view. Furthermore, it facilitated the comprehensive anatomohistopathological analysis of the lesion including its clinical, histopathological, and radiological aspects.

Highlights

Reclassified in 2005 by the World Health Organization as a benign tumor, odontogenic keratocyst is an intraosseous lesion of the maxilla with a destructive and invasive behavior, high recurrence rate (25% to 62.5%), and specific histological aspects[1]
Developmental odontogenic cysts bone expansion resulting in its delayed observation[5]
The lesion was enucleated and sent for histopathological examination, which confirmed the diagnosis of parakeratinized odontogenic keratocyst (Figure 4)

Summary

Introduction

Reclassified in 2005 by the World Health Organization as a benign tumor, odontogenic keratocyst is an intraosseous lesion of the maxilla with a destructive and invasive behavior, high recurrence rate (25% to 62.5%), and specific histological aspects[1]. first described in 19562, its etiopathogenesis is not yet entirely clear; there are two accepted theories of their origin: remnants of dental lamina and proliferation of cells from the basal layer of oral epithelium into the mandible or maxilla[3]. Odontogenic keratocysts are asymptomatic lesions, but occasionally, in severe cases, some symptoms such as swelling, drainage, or pain can be shown[5]. Usually asymptomatic, are often discovered only during radiographic examination[4,6] and may be associated with basal cell nevus syndrome, known as Gorlin-Goltz syndrome . According to Chow[10], in the mandible, this lesion tends to grow in an anteroposterior direction within the medullary cavity of the bone, without causing obvious. Developmental odontogenic cysts bone expansion resulting in its delayed observation[5]. Since it is a less compact bone and due to the proximity to the maxillary sinus, the lesion tends to grow spherically, and it can be observed in its early stages of formation

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