Abstract
Purpose: to review in detail various aspects of odontogenic keratocyst, emphasizing recent nomenclature, clinical, histopathological, recurrence, and management of odontogenic keratocyst.
 Methods: To achieve the objective of this review, a manual search was done in hard copy books of oral and maxillofacial pathology, and an electronic search was done in the google website, oral and maxillofacial pathology E-books, virtual database sites, such as PubMed, Research Gate, Academia, and Google scholar using the descriptors: odontogenic cyst, kerato odontogenic tumor, odontogenic keratocyst, and jaws cystic lesion. The eligibility criteria for selecting articles were: to be in the English language, studies published in journals, or indexed in these databases until 2021. Exclusion criteria were: articles in any languages other than English, studies presented in duplicate between the bases, whose theme did not contemplate the objective proposed in this review, or those not available in the digital environment. Data collection occurred from October to December 2020, followed by a thorough evaluation of the studies found, including an exploratory, selective, analytical, and interpretative reading.
 Summary and conclusions: the odontogenic keratocyst is noteworthy because of its unusual growth pattern, the tendency to recur, and association with an inherited syndrome. The renaming of odontogenic keratocysts as keratocystic odontogenic tumors has been one of the most debatable changes in the terminology of odontogenic lesions in recent years. Early diagnose of this lesion is important to perform the more conservative treatment. A wait-and-see policy, with yearly follow-up for the first five years and every two years after that, is strongly advocated.
Highlights
Lesions arising from odontogenic tissues of the jaws vary from very common to very rare
(1) Odontogenic keratocysts (OKCs) has been re-classified in the 2005 edition of the WHO Classification of Head and Neck Tumors, from cystic to neoplastic lesions, and named "keratocystic odontogenic tumors."(KCOT) [2, 3] This has been centered on its aggressive behavior, and PTCH1 gene mutation or inactivation, that was structured as a main cause, obligated the rename of OKC as a tumor
(5) The evidence of allelomorphic loss, mainly in the p16, p53, PTCH, MCC, TSLC1, LTAS2, and FHIT genes, have been found in OKC.[6]. During the years, many conservative and aggressive treatments have been proposed to minimize the high rate of recurrence, but none of them has been recognized as the gold standard for this entity
Summary
Lesions arising from odontogenic tissues of the jaws vary from very common to very rare. [1] OKC has been re-classified in the 2005 edition of the WHO Classification of Head and Neck Tumors, from cystic to neoplastic lesions, and named "keratocystic odontogenic tumors."(KCOT) [2, 3] This has been centered on its aggressive behavior, and PTCH1 gene mutation or inactivation, that was structured as a main cause, obligated the rename of OKC as a tumor. The last fourth edition of the WHO Classification of Head and Neck tumors restores the OKC to cysts category and declines the prior name KCOT; it considered as a developmental cyst with more aggressive behavior. While most epithelial cysts are thought to grow passively driven by hydrostatic pressure inside the lumen, OKC is believed to grow due to active cellular proliferation. [10] This review is an attempt to report and summarize the available and upto-date knowledge about this dilemma lesion
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