Orthokeratinized Odontogenic Cyst: Clinical, Radiological, Histopathological, and Therapeutic Approach

Abstract

Orthokeratinized odontogenic cyst is a developmental cyst of odontogenic origin, which was initially defined as an uncommon orthokeratinized variant of odontogenic keratocyst. It is not an aggressive lesion and has slow growth, occurring predominantly in the posterior mandibular region. Typically, it presents as a well-defined, unilocular, radiolucent lesion associated with an impacted tooth. Histologically, it is characterized by an orthokeratinized stratified squamous epithelium with a prominent granular layer and a basal layer without palisade, hyperchromatism, or polarization of cells. A 35-year-old white patient presented with asymptomatic swelling on the left side of the face that had first appeared 6 months earlier. Computed tomography revealed a well-defined unilocular lesion located in the posterior mandible. An incisional biopsy was performed, and the diagnosis of orthokeratinized odontogenic cyst was established. Enucleation and curettage were performed, in conjunction with liquid nitrogen cryotherapy. The patient remains in clinical and radiographic follow-up.