Sub-epithelial hyalinization, incomplete cystic lining, and corrugated surface could be a predictor of recurrence in Odontogenic Keratocysts

Abstract

BackgroundOdontogenic Keratocysts (OKCs) are known for their rapid growth and tendency to invade the adjacent tissues. Its high recurrence rate (2.5%–62%) has attracted many kinds of research to identify new parameters to predict recurrence that would enable better treatment outcomes for such patients. The present study aims to correlate Sub-Epithelial Hyalinization (SEH) that has not been explored in an Asian population to date and other histopathologic features of OKC to its recurrence propensity. Materials & MethodsA total of 60 OKCs were analyzed for histopathologic correlation of thickness of lining, complete/incomplete lining, corrugated surface, ortho/para keratinization, intercellular edema, reversed polarity, basilar hyperplasia, the palisading arrangement of basal cells, presence/absence of rete pegs, folding of the epithelium, epithelial/connective tissue separation, SEH, basal offshoots, daughter cysts and inflammation with recurrence to arrive at the most significant histologic feature predicting recurrence. ResultsThe most significant histologic parameter differentiating recurrent and non-recurrent OKCs was the presence of SEH (p = 0.004), incomplete lining epithelium (p ​= ​0.023), and a corrugated surface (p ​= ​0.049). Several other histologic parameters evaluated did not statistically correlate with recurrence, this can be attributed to the smaller sample size considered in the present study. ConclusionSEH is a reliable histologic parameter to predict recurrence in OKCs. The presence of SEH is indicative of a higher recurrence potential in OKCs. Evaluation of histological parameters and their correlation with recurrence in OKCs on a larger sample size could validate the results of the current study undertaken and potentially unravel more insights on predicting recurrence. Key messagesSub-epithelial hyalinization is a significant feature for predicting recurrence in OKC