Based on a literature review, we analyzed the World Health Organization (WHO) classification and the treatment algorithm for the odontogenic keratocyst (OKC), formerly referred to as keratocystic odontogenic tumor (KCOT). The KCOT reclassification from benign odontogenic tumors to odontogenic developmental cysts resulted from the emergence of new evidence regarding their morphogenesis and biological behavior. The authors of the most recent 2017 classification do not provide specific guidelines for OKC. Nevertheless, it has been observed that conservative surgical management is not necessarily associated with recurrences characteristic of neoplastic disease. The aim of this paper was to present the effective management strategy for a local recurrence that developed following conservative OKC enucleation in a 53-year-old patient. The treatment for recurrence consisted of enucleation, marginal osteotomy and augmentation with a cancellous bone graft harvested from a tibial tuberosity. A 6-year observation period (clinical and radiological monitoring) revealed normal bone regeneration and no evidence of recurrence. The algorithm applied in our center for the treatment of OKC/KCOT was compared with the management strategies proposed by other authors.
Keywords: WHO classification; autogenic bone graft; odontogenic keratocyst; recurrence.
Madras J, Lapointe H. Madras J, et al. J Can Dent Assoc. 2008 Mar;74(2):165-165h. J Can Dent Assoc. 2008. PMID: 18353202
Laino L, Russo D, Cicciù M, D'Amico C, Fiorillo L, Cervino G. Laino L, et al. Minerva Dent Oral Sci. 2021 Feb;70(1):26-31. doi: 10.23736/S2724-6329.20.04422-2. Epub 2020 Oct 23. Minerva Dent Oral Sci. 2021. PMID: 33094933
Uddin N, Zubair M, Abdul-Ghafar J, Khan ZU, Ahmad Z. Uddin N, et al. Diagn Pathol. 2019 Apr 4;14(1):28. doi: 10.1186/s13000-019-0801-9. Diagn Pathol. 2019. PMID: 30947718 Free PMC article.
Bhargava D, Deshpande A, Pogrel MA. Bhargava D, et al. Oral Maxillofac Surg. 2012 Jun;16(2):163-70. doi: 10.1007/s10006-011-0302-9. Epub 2011 Nov 11. Oral Maxillofac Surg. 2012. PMID: 22072419 Review.
Radia S, Cash AC, Moar K. Radia S, et al. Cleft Palate Craniofac J. 2019 Jan;56(1):110-115. doi: 10.1177/1055665618770053. Epub 2018 Apr 19. Cleft Palate Craniofac J. 2019. PMID: 29672163 Review.
Albagieh H, Aldosari M, Alkhathlan A, Alfawaz N, Almutairi M. Albagieh H, et al. Saudi Dent J. 2023 Dec;35(8):916-919. doi: 10.1016/j.sdentj.2023.11.003. Epub 2023 Nov 7. Saudi Dent J. 2023. PMID: 38107039 Free PMC article. Review.
Gelețu GL, Burlacu A, Baciu ER, Diaconu-Popa D, Murariu A, Foia LG, Ungureanu L, Onică N. Gelețu GL, et al. Healthcare (Basel). 2023 Feb 1;11(3):416. doi: 10.3390/healthcare11030416. Healthcare (Basel). 2023. PMID: 36766990 Free PMC article.
Behnia P, Malekigorji M, Tabrizi R, Dehghanpour M, Ghaffarpasand A. Behnia P, et al. World J Plast Surg. 2022;11(3):98-102. doi: 10.52547/wjps.11.3.98. World J Plast Surg. 2022. PMID: 36694672 Free PMC article.