OKC

1. •ODONTOGENIC
KERATOCYST
SUKESH KUMAR.V
IV B.D.S

2. ODONTOGENIC
KERATOCYST
DEVELOPMENTAL CYST OF UNKNOWN
ORIGIN
FROM REMINANTS OF DENTAL LAMINA
11% OF ALL JAW DERIVED CYSTS ARE
OKC
ALSO KNOWN AS PRIMORDIAL
CYST(BASED UPON PRIGIN)

3. CLINICAL FEATURES
 AGE:-OCCURS OVER A WIDE
RANGE,INTIATED IN EARLY LIFE,PEAK
INCIDENCE IN 2nd & 3rd DECADES.
 SEX:- MALES>FEMALES;BLAKS>WHITES
 SITE:-MORE IN MANDIBLE;AT ANGLE
MOSTLY
 SYMPTOMS:-ASYMPTOMATIC TILL 2ndrly
INFECTED
IF 2ndrly INFECTD PID COMPLAINTS OF
PAIN,SWELLING,EXPANSION OF
BONE,PARASTHESIA OF LOWER LIP AND
TEETH

5. TEETH:-MAY BE DISPLACED IF EXPANDS
THROUGH CANCELLOUS BONE&BODY OF
MANDIBLE
SIGNS:-CAN LEAD TO PATHOLOGIC
FRACTURE & AS THESE CYSTS GROW IN
ANTEROPOSTERIOR DIRECTION THERE IS
NO BONY EXPANSION IN MOST CASES
ASPIRATION:-ON THIS GETS A
ODORLESS,REAMY OR CASEOUS MATERIAL

7. SYNDROMES ASSOCIATED
GORLIN-GOLTZ
MARFANS
EHLERS-DANLOS
NOONAN’S
MULTIPLE OKC’S ARE FOUND IN
RELATION TO THESE

8. ROENTGENOGRAPHIC
FEATURES
• SITE:- >90% SEEN POSTERIOR TO
CANINE IN MANDIBLE;AMONG THEM
>50% AT ANGLE OF MANDIBLE.
• CHARACTERISTIC:- 40%SUGGESTIVE
DENTIGEROUS CYST
25% OF PRIMORDIAL CYST
25% OF LATERAL PERIODONTAL CYST
10% GLOBULO MAXILLARY CYST

9. Odontogenic Keratocyst

10. 3)INTERNAL STRUCTURE:- UNDULATING
BORDERS WITH CLOUDY INTERIOR
APPEARENCES SUGGESTIVE OF
MULTILOCULARITY.
4)SIZE:- VARIES FROM 5Cm or MORE IN DIAMETER.
5)SHAPE:- USUALLY OVAL EXTENDING ALONG BODY
OF MANDIBLE.
6)MARGINS ARE HYPEROSTOTIC
7)UNILOCULAR VARIETY:- MAJORITY OF LESIONS
ARE UNILOCULAR WITH SMOOTH BORDERS OR
LARGE IRREGULAR BORDERS.
 RADIOLUCENCY IS HAZY DUE TO KERATIN FILLED
CAVITY& SURRONDED BY THIN SCLEROTIC RIM.

13. IN SOME CASES IT CAN PERFORATE BUCCAL
&LINGUAL CORTICAL PLATES OF BONE,DUE TO
WHICH DISPLACEMENT OF INFERIOR ALVEOLAR
CANAL OCCURS.
CT FEATURES WILL DEMONSTRATE EXACT
DIMENSIONS OF RADIOLUCENCY.
RADIOLOGICAL TYPES OF KERATOCYST:-
ENVELOPMENTAL TYPE
REPLACEMENT TYPE
EXTRANEOUS TYPE
COLLATERAL TYPE

14. HISTOLOGICAL FEATURES
• LINING EPITHELIUM IS HIGHLY
CHARACTERISTIC &COMPOSED OF
1)PARAKERATINISED SURFACE WHICH IS
TYPICALLY CORRUGATED,RIPPLED.
2)6-10CELL THICKNESS OF EPITHELIUM
3)PROMINENT PALISADED POLARISED
BASAL LAYER OF CELLS OFTEN
DESCRIBE AS “PICKET FENCE” or
“TOMBSTONE” appearance.

15. Odontogenic Keratocyst

16. FORMED WITH STRATIFIED SQUAMOUS
EPITHELIUM THAT PRODUCES
ORTHOKERATIN(10%)
PARAKERATIN(83%).
NO RETERIDGES ARE PRESENT.
LUMEN IS FILLED WITH STRAW COLOUR
FLUID WITH GR8 DEAL OF KERATIN.
CHOLESTEROL,HYALINE BODIES ARE
PRESENT AT SITE OF INFLAMMATION.
DYSPLASTIC &NEOPLASTIC FEATURES
OF LINING EPITHELIUM IS UNCOMMON.
C.TISSUE HAS DAUGHTER or SATELLITE
CYSTS

17. DIAGNOSIS
 CLINICAL DIAGNOSIS- Not so specific.
 RADIOLOGICAL- Radiolucency extending in
anteroposterior direction with undulating borders
suggest OKC.
 LAB DIAGNOSIS-Biopsy reveals the related
histological features.
 DIFFERENTIAL DIAGNOSIS:
 AMELOBLASTOMA
 RESIDUAL CYST
 TRAUMATIC CYST
 FIBROMA
 GAINT CELL GRANULOMA

18. MANAGEMENT
 ENUCLEATION-WITH VIGOROUS CURETTAGE OF
CYSTIC WALL.
 PERIPHERAL OSTEOTOMY-REDUCES CHANCES
OF RECURRENCE.
 CHEMICAL CAUTERIZATION-WITH INTRALUMINAL
Inj .OF CARNOY’S Sol.
 DECOMPOSITION-WITH HELP OF POLYETHYLENE
DRIANAGE TUBE KEPT IN BONY CAVITY.

19. RECURRENCE
VERY HIGH DUE TO--
SATELLITE CELLS
NEW CYST FORMATION
DIFFICULTY IN ENUCLEATION
INTRINSIC GROWTH POTENTIAL
PROLIFERATION OF BASAL CELL.

20. REFERENCES
• ANIL GOVINDARAO GHOM
• SHAFFER-HINE-LEVY.
• BURKITT’S
• SCULLEY

21. THANKYOU