Diagnosis is usually radiological.
However, definitive diagnosis is through biopsy.
Aspirational biopsy of odontogenic keratocysts contains a greasy fluid which is pale in colour and contains keratotic squames.
Protein content of cyst fluid below 4g% is diagnostic of odontogenic keratocysts..
The odontogenic keratocyst (OKC) is known for its high recurrence rate, aggressive behavior, and its occasional association with the nevoid basal cell carcinoma syndrome (NBCCS).
Three histologic variants were recognized initially: a parakeratinized variant, an orthokeratinized variant, and combination of the two..
[9] It includes: A thin, uniform lining of stratified squamous epithelium with tendency to detach from the underlying connective tissue capsule; a thin corrugated surface layer of parakeratin; a spinous cell layer 8 to 4 cells in thickness, often showing intracellular oedema; a flat epithelial-fibrous tissue junction, .
Compared to other odontogenic cysts, the histological appearance of OKC is rather peculiar.
It consists of a uniformly thick cystic epithelial lining, composed of 6–10 cell layers with a well-polarized basal layer.
Such epithelial layer tends to separate from the underlying connective tissue..
Cytology of a odontogenic keratocyst contains dispersed orthokeratinized cells and a group of intermediate keratinocysts..
Compared to other odontogenic cysts, the histological appearance of OKC is rather peculiar.
It consists of a uniformly thick cystic epithelial lining, composed of 6–10 cell layers with a well-polarized basal layer.
Such epithelial layer tends to separate from the underlying connective tissue..
Histology.
Odontogenic keratocysts have a diagnostic histological appearance.
Under the microscope, OKCs vaguely resemble keratinized squamous epithelium; however, they lack rete ridges and often have an artifactual separation from their basement membrane.
The fibrous wall of the cyst is usually thin and uninflamed..
Histologically, a periapical cyst has one to two thin cell layers of nonkeratinized stratified squamous epithelium associated with inflamed fibrous connective tissue and inflammatory infiltrates.
The luminal epithelium will appear “looped and arcaded” due to the inflammatory hyperplasia..
The clinical manifestation, diagnosis and treatment option should be evaluated carefully.
Before selecting treatment for keratocystic odontogenic tumors, the preoperative image data must be read carefully to make sure that the operative area is clear; the omission of the tumor is avoided, and the tumor is completely removed.
Most common odontogenic cyst is periapical / radicular cyst (inflammatory cyst), followed by dentigerous cyst, which is usually considered developmental but can arise from inflammation ( J Investig Clin Dent 2014;5:9 ) Odontogenic cyst, inflammatory:
Abstract An odontogenic keratocyst (OKC) is a benign but aggressive intraosseous tumor derived from the remains of the original tooth germ or dental lamina.
It has a marked ability to recur and become cancerous.
However, patients with early-stage OKC often have no symptoms and manifestations.
The common clinical manifestation is swelling.
The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with Nevoid basal cell carcinoma syndrome Two-hit mechanism results in bi-allelic loss of PTCH ("patched") tumor suppressor on 9q22.3-q31 causing dysregulation of p53 and cyclin D1 oncoproteins .
