Keratocyst: Definition, Diagnosis & Management
Diagnosis: The odontogenic keratocyst has a characteristic though not pathognomic, radiological appearance. Of keratocysts 70% appear in the mandible. Normally at the mandibular angle and ascending ramus_ The radiographic appearance is normally of a multilobular lesion, which causes expansion of the cortical hone. Aspiration biopsy may be possible and identification of epithelial squames from this is diagnostic. However such a sample cannot always be obtained and often an incisional biopsy and histological examination is required to confirm the diagnosis.
Management: The reported frequency of recurrence of these lesions is reputed to be due to incomplete removal of the cyst lining in one piece_ There is conflicting evidence that recurrence is related to the surgical treatment of this lesion. Enucleation is the surgical treatment of choice although size and position may dictate the use of a marsupialisetion technique. Enucleation combined with the removal of the overlying mucoperiostium may further reduce the risk of recurrence. The most important features affecting the recurrence rate appear to be the size and location of the lesion.