Cysts, keratinizing cystic odontogenic tumor, odontogenic tumors. A dentigerous cyst is a developmental odontogenic cyst that develops when fluid accumulates between the reduced enamel epithelium and the tooth crown of an unerupted tooth. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to be known as a primordial cyst. Three important things associated with this diagnosis. Fluid is accumulated between reduced enamel epithelium and the crown of an unerupted tooth. Orthokeratinized odontogenic cyst usually occurs most often between third and fourth and decades and with a male gender predilection. Intraosseous jaw cysts with a solely orthokeratinized lining epithelium have been suggested to differ from the typical odontogenic keratocysts okc by exhibiting a less aggressive behaviour.
Orthokeratinized odontogenic cyst ooc is an uncommon developmental cyst arising from the cell rests of the dental lamina. Orthokeratinized odontogenic cyst a clinicopathologic. Treatment modalities range from marsupialization to enucleation and are based on the premise that the pathological process can be controlled locally with minimal injury to. Several studies subsequently discussed the true nature and the histopathological classification of oocs 2,3. The suggestive etiology for okc is either from epithelial remnants of tooth germ in the mandible and maxilla or the. In this case report, we are highlighting an unusual presentation of okc with paresthesia, nonvital teeth, and minimal cortical expansion. There is a critical account of the group of lesions which includes the gingival cyst of adults, lateral periodontal cyst, hotryoid odontogenic cyst and glandular. Orthokeratinized odontogenic cyst ooc is a developmental cyst of odontogenic origin and was initially defined as the uncommon orthokeratinized variant of the odontogenic keratocyst okc, until the world health organizations whos classification in 2005, where it was separated from the keratocystic odontogenic tumor kcot. Clinically, it presents no tendency to relapse due to low local aggressiveness, and. Expression of proliferation markers ki67 and cyclin d1 in.
Radicular cyst, dentigerous cyst, surgical cyst management, cyst pathology. Orthokeratinized odontogenic keratocyst is a lessaggressive nonsyndromic variant of odontogenic keratocyst okc. The orthokeratinized odontogenic cyst ooc was first identified by wright in 1981 as an individual entity distinct from other odontogenic cysts 1. Orthokeratinized odontogenic cyst in a hong kong community. This report describes a case of ooc involving the right posterior mandible in a 14yearold female patient.
It has long been documented and established that in addition to odontogenic keratocyst okc, the majority of. Nonodontogenic cyst definition of nonodontogenic cyst by. Immunohistochemical study of the orthokeratinized odontogenic. Introduction classification types of odontogenic cysts conclusion reference 3.
A case presented is a 38yearold man with intraosseous keratinizing epidermoid cyst in the mandible, the wall of which. Cyst is defined as a pathological cavity filled with fluid which is solid semisolid or gaseous form which may or may not be. Prevalence profile of odontogenic cysts and tumors on. An aggressive orthokeratinized odontogenic cyst of the.
Who defined it as a cystic lesion in which the epithelial lining shows a welldefined basal layer of columnar cells, an overlying layer that is often many cells thick and that may resemble stellate reticulum, and masses of ghost epithelial cells that may be in the epithelial cyst lining or in the fibrous. The most frequent odontogenic cyst of teeth bearing areas is the radicular cyst, also called periapical cyst. Although orthokeratinized odontogenic cyst ooc was first described as early as in 1927 by schultz 1, it was first considered to be a variant of okc. They were originally believed to be part of the spectrum of odontogenic keratocyst, but are now considered to be a distinct entity. The orthokeratinized odontogenic cyst ooc 1 was first clearly identified as an orthokeratinzed variant of the odontogenic keratocyst by wright in 1981 2 owing to its different histopathology and reduced likelihood to recur. Quizlet flashcards, activities and games help you improve your grades. Ki67 and cyclin d1 in the odontogenic keratocyst and orthokeratinising jaw cyst johannesburg 20 fatima gani 91720 a research report submitted to the faculty of health sciences, university of witwatersrand, johannesburg, in partial fulfillment of the degree of master of science in the branch of dentistry. Our study showed a higher occurrence of radicular cysts which is in contrary to other studies that have reported dentigerous cyst to be the commonest cyst in children. On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency dark area. This case report describes a rare malignant transformation of ooc, with the aim of raising awareness of the malignant potential of ooc and distinguishing it from okc.
Orthokeratinized odontogenic cyst ooc is a developmental cyst that occurs mostly in the maxillary corpus, it was initially defined by the world health organization in 1992 as the uncommon orthokeratinized type of odontogenic keratocyst okc sciubba jj et al, 1999. Odontogenic keratocyst associated with an ectopic tooth in the. Orthokeratinized odontogenic cyst ooc is also a developmental cyst occurring in the tooth bearing regions of jaws and is defined by the world health organisation as the uncommon orthokeratinized type of odontogenic keratocyst okc. Also called as odontogenic ghost cell cyst or gorlin cyst.
The epithelial lining of odontogenic keratocysts exhibits either parakeratosis or orthokeratosis. Orthokeratinized odontogenic cyst ooc is a relatively uncommon developmental cyst comprising about 10% of cases that had been previously coded as odontogenic keratocysts okcs. It is most common in people in their second to third decades but can be seen at almost any age. Odontogenic cysts oc are epithelial lined cystic lesions of the jaws. We described a case of orthokeratinized odontogenic cyst originated from a dentigerous cyst in a 30yearold female discovering accidentally in routine radiography. Apr 28, 2009 cartilaginous metaplasia is a rare but welldocumented phenomenon occurring in the wall of odontogenic keratocyst. The purpose of this report is to document the clinical, radiographic, pathological and molecular findings of the first case of multiple orthokeratinized odontogenic cysts oocs. Orthokeratinized odontogenic cyst of the mandible with. Orthokeratinized odontogenic cyst ooc is a relatively rare lesion of the jaws, mainly located in the posterior segment of the mandible 1,3. This obviously requires a compliant and dextrous patient who would be able to maintain hygiene.
On clinical examination, a painless swelling on right side of face was noted. Sep 30, 2012 eruption cyst is defined as an odontogenic cyst that surrounds a tooth crown that has erupted through bone but not soft tissue and is clinically visible as a soft fluctuant mass on the alveolar ridges 15. It has long been documented and established that in addition to odontogenic keratocyst okc, the majority of odontogenic cysts produce orthokeratin. Histologically, it bears a resemblance to lateral periodontal cyst lpc, botryoid odontogenic cysts bocs, radicular and residual cysts with mucous metaplasia. Orthokeratinized odontogenic cyst arising from dentigerous. Case report malignant transformation of an odontogenic cyst. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. Orthokeratinized odontogenic cyst ooc is a rare intraosseous cyst characterized by an orthokeratinized epithelial lining and minimal clinical aggressiveness 1.
Ky why is an odontogenic keratocyst often difficult to diagnose. In 2005, the who classified odontogenic keratocysts with parakeratosis as keratocystic odontogenic tumors kcot. Odontogenic keratocyst okc is an aggressive cyst and its recurrence is higher than other odontogenic cysts, orthokeratinized odontogenic cyst ooc is a cyst with moderate biological behavior in. Orthokeratinized odontogenic cysts ooc are developmental odontogenic cysts characterised by an orthokeratinized stratified squamous epithelial lining. Radicular cysts are rare in the primary dentition, representing only 0. Orthokeratinized odontogenic cyst ooc is a relatively rare lesion of the jaws, mainly located in the posterior segment of the mandible. Orthokeratinized cyst 7 6 1 0 3 0 3 0 1 0 0 0 eruption cyst 1 0 1 0 0 0 0 0 0 0 1 0 paradental cyst 5 4 0 1 0 0 4 0 0 0 0 0 total 470 228 205 37 47 4 175 2 111 7 81 6 a anterior, p posterior, u unstated in some counties to. This decompression facilitates a reduction in the size of the cyst and so, at a later an odontogenic cyst is a pathological. Because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. The orthokeratinized odontogenic cyst ooc is a developmental odontogenic cyst relatively rare, arising from the cell rests of the dental lamina.
Effective management of large radicular cysts using surgical. The odontogenic cysts are a diverse groups of odontogenic lesions of the jaws the radicular cyst is an inflammatory lesion, and although by far the most common, it is clinically easy to diagnose and manage other cysts are less frequently encountered and some e. For some, this term is used to characterize a dentigerous cyst suspected to be induced by inflammation rather than a developmental odontogenic cyst others use the term paradental cyst synonymously with buccal bifurcation cyst. A follicular cyst, or dentigerous cyst is a developmental odontogenic cyst which develops around the fullyformed crown of an unerupted tooth. The aim of this study was to evaluate the impact of the reclassification of odontogenic keratocyst okc as a tumor on the prevalence profile of odontogenic cysts ocs and odontogenic tumors ots.
The pathogenesis of the three common forrns of odontogenic cyst is discussed. Dentigerous cyst is the second most common form of benign developmental odontogenic cysts. The databases searched were the pubmed interface of medline and lilacs. An abnormal space within tissue lined by epithelium. Carcinoma ex odontogenic cyst very rarely, the stratified squamous lining of an apical or residual cyst undergoes dysplastic change and may then evolve into a squamous cell carcinoma microscopically, one sees a cyst lining with dysplastic change and invasive islands of carcinoma are evident in the fibrous tissue of the cyst wall. The microcysts subsequently collapse, merge and form a welldefined. Orthokeratinized odontogenic cyst ooc is a benign odontogenic cyst that rarely undergoes malignant transformation. Pdf orthokeratinized odontogenic cyst of the maxilla. Odontogenic keratocyst keratocystic odontogenic tumor, markedly inflamed dental follicle, inflamed eruption cyst. Odontogenic cysts a clinicopathological study manal a. Dentigerous cyst is the second most prevalent type of odontogenic cysts after radicular cyst. The expression of cytokeratin in keratocystic odontogenic.
The cysts are male predominant and occur 10 to 15 years earlier compared with those in the white population. This cyst has broken through the bone and the bluish. It is a rare developmental odontogenic cyst with notable presence of histopathological features which include a cystic lining demonstrating characteristic ghost. Dentistry 204 oral pathology 54 cysts of the oral region a. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Expression of p73 and trail in odontogenic cysts and tumors. Multiple odontogenic keratocysts are one of the major features of nevoid basal cell carcinoma syndrome nbccs, and loss of heterozygosity in the ptch gene, the culprit gene for nbccs, has recently been. The orthokeratinized odontogenic cyst ooc is a rare developmental odontogenic cyst that has been considered as a variant of the keratocystic odontogenic tumour kcot until wright 1981 defined it as a different entity. Ooc shows a different clinical behavior from okc and most authors have concluded that it is not associated with nevoid basal cell carcinoma syndrome nbccs 14, in which multiple okcs are one of the major features. Dentistry 204 oral pathology 59 cysts of the oral region 3 orthokeratinized odontogenic cyst originally believed to be a variant of the keratocystic odontogenic tumor, but with a much less aggressive biological behaviour. The orthokeratinized odontogenic cyst ooc was first described by schultz 1 in 1927 as a dermoid cyst, and in 1945, it was considered by philipsen 2 as an eventual type of odontogenic keratocyst okc. Odontogenic keratocyst okc is a developmental cyst of tooth origin with an aggressive behaviour including high recurrence rate. Odontogenic cysts that can be problematic because of recurrence andor aggressive growth include odontogenic keratocyst okc, calcifying odontogenic cyst.
Treatment consisted of enucleation and curettage for 22 of the lesions, resection for 2 and marsupialization for 3. Case report malignant transformation of an odontogenic cyst in aperiodof10years julianepiraginearaujo, 1 luizpaulokowalski, 2 monicaluciarodrigues, 2 osleipaesdealmeida, 3 clovisantoniolopespinto, 4 andfabioabreualves 1,5. Odontogenic cysts clinical features radiographic features differential diagnosis yasmin moidin 2008 batch al azhar dental college thodupuzha 2. Orthokeratinized odontogenic cyst ooc is a benign odontogenic cyst. Surgery is the usual treatment, and recurrence or association with gorlingoltz syndrome has rarely been described. The orthokeratinized odontogenic cyst was recognized as a variant of okc based on the presence of abundant orthokeratin in the cystic lining. Orthokeratinized odontogenic cyst is a specific type of keratinized odontogenic cysts which is completely different from keratocystic odontogenic tumor from the viewpoint of the clinical and. Radicular cysts are the most common odontogenic jaw cysts approx. References 1 sarvaiya b, vadera h, sharma v, bhad k, patel z, thakkar m. Odontogenic cysts, odontogenic tumors, fibroosseous, and. Calcifying odontogenic cyst was first described by gorlin et al. The orthokeratinized odontogenic cyst ooc is a rare developmental jaw cyst. Due to their aetiological origin, radicular cysts are always associated with the root of a nonvital tooth, and their location may be apical or lateral. Calcifying odontogenic cyst with atypical features ncbi.
Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development. Introduction a cyst is an epithelium lined sac containing fluid or semifluid material the epithelial cells first proliferate and later undergo degeneration and liquefaction grow by expansion, causing displacement of adjacent teeth. Stanford medicine school of medicine departments surgical pathology criteria odontogenic jaw cysts. In 1981, wright identified it, owing to its different histology and relatively low recurrence rate, as orthokeratinized variant of odontogenic. Odontogenic keratocyst was designated as keratocystic odontogenic tumor kcot in the new world health organization classification and ooc should be distinguished from kcot for differences in histologic features and. Orthokeratinized odontogenic cyst ooc is a relatively uncommon developmental cyst of the jaw constituting about 10%. It is a variant of the common odontogenic keratocyst okc. Orthokeratinized odontogenic cyst ooc is a rare, developmental odontogenic cyst which was considered in the past to be a variant of odontogenic keratocyst okc later renamed as keratocystic odontogenic tumor kcot. Calcifying odontogenic cyst with odontogenic keratocyst oral surg oral med oral pathol oral radiol endod 2010. Odontogenic keratocyst was designated as keratocystic odontogenic tumor kcot in the new world health organization classification and ooc should be distinguished. Could be dermal metaplasia of an odontogenic cyst especially when found in association with a tooth or epithelial remnant. The percentages of cells immunohistochemically positive for p73 were 52. Orthokeratinized odontogenic cyst ooc is a developmental cyst that occurs in the maxilla and the mandible and is defined by the world health organization as the uncommon orthokeratinized type of. Oocs were first described in 1927 by schultz 2asa variant of odontogenic keratocysts, now known as keratocystic odontogenic tumours kcots 3.
Various studies have shown that ooc has typical characteristic clinicopathologic. Orthokeratinized odontogenic cyst ooc is an odontogenic cyst was initially termed as the uncommon orthokeratinized type of odontogenic keratocyst by the world health organization. Non odontogenic jaw cysts are cysts arising from epithelial remnants of embryonic ducts left behind after embryonal facial and jaw development. Recognition of ooc as a unique entity has long been due, yet its inexplicable radiographic presentation resembling dentigerous cyst, histological likeness to odontogenic keratocyst okc and inconsistent cytokeratin expression profiles overlapping with both as well as with the epidermis, makes it rather. With irb approval, cases from the following entities were identified from archives of the uf oral pathology biopsy service 2005. They are rare, making up approximately 1% of all odontogenic cysts and they usually occur singly. Keratocystic odontogenic tumour of lesions treated in our clinic. Odontogenic cysts, nonodontogenic cysts j craniofac surg 2011. Odontogenic keratocyst was designated as keratocystic odontogenic tumor kcot in the new world health organization classification and ooc should be distinguished from. Why is its differentiation from other types of cysts important. In order to highlight the malignant potential of ooc, especially in patients with a history of recurrence and inflammation, we describe a rare case of recurrent ooc that transformed into squamous cell carcinoma after. Since the 4th edition of the world health organizations classification of head and neck tumours was published in january of 2017, the keratocystic odontogenic tumor is back into the cyst category. Calcifying odotogenic cyst is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. In contrast to other studies, the lesion was located in the body of mandible, starting from lower left canine region involving lower left premolars.
Has many features of odontogenic tumor, therefore it is placed in the category of tumors in the latest who classification of odontogenic cysts and tumors. The treatment of ooc is by enucleation and the prognosis, following enucleation is excellent with a recurrence rate of less than 2%. A clinical diagnosis of bilateral dentigerous cyst dc was rended. Orthokeratinized odontogenic cyst ooc is a relatively uncommon developmental cyst comprising about 10% of cases that had been previously coded as odontogenic keratocysts. Clinically, it presents no tendency to relapse due to low local aggressiveness, and is not associated with the nevoid basal cell carcinoma syndrome nbccs. S farooqia dental college and hospital, india keywords. A rare case report of orthokeratinized odontogenic. It arises from epithelial malassez rests in periodontal ligament as. Orthokeratinized odontogenic cyst ooc is a rare intraosseous cyst characterized by an orthokeratinized epithelial lining and minimal clinical aggressiveness. Classification of odontogenic cysts and tumors antecedents imran. Orthokeratinized odontogenic cyst critical appraisal of a distinct entity ovi dental. Recognition of ooc as a unique entity is of utmost importance as it bears resemblance to dentigerous cyst, and odontogenic keratocyst okc. Odontogenic keratocysts with orthokeratosis were not classified as odontogenic tumors, but instead referred to as orthokeratinized odontogenic cysts ooc.
The orthokeratinized odontogenic cyst ooc 1 was first clearly identified as a distinct entity by wright in 1981. The opening can also be maintained with packing material or a prosthetic bung. Neoplastic keratocystic odontogenic tumor calcifying cystic odontogenic tumor lumen cavity. Due to its different histopathology and reduced likelihood to recur, wright held it to be distinct from the parakeratotic type.
The orthokeratinized odontogenic cyst is a relatively rare developmental odontogenic cyst of the jaws that occurs predominantly in males between the third and fourth decades. According to the 2005 world health organizations classification. Glandular odontogenic cyst goc is an uncommon and aggressive jaw cyst with a high recurrence rate. Inflammatory odontogenic cysts 1 radicular cyst see od1 notes cyst at apex or around root of a nonvital tooth. The histopathological examination showed bilateral orthokeratinized odontogenic cyst. Orthokeratinized odontogenic cyst ooc, also called orthokeratinized variant of odontogenic keratocyst okc, was first described by wright in 1981. We report 15 cases of such cyst type under the term of orthokeratinized odontogenic cyst ooc and compared their clinical, histological and. Oocs were first described in 1927 by schultz as a variant of odontogenic keratocysts, now known as keratocystic odontogenic. Examining frequency data of the most common odontogenic cysts. The mural cartilage not associated with odontogenic keratocyst has been reported only once in a maxillary teratoid cyst of congenital origin to our knowledge. Introduction odontogenic cysts are probably the most common tissue degrading lesions of the maxillofacial skeleton. Odontogenic keratocysts are often difficult to diagnose because they may occur in many.
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