Odontogenic Keratocysts – A Case-based Clinical Review

Odontogenic keratocysts (OKCs) are unique jaw cysts distinguished by their aggressive behavior and high recurrence rates. This report presents a case of a 13-year-old male with a marked swelling on the left side of the palate, associated with pain in adjacent teeth, persisting for 6 months. Clinical evaluation revealed stable vital signs and no systemic symptoms, while computed tomography confirmed an expansile, cystic lesion suggesting odontogenic origins. Surgical intervention was performed under general anesthesia, involving the elevation of a mucoperiosteal flap, complete excision of the cystic lining, and removal of two impacted teeth. Curettage was conducted with povidone–iodine to minimize postoperative infection risks. The area was meticulously closed, and the patient experienced an uneventful recovery, allowing for discharge on the 2 nd postoperative day. Histopathological analysis revealed distinctive features of an OKC, including corrugated surfaces and palisaded basal cells. These findings underscore the importance of regular follow-up for recurrence in such cases. OKCs are most prevalent in younger populations, particularly males aged 10–40, and represent approximately 2% to 11% of all odontogenic cysts. The clarity in their clinical presentation, often asymptomatic, combined with their potential for aggressive behavior, necessitates careful surgical management. Current treatment strategies involve surgical excision, potentially supplemented by adjunctive therapies to reduce recurrence rates, which vary significantly. Long-term follow-up is critical for early detection of recurrences. Understanding the pathogenesis and genetic associations of OKCs will guide future treatment paradigms, ultimately aiming to enhance patient care and outcomes in those affected by this complex cystic disease.