ODONTOGENIC KERATOCYST: FROM CYST TO TUMOR AND BACK: AN EVOLVING PERSPECTIVE

ABSTRACT Odontogenic Keratocyst (OKC) is a benign neoplasm of odontogenic origin with the potential for aggressiveness and infiltrative behavior. Philipsen introduced the term 'odontogenic keratocyst' (OKC) in 1956 to describe jaw cysts with keratinized epithelial linings. Studies have reported a male predominance, with a peak occurrence at the age of 30 and a minor occurrence in the fifth to seventh decades of life.[1]. In 2017, it was reclassified as a cyst because numerous studies demonstrated that mutations in the PTCH gene can occur in non-neoplastic conditions, such as dentigerous cysts [4]. Diagnosis of OKC is mostly radiographic, with well-defined radiolucency with scalloped margins, either unilocular or multilocular, with anteroposterior extension. As a result of its aggressive behavior, the management of OKC remains a debatable topic in the literature. Both conservative and surgical methods, or a combination of both, are described as treatment options. These include marsupialization/decompression, enucleation, adjunct therapies like Cornoy’s solution, peripheral osteotomy, cryotherapy, 5-Fluorouracil, and marginal/segmental resection. The primary purpose of this review is to give complete insights into changes in nomenclature of OKC terminology, classification, etiopathogenesis, molecular & genetic basis, clinical, radiographical, histopathological features, immunohistochemistry, treatment options, prognosis, recurrence, and malignant transformation of OKC. Keywords: OKC, 5-Fluorouracil, cryotherapy, marsupialization, decompression, enucleation.