Odontogenic Keratocyst with Atypical and Aggressive Behavior
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The Odontogenic Keratocyst (OKC) is a potentially destructive cyst with a high probability of recurrence. This pathological lesion represents about 11% of all odontogenic cysts, being considered the third most common cyst of the jaws and with a slight predilection for the male gender.

Clinically, patients affected by OKC are generally asymptomatic and 80% of them remain in this form for about 2 years. The objective of this work is to report a clinical case of a 14-year-old male patient who sought dental care with painful symptoms and facial asymmetry. After performing imaging tests, it was possible to observe an extensive radiolucent lesion with cortical bone expansion associated with tooth 17, displaced by the lesion. The initial hypothesis was a dentigerous cyst.

The lesion was enucleated and a diagnosis of OKC was determined after histopathological evaluation. The treatment of choice was the complete enucleation of the cyst. The OKC has a high rate of recurrence and, so, it is necessary to know the various risk factors that can influence the reappearance of the injury. The method of treating OKC is a controversial subject that generates much discussion.

In particular, the present case demonstrates that the odontogenic keratocyst can present atypical behavior and characteristics, with the presence of bone cortical expansion, displacement of teeth, facial asymmetry, and painful symptoms. Even with the OKC showing such aggressive biological characteristics, the treatment of choice was the complete enucleation of the cyst.

Oral & Maxillofacial Pathologists Journal
Source: http://ompj.org/files/ompj 11 2 article8-b65363d7b254794f1f3767caa3f4b75c24630300.pdf
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