Surgical therapy of keratocystic odontogenic tumors

Oh, Ji-Su;Kim, Su-Gwan

  • Received : 2015.07.24
  • Accepted : 2015.12.11
  • Published : 2015.12.30


Objectives: Since World Health Organization reclassified the odontogenic keratocyst as a keratocystic odontogenic tumor(KCOT) in 2005, management of KCOT remains controversial. The purpose of the this study is to present a current concept of the treatment of the KCOT. Methods: Recent articles were focused on the method of the surgical therapy and the recurrence rate of KCOT. Results: The treatment modality is divided into conservative treatment-such as simple enucleation with or without curettage or marsupialization-and aggressive treatment including peripheral ostectomy, chemical curettage with Carnoy's solution, and resection. Conclusions: Keratocystic odontogenic tumors have higher recurrence rates than other odontogenic lesions; thus, the selected type of treatment is very important.


decompression;jaw cyst;odontogenic cyst;recurrence


  1. Kaczmarzyk T, Mojsa I, Stypulkowska J. A systematic review of the recurrence rate for keratocystic odontogenic tumour in relation to treatment modalities. Int J Oral Maxillofac Surg 2012; 41(6): 756-67.
  2. Sansare K, Raghav M, Mupparapu M, Mundada N, Karjodkar FR, Bansal S, et al. Keratocystic odontogenic tumor: systematic review with analysis of 72 additional cases from Mumbai, India. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115(1): 128-39.
  3. Philipsen HP. Keratocystic odontogenic tumour. In: World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. Edited by Barnes L EJ, Reichart P, Sidransky D: Lyon : International Agency for Research on Cancer; 2005: 306-7.
  4. Madras J, Lapointe H. Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumour. J Can Dent Assoc 2008; 74(2): 165-65.
  5. Telles DC, Castro WH, Gomez RS, Souto GR, Mesquita RA. Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization. Braz Oral Res 2013; 27(6): 496-502.
  6. Morgan TA, Burton CC, Qian F. A retrospective review of treatment of the odontogenic keratocyst. J Oral Maxillofac Surg 2005; 63(5): 635-9.
  7. Johnson NR, Batstone MD, Savage NW. Management and recurrence of keratocystic odontogenic tumor: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116(4): e271-6.
  8. Jafaripozve N, Jafaripozve S, Khorasgani MA. Kerathocyst Odontogenic Tumor: Importance of selection the best treatment modality and a periodical follow-up to prevent from recurrence: a case report and literature review. Int J Prev Med 2013; 4(8): 967-70.
  9. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral &Maxillofacial Pathology. 2nd ed. Philadelphia: WB Saunders; 2002: 493-540.
  10. Nayak MT, Singh A, Singhvi A, Sharma R. Odontogenic keratocyst: What is in the name? J Nat Sci Biol Med 2013; 4(2): 282-5.
  11. Hong YY, Yu FY, Qu JF, Chen F, Li TJ. Fibroblasts regulate variable aggressiveness of syndromic keratocystic and non-syndromic odontogenic tumors. J Dent Res 2014; 93(9): 904-10.
  12. Nakamura N, Mitsuyasu T, Mitsuyasu Y, Taketomi T, Higuchi Y, Ohishi M. Marsupialization for odontogenic keratocysts: long-term follow-up analysis of the effects and changes in growth characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94(5): 543-53.
  13. Simiyu BN, Butt F, Dimba EA, Wagaiyu EG, Awange DO, Guthua SW, et al. Keratocystic odontogenic tumours of the jaws and associated pathologies: a 10-year clinicopathologic audit in a referral teaching hospital in Kenya. J Craniomaxillofac Surg 2013; 41(3): 230-4.
  14. Marker P, Brondum N, Clausen PP, Bastian HL. Treatment of large odontogenic keratocysts by decompression and later cystectomy: a long-term follow-up and a histologic study of 23 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82(2): 122-31.
  15. Finkelstein MW, Hellstein JW, Lake KS, Vincent SD. Keratocystic odontogenic tumor: a retrospective analysis of genetic, immunohistochemical and therapeutic features. Proposal of a multicenter clinical survey tool. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116(1): 75-83.
  16. Boffano P, Ruga E, Gallesio C. Keratocystic odontogenic tumor(odontogenic keratocyst): preliminary retrospective review of epidemiologic, clinical, and radiologic features of 261 lesions from University of Turin. J Oral Maxillofac Surg 2010; 68(12): 2994-9.
  17. de Molon RS, Verzola MH, Pires LC, Mascarenhas VI, da Silva RB, Cirelli JA, et al. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: A case report and literature review. Contemp Clin Dent 2015; 6(Suppl 1): S106-10.
  18. Gosau M, Draenert FG, Muller S, Frerich B, Burgers R, Reichert TE, et al. Two modifications in the treatment of keratocystic odontogenic tumors(KCOT) and the use of Carnoy's solution(CS)--a retrospective study lasting between 2 and 10 years. Clin Oral Investig 2010; 14(1): 27-34.
  19. Mendes RA, Carvalho JF, van der Waal I. Characterization and management of the keratocystic odontogenic tumor in relation to its histopathological and biological features. Oral Oncol 2010; 46(4): 219-25.
  20. August M, Faquin WC, Troulis MJ, Kaban LB. Dedifferentiation of odontogenic keratocyst epithelium after cyst decompression. J Oral Maxillofac Surg 2003; 61(6): 678-83; discussion 83-4.
  21. Shudou H, Sasaki M, Yamashiro T, Tsunomachi S, Takenoshita Y, Kubota Y, et al. Marsupialisation for keratocystic odontogenic tumours in the mandible: longitudinal image analysis of tumour size using 3D visualised CT scans. Int J Oral Maxillofac Surg 2012; 41(3): 290-6.
  22. Chuan L, Hongzhi Z, Rui H, Yuxiang D, Ruifeng Q, Kaijin H. Clinical observation of a conservative treatment for large keratocystic odontogenic tumors in the mandible: enucleation followed by open packing. Hua Xi Kou Qiang Yi Xue Za Zhi 2014; 32(6): 566-9.
  23. Kinard BE, Chuang SK, August M, Dodson TB. For treatment of odontogenic keratocysts, is enucleation, when compared to decompression, a less complex management protocol? J Oral Maxillofac Surg 2015; 73(4): 641-8.
  24. Sanchez-Burgos R, Gonzalez-Martin-Moro J, Perez-Fernandez E, Burgueno-Garcia M. Clinical, radiological and therapeutic features of keratocystic odontogenic tumours: a study over a decade. J Clin Exp Dent 2014; 6(3): e259-64. 51408.
  25. Pogrel MA. The keratocystic odontogenic tumour (KCOT)-an odyssey. Int J Oral Maxillofac Surg 2015 May 21. [Epub ahead of print].
  26. Padaki P, Laverick S, Bounds G. Conservative management of a large keratocystic odontogenic tumour. J Surg Case Rep 2014; 2014(9)
  27. Brannon RB. The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part I. Clinical features. Oral Surg Oral Med Oral Pathol 1976; 42(1): 54-72.
  28. Titinchi F, Nortje CJ. Keratocystic odontogenic tumor: a recurrence analysis of clinical and radiographic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114(1): 136-42.
  29. Pitak-Arnnop P, Chaine A, Oprean N, Dhanuthai K, Bertrand JC, Bertolus C. Management of odontogenic keratocysts of the jaws: a ten-year experience with 120 consecutive lesions. J Craniomaxillofac Surg 2010; 38(5): 358-64.
  30. Roopak B, Singh M, Shah A, Patel G. Keratocystic odontogenic tumor: treatment modalities: study of 3 cases. Niger J Clin Pract 2014; 17(3): 378-83.
  31. Lee DG, Yoo WK. Relations between oral health status and subjective oral health recognition in Korean adolescents. J Korean Soc of Dent Hyg 2015; 15(4): 593-602.
  32. Ju OJ, Jang YJ, Jung JA. Oral health awareness and behavior affecting oral health indexes. J Korean Soc of Dent Hyg 2013; 13(1): 69-81.


Supported by : Chosun University Dental Hospital