Keratocysts in the jaws

Abstract

Background. Jaw cysts are a common pathology; among them, the odontogenic keratocysts (OKC) represent a special group because of their aggressive growth and recurrence.

Patients and methods. We established retrospectively the epidemiology and clinical characteristics of OKC among all the pathohistologically confirmed jaw cysts that had been surgically cured in the past ten years (from 1994 to 2003) at the Clinical Department of Maxillofacial and Oral Surgery, University Medical Centre in Ljubljana.

Results. Among 992 surgically removed jaw cysts, 106 were OKC (10.6% of all). Pathohistological diagnosis of OKC was confirmed in 90 patients, in 51 men (56.7%) and 39 women (43.4%). Mean age of patients with OKC at the time of treatment was 36 years. The youngest one was 7 years old, the oldest one 83 years. Seventy-four (69.8%) of OKC were removed from the lower jaws, 32 (30.2%) from the upper jaws. As to the location, OKC (49 cases - 46.2%) predominated in the angles and vertical branches of the lower jaw. Recurrence rate after the first removal of OKC was 22.2% (in 20 patients). First recurrence occurs most frequently (in 70%) within the first 5 years after primary treatment; the mean time till the first recurrence was 4 years and 7 months. Multiple recurrences of OKC were observed in 9 patients (10% of all patients with OKC). Five of the patients with OKC had the syndrome of basal cell carcinoma (Gorlin–Goltz Sy.). We found out that one third of OKC were clinically unexpected in regard to their untypical locations in the jaws.

Conclusions. It is critical for the jaw cysts to be pathohistologically examined. The number of cases of OKC among all jaw cysts in our study is significantly larger (3.5-time) than in the previous epidemiological study in Slovenia; but this may be the consequence of previous underdiagnosis of that pathology entity. Our study is comparative with other similar foreign studies in literature in respect to the patient’s sample and epidemiological results.