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The Chinese Journal of Dental Research

Year 2002
Volume 5 , Issue 2

Pages: 47 - 54

Orthokeratinized Odontogenic Cyst: A New Clinicopathological Entity?

Tie Jun Li, DDS, MS, PhD/Hai Yan Luo, DDS, MS/Shi Feng Yu, DDS, MS

Objective: It has been suggested that intraosseous jaw cysts with a solely orthokeratinized lining epithelium differ from typical odontogenic keratocysts (OKC) by exhibiting a less aggressive behavior. Our objective is to ascertain the clinicomorphological features and biological behavior of this cyst group: 20 cases of “orthokeratinized odontogenic cyst (OOC)” were reported. Methods: Clinical, histological and immunohistochemical examinations were carried out on OOC from 20 patients and comparisons were made between OOC and OKC. Results: The cysts in the present series were all solitary intraosseous lesions that represent approximately 9.9% of all cases of OKC seen in our hospital over a 15-year period. Of the 20 patients, 14 were male and 6 female. The age at diagnosis ranged from 13 to 68 years (mean 39.1) and peaked at the third and fourth decades (55%). Eighteen cysts (90%) occurred in the mandible, only 2 cases in the maxilla, with a predilection for the posterior mandible areas. Follow-up of 15 patients, 14 of whom were treated by simple enucleation, revealed no recurrence over a period of 6 months to 15 years after surgery. None of the patients had any association with the nevoid basal cell carcinoma syndrome. Furthermore, histological and immunocytochemical comparison between OOC and OKC revealed marked differences in their morphology and epithelial expression. The lining epithelium of OOC lacked the typical features of OKC and appeared to show a lower proliferative activity. Conclusion: These findings suggest that OOC is clinicopathologically distinctive from other types of odontogenic cyst and may thus constitute its own clinical entity.



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