DREDGING- A CONSERVATIVE MODALITY TO TREAT KERATOCYSTIC ODONTOGENIC TUMOUR
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 43
Abstract
PRESENTATION OF CASE Odontogenic Keratocyst or as now better called as Keratocystic Odontogenic Tumour is a type of cyst with locally aggressive behaviour with high recurrence rate and typical histological appearance and it makes upto 11% of the total cysts of the jaws.[1] KCOTs can be seen in any part of the jaws, but has higher predilection for the body of the mandible and ascending ramus with peak incidence seen between 10- 30 years of age and a slight male predominance.[2-4] Radiographically, it can appear as either unilocular or multilocular with well-defined boundaries and scalloped and corticated margins. Its association with impacted tooth has been reported in 25% - 40% of cases.[5] Evidence shows its association with displaced, impacted or erupted teeth, displaced roots or extruded teeth.[6] These cases are usually diagnosed during routine dental examination and the frequency of these cases range from 5.5% to 42.5%.[2,7,8] The parakeratinising variant is more aggressive in terms of growth and shows recurrence post-surgical treatment. They show high level of mitosis in the cystic epithelium with high potential of budding of the basal layer and presence of the daughter cysts in the cystic wall. Usually, they are associated with naevoid basal cell carcinoma syndrome.[9,10] In the year 2005, WHO working group considered the parakeratinising variant of KCOT to be a cystic neoplasm and recommended the term “Kerato-Cystic Odontogenic Tumour.” [11] KCOT originates from remnants of the dental lamina and shows following features like sand-like stratified squamous epithelium with a spinous cell layer with a thickness of about 8-10 cells and a corrugated keratinised lining, a thin connective tissue capsule and a lumen which contains variable amounts of desquamated keratin. Parakeratin lining predominates and it is ranging from 83% to 97% in a KCOT[12-15] and has invasive properties causing local destruction and extension into adjacent tissues. The reason behind this is its active epithelial proliferation, tumour necrosis factor, prostaglandin-induced bone resorptive properties via interleukins and active collagenases in the fibrous cystic wall.
Authors and Affiliations
Ankita Parihar, Shishir Dubey
Keywords
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