Overview
Odontogenic keratocysts are benign but locally aggressive odontogenic tumors that arise from the dental lamina or remnants of the dental pulp. They are characterized by their cystic lining and potential for recurrence if not adequately managed 2.Diagnosis
Imaging (e.g., MRI) can help assess abscess size and associated edema patterns, particularly useful in odontogenic neck abscesses 1.
Histopathological examination is essential for definitive diagnosis, identifying the characteristic keratin-filled lining and other microscopic features 2.Management
Enucleation: Involves complete removal of the cyst wall, often with adjuvant therapies like Carnoy solution, cryotherapy, or peripheral ostectomy to reduce recurrence risk 2.
Decompression: Involves marsupialization to drain the cyst, sometimes followed by residual cystectomy, generally considered less complex but may require additional procedures for complete management 2.Special Populations
No specific guidance provided in the abstracts for pregnancy, pediatrics, or elderly patients regarding odontogenic keratocysts management [].Key Recommendations
For managing odontogenic keratocysts, enucleation with adjuvant therapies may be more effective in preventing recurrence compared to decompression alone, though decompression can be less complex initially 2 (Evidence: Moderate).
MRI findings, particularly the presence of mediastinal edema, can predict the likelihood of Streptococcus anginosus group (SAG) bacteria involvement in odontogenic neck abscesses, aiding in targeted antibiotic therapy 1 (Evidence: Moderate).
Histopathological confirmation is crucial for diagnosing odontogenic keratocysts due to the characteristic features observed under microscopy 2 (Evidence: Expert opinion).References
1 Lääveri M, Heikkinen J, Happonen T, Sirén A, Nurminen J, Vierula JP et al.. Odontogenic neck abscesses caused by Streptococcus anginosus group bacteria: emergency MRI findings. Oral surgery, oral medicine, oral pathology and oral radiology 2025. link
2 Kinard BE, Chuang SK, August M, Dodson TB. For treatment of odontogenic keratocysts, is enucleation, when compared to decompression, a less complex management protocol?. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2015. link
3 Sakai H, Mori T, Iida T, Tokuma Y, Maruo K, Masegi T. Immunohistochemical features of proliferative marker and basement membrane components of two feline inductive odontogenic tumours. Journal of feline medicine and surgery 2008. link