The implications of inflammation in odontogenic keratocysts

The histologic features of 112 odontogenic keratocysts (OKC's) were examined from both a clinical and histopathological perspective with emphasis on the microscopic presence of inflammation and its relationship to transformation of the classic epithelial cyst lining found in OKC's to a nonkeratinized lining characteristic of common inflammatory odontogenic cysts. Eighty-five (76%) of these cases exhibited inflammation. The sensitivity of inflammation as a predictor of this aforementioned transformation is 100%, and its positive predictive value is 88%. The specificity of the same parameters remains high at 73%. Using previous studies, the implications of these findings on the biologic behavior of OKC's is discussed with special reference to therapeutic considerations.