Orthokeratinized versus parakeratinized odontogenic keratocyst: Our institutional experience

The odontogenic keratocyst (OKC) is quite unique among odontogenic cysts in its specific histological features and in clinical characteristics. The OKC has two variants orthokeratinized odontogenic cyst (OOC) and parakeratinized odontogenic cyst (POC), and POC is considered to be more aggressive and has a high recurrence rate. Therefore, OKC has generated considerable controversy with regard to its true nature.

The purpose of this study was to determine the differences between POC and OOC variants of odontogenic cysts on the basis of clinical as well as radiological features.

A total of 85 cases were included in the present study. There was a marked difference in the age of occurrence, sex, location and radiological presentation of both these entities.

Our institutional experience suggests that POC is more common than OOC and both the variants were commonly found in males. Most of the cases of POC were found in the third decade of life and most of the cases of OOC were frequently seen in the second, fourth and fifth decades. Mandibular posterior area was frequently occurring in both variants. Left side involvement was seen in maxilla and right side in mandible in both variants. Most of the cases were clinically diagnosed as OKC.

The treatment and prognosis varies in both the variants of OKC, hence such epidemiological studies are helpful to ensure proper treatment for these distinct entities.