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Viva in Odontogenic Keratocyst

  1. What is an odontogenic keratocyst (OKC)?
    • A: Odontogenic keratocyst (OKC) is a developmental odontogenic cyst that arises from the dental lamina epithelium. It is a benign but locally aggressive cystic lesion.
  2. Q: What are the common locations for odontogenic keratocysts?
    • A: OKCs are often found in the mandible, with a predilection for the posterior body and ascending ramus regions.
  3. Q: What age group is commonly affected by odontogenic keratocysts?
    • A: OKCs commonly occur in the second and third decades of life, with a slight male predilection.
  4. Q: What are the clinical signs and symptoms of odontogenic keratocysts?
    • A: Patients may be asymptomatic, but swelling, pain, and paresthesia may occur. Expansion of the jaw may be observed in some cases.
  5. Q: How is odontogenic keratocyst diagnosed?
    • A: Diagnosis is typically based on clinical and radiographic findings. Panoramic radiographs and cone-beam computed tomography (CBCT) are commonly used.
  6. Q: What is the histological appearance of odontogenic keratocysts?
    • A: OKCs show a characteristic parakeratinized stratified squamous epithelial lining, often with a corrugated or “cobbled” appearance.
  7. Q: What is the recurrence rate of odontogenic keratocysts?
    • A: OKCs have a relatively high recurrence rate, ranging from 10% to 60%, even after complete surgical removal.
  8. Q: What is the treatment of choice for odontogenic keratocysts?
    • A: The primary treatment is enucleation with or without curettage. Some advocate for adjunctive treatments like Carnoy’s solution to reduce the recurrence rate.
  9. Q: What is the significance of the epithelial lining in odontogenic keratocysts?
    • A: The thin, friable epithelial lining contributes to the high recurrence rate of OKCs, as it can be difficult to remove completely during surgery.
  10. Q: How does the radiographic appearance of an odontogenic keratocyst differ from other jaw cysts?
    • A: Radiographically, OKCs often present as well-defined, unilocular or multilocular radiolucencies with a scalloped border.

Viva questions in Anatomy of Head and Neck

  1. Q: Are odontogenic keratocysts associated with any syndromes?
    • A: Yes, odontogenic keratocysts are associated with nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome).
  2. Q: What is the role of imaging techniques like CBCT in diagnosing odontogenic keratocysts?
    • A: CBCT is valuable for assessing the size, extent, and relation to adjacent structures, aiding in treatment planning and reducing the risk of recurrence.
  3. Q: Can odontogenic keratocysts be diagnosed through fine-needle aspiration (FNA)?
    • A: FNA is not commonly used for diagnosing odontogenic keratocysts due to the need for histopathological examination of the entire cyst lining.
  4. Q: What are the potential complications of odontogenic keratocysts?
    • A: Complications may include cortical plate expansion, tooth displacement, and a risk of pathological fractures.
  5. Q: How do you differentiate odontogenic keratocysts from other cystic lesions, such as dentigerous cysts, radiographically?
    • A: Dentigerous cysts are usually associated with the crown of an unerupted tooth, while odontogenic keratocysts may cause displacement of adjacent teeth without a clear association with a tooth.
  6. Q: Is there any role for molecular markers in the diagnosis or prognosis of odontogenic keratocysts?
    • A: Some studies suggest a potential role for molecular markers like PTCH (Patched) gene mutations in the diagnosis and prognosis of odontogenic keratocysts.
  7. Q: Can odontogenic keratocysts present with an impacted tooth?
    • A: Yes, odontogenic keratocysts may cause impaction of adjacent teeth due to their expansile growth.
  8. Q: How do you manage a recurrent odontogenic keratocyst?
    • A: Treatment of recurrent cases may involve more aggressive surgical approaches, such as en bloc resection, and close follow-up.
  9. Q: Can odontogenic keratocysts undergo malignant transformation?
    • A: Although rare, odontogenic keratocysts have been reported to undergo malignant transformation, typically to a squamous cell carcinoma.
  10. Q: What is the role of long-term follow-up in patients treated for odontogenic keratocysts?
    • A: Long-term follow-up is crucial to monitor for potential recurrence, especially within the first 5 years after treatment. Regular imaging and clinical examinations are recommended.

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