Another interesting pathology case

Another interesting pathology case…A 60 year-old female came into the clinic complaining of pain and swelling in the lower left quadrant. Examination revealed an expansile lesion in the lower left vestibule with expansion of the buccal cortex of the mandible. An incisional biopsy was performed, and the diagnosis came back as Odontogenic Keratocyst (OKC). Treatment of OKC requires performing an additionial procedure of peripheral ostectomy (removing the layer of the bone that was next to the cyst in order to minimize recurrence). Studies have shown that simple enucleation (shelling out) of the cyst is associated with increased recurrence rate. This is due to the fact that OKC, being a locally aggressive cyst, invades into the adjacent bone with tiny outpouchings. These outpouchings need to be removed with peripheral ostectomy (seen here performed with a round diamond bur) in order to minimize the chance of recurrence.