Pazdera Jindrich, Kolar Zdenek, Zboril Vitezslav, Tvrdy Peter, Pink Richard
Department of Oral and Maxillofacial Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014 Jun;158(2):170-4. doi: 10.5507/bp.2012.048. Epub 2012 Jun 1.
Odontogenic keratocysts (OKCs) now reclassified as Keratocystic odontogenic tumours (KCOTs) are a clinical entity with a characteristic microscopic picture, kinetic growth and biological behaviour. They arise from the proliferation of the epithelial dental lamina in both maxilla and mandible and occur in patients of all ages. 70-80% of keratocysts are found in the mandible commonly in the angle between the jaw and mandibular branch and maxillary region of the third molar. The cysts are long latent, often symptomless and may attain remarkable dimensions without significant deformation of the jaw bones. They are often found during routine dental X-ray examination. Compared to other types of jaw cyst, odontogenic cysts have a striking tendency to rapid growth and re-occurrence.
This review focuses on the biological characteristics, clinical behaviour and treatment of KCOTs.
The databases searched were the PubMed interface of MEDLINE and LILACS.
Ondontogenic keratinocysts are not currently a diagnostic problem. Orthopantomograms which are today ordinary tools of dental investigation enable diagnosis of clinically asymptomatic cystic lesions. The problem remains the optimal therapeutic approach to reduce the still high likelihood of postoperative recurrence. There is no complete consensus on the ideal operating procedure but cystectomy with delayed extirpation is favoured. An open question also remains the timeliness of screening for postoperative recurrences. Given that the first clinical manifestation of Nevoid Basal Cell Carcioma Syndome (NBCCS) may be lesions of this type, routine histopathological classification supplemented by analysis of immunophenotype should be done. Patients with proven sporadic and especially syndromic OKC should be long term screened. In patients with NBCC preventive X ray examination is recommended only once a year.
牙源性角化囊肿（OKCs）现重新分类为角化囊性牙源性肿瘤（KCOTs），是一种具有特征性微观表现、生长动力学和生物学行为的临床实体。它们起源于上颌骨和下颌骨上皮性牙板的增殖，可发生于各年龄段患者。70% - 80%的角化囊肿见于下颌骨，常见于下颌角与下颌支之间以及第三磨牙的上颌区域。这些囊肿潜伏期长，通常无症状，在不引起颌骨明显变形的情况下可长得很大。它们常在常规牙科X线检查时被发现。与其他类型的颌骨囊肿相比，牙源性囊肿有迅速生长和复发的显著倾向。
本综述聚焦于角化囊性牙源性肿瘤的生物学特征、临床行为及治疗。
检索的数据库为MEDLINE的PubMed界面和LILACS。
目前牙源性角化囊肿并非诊断难题。口腔全景片作为当今牙科检查的常用工具，能够诊断临床上无症状的囊性病变。问题仍在于如何采用最佳治疗方法以降低术后仍较高的复发可能性。对于理想的手术操作尚无完全共识，但倾向于囊肿切除术加延期摘除术。术后复发筛查的时机也是一个悬而未决的问题。鉴于痣样基底细胞癌综合征（NBCCS）的首发临床表现可能是此类病变，应进行常规组织病理学分类并辅以免疫表型分析。确诊为散发性尤其是综合征性OKC的患者应进行长期筛查。对于NBCC患者，建议每年仅进行一次预防性X线检查。
