The odontogenic keratocyst: a benign cystic tumor?

Three hundred nineteen odontogenic keratocysts from 255 patients (167 males and 88 females, a 2:1 ratio) were histologically and clinically examined. The cysts sometimes occurred as multiple or recurrent lesions or in association with Gorlin's syndrome. The rate of recurrence for the total population was 27%. The 116 patients who were tentatively diagnosed as having keratocyst prior to surgery had a recurrence rate of 26%. There was no direct correlation between a large number of different histopathologic parameters and the propensity of a lesion to recur. Based on these data, a theory for the growth mechanism of these lesions is presented, and it is that the odontogenic keratocyst should be regarded as a benign cystic neoplasm and treated accordingly.