Scientific Journal Of King Faisal University
Basic and Applied Sciences


Scientific Journal of King Faisal University / Basic and Applied Sciences

Conservative Treatment of Odontogenic Keratocyst Using a Specially Designed Acrylic Stent-Obturator: A Case Report

(Amjad Reda Al Ateyah , Mohammed M. Al Ali 1, Manaf Omar Al Habshi , Hussain Jafar Alshoulah , Abdulkader Abdulmadzhid and Mohammed H. Al Bahrani)


An odontogenic keratocyst is a common oral lesion with high recurrence rates. There is an absence of a solid treatment consensus. Recurrence rates are reported to be higher in conservative treatment options. In this case report, we present a new method, utilizing a specially fabricated acrylic stent-obturator, aiding the conservative treatment methods in order to minimize lesion recurrence. A 42-year-old Saudi male with a 3.5 x 2.5 keratocyst on the right mandibular angle was treated successfully and conservatively in full abidance by medical community standards using the stent-obturator after lesion curettage alone, with no recurrence at three year follow up.
Odontogenic keratocyst, conservative management, obturator, re-curettage


l-Bodbaij, M., Al-Ateyah, A., Chopra, R., Al-Marzooq, N. and Al-Qassab, G. (2016). Keratocystic odontogenic tumor in the maxillary sinus: A case report. Oral Health and Care, 1(1), 1–3. DOI:10.15761/OHC.1000101 
Boffano, P., Cavarra, F., Agnone, A.M., Brucoli, M., Ruslin, M., Forouzanfar, T.,  Ridwan-Pramana, A., Rodríguez-Santamarta, T., Carlos de Vicente, J., Starch-Jensen, T., Pechalova, P., Pavlov, N., Doykova, I., Gospodinov, D., Konstantinovic, V., Jovanović, M., Barrabé, A., Louvrier, A., Meyer, C., Tamme, T., Andrianov, A., Dovšak, T., Birk, A., Masu, L. and Rocchetti, V. (2021). The epidemiology and management of odontogenic keratocysts (OKCs): A European multicenter study. Journal of Cranio-Maxillo-Facial Surgery, E-pub ahead of print - 2021. DOI:10.1016/j.jcms.2021.09.022
Borghesi, A., Nardi, C., Giannitto, C., Tironi, A., Maroldi, R., Di Bartolomeo, F. and Preda, L. (2018). Odontogenic keratocyst: Imaging features of a benign lesion with an aggressive behaviour. Insights Into Imaging, 9(5), 883–97. DOI:10.1007/s13244-018-0644-z
Chouchene, F., Ameur, W.B., Hamdi, H., Bouenba, M., Masmoudi, F., Baaziz, A. Maatouk, F. and Ghedira, H. (2021). Conservative approach of a dentigerous cyst. Case Reports in Dentistry, 2021(n/a), 1–6. DOI:10.1155/2021/5514923 
Dashow, J., Helman, J.I., Edwards, S.P., McHugh, J. and Ward, B.B. (2013). Keratocystic odontogenic tumor recurrence rates with enucleation and curettage using carnoy's versus modified carnoy's solution. Journal of Oral and Maxillofacial Surgery, 71(9), 4–5. DOI:10.1016/j.joms.2013.06.008
de Castro, M.S., Caixeta, C.A., de Carli, M.L., Ribeiro Júnior, N.V., Miyazawa, M., Pereira, A.A.C. and Hanemann, J.A.C. (2018). Conservative surgical treatments for nonsyndromic odontogenic keratocysts: A systematic review and meta-analysis. Clinical Oral Investigations, 22(5), 2089–101. DOI:10.1007/s00784-017-2315-8
Goto, M., Ueda, S., Miyabe, S., Watanabe, S., Sugita, Y. and Nagao, T. (2020). A rare case of odontogenic keratocyst extending into the sphenoid bone from the maxilla. International Journal of Surgery Case Reports, 71(n/a), 132–8. DOI:10.1016/j.ijscr.2020.05.003
Hellstein, J., Hopkins, T. and Morgan, T. (2007). The history and mystery of carnoy solution: An assessment of the need for chloroform. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 103(4), n/a. DOI:10.1016/j.tripleo.2006.12.055
Mohanty, S., Dabas, J., Verma, A., Gupta, S., Urs, A.B. and Hemavathy, S. (2021). Surgical management of the odontogenic keratocyst: A 20-year experience. International Journal of Oral and Maxillofacial Surgery, 50(9), 1168–76. DOI:10.1016/j.ijom.2021.02.015
Safadi, A., Kleinman, S., Gigi, D., Wengier, A., Oz, I., Abergel, A. and Ungar, O. J. (2020). Surgical management of odontogenic cysts involving the maxillary sinus- a retrospective study. Journal of Cranio-Maxillo-Facial Surgery, 48(8), 800–7. DOI:10.1016/j.jcms.2020.06.011
Scalas, D., Roana, J., Boffano, P., Mandras, N., Gallesio, C., Amasio, M. and Cuffini, A.M. (2013). Bacteriological findings in radicular cyst and keratocystic odontogenic tumour fluids from asymptomatic patients. Archives of Oral Biology, 58(11), 1578–83. DOI:10.1016/j.archoralbio.2013.07.009
Titinchi, F. (2020). Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 46(5), 358–60. DOI:10.5125/jkaoms.2020.46.5.358
Titinchi, F. (2021). Novel recurrence risk stratification of odontogenic keratocysts: A systematic review. Oral Diseases, E-pub ahead of print. DOI:10.1111/odi.13931
Zecha, Judith A.E.M., Mendes, R.A., Lindeboom, V.B. and van der Waal, I. (2010). Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without adjunctive therapies - A 35-year single institution experience. Oral Oncology, 46(10), 740–2. DOI:10.1016/j.oraloncology.2010.07.004.