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MANAGEMENT OF ODONTOGENIC

KERATOCYST OF MANDIBLE WITH


SEGMENTAL RESECTION AND A-O
PLATE RECONSTRUCTION

Case Report
By
Heri Herliana, Herman Hambali, Winarno Priyanto
INTRODUCTION

 The odontogenic keratocyst (OKC) is a cystic


lesion of odontogenic origin.
 Itis one of the most aggressive odontogenic cysts
of the oral cavity.
 Rapid growth and its tendency to invade the
adjacent tissues including bone WHO made
new classification as keratocyst odontogenic
tumor (KCOT)
 Highly recurrence rate (25% – 60%)
CASE REPORT
A 18 years old male with chief complaint there
was a lump at left mandible region since
about 3 years ago, there was no pain and no
other lump found from other part of patient
body.
 Clinical
examination found a lump at left
mandible angle region extend to simphysis
region. Size 10 x 6 x 5 cm
Orthopantomogram show a multiloculer
radiolucent lesion from left mandible
angle region extend to right lower
premolar region with left lower second
premolar tooth impacted.
OPG

CLINICAL PICTURE
 Biopsy
examination revealed the
Odontogenic Keratocyst of left mandible.
 The definitive treatment was mandible
segmental resection from left angulus region
until tooth 45 region
 Then performed A-O plate reconstruction.
Intra Operation Pictures

Tumor mass with mandible Rekonstruction with A-O plate


after resection
Post Op picture
Control post op
Histopathological picture
DISCUSSION
• OKC involves approximately 11% of all
cysts in the jaws and is most often located
in the mandibular ramus and angle, with
highly recurrence rate.
• Surgical treatment methods can be
divided as conservative or aggressive.
Conservative treatment is “cyst-
oriented” and, thus, includes
enucleation, with or without curettage,
or marsupialization.
Aggressive treatment addresses the
“neoplastic nature” of the KCOT and
includes peripheral ostectomy,
chemical curettage with Carnoy’s
solution or en bloc resection
 Inthis case report we decided
to perform segmental resection
of left mandible according to
the size of lesion is quite big
about 10x6x5 cm to prevent the
recurrence.
 Thenwe did reconstruction with
A-O plate to maintain the
natural shape of mandible and
to support its physiological
function
CONCLUSION
• Odontogenic keratocysts (OKCs) or KCOT
are a benign lesion but they are often
locally destructive and tend to recur after
conservative surgical treatment.
• We reported a 18 years old male with OKC
of mandible and we perfomed a
segmental resection then reconstruction
with A-O plate.

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