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Article: Volume 46 Number 5 Page 473 - May 2019

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  Dent Update 2019; 46: 473-479

Oral Surgery/Orthodontics:  Surgical/Orthodontic Management of a Large Mandibular Odontogenic Keratocyst (OKC)

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Abstract: The odontogenic keratocyst (OKC) is the third most common cyst of the jaw. OKCs are benign developmental cysts that are often locally destructive and large at presentation. They are usually identified during radiographic examination and require appropriate treatment planning to ensure optimal care. We present a very challenging case of a 12-year-old boy with a large mandibular OKC. The roots of several teeth were displaced, with both LR3 and LR5 unerupted and severely malpositioned. A multidisciplinary approach was therefore essential in view of the complexity, with joint planning and close liaison of treatment between the surgeon, orthodontist and general dental practitioner (GDP). This was fundamental to ensure the best possible outcome was achieved for the patient.

Clinical relevance: This case report aims to increase awareness of OKCs to GDPs and outlines the surgical, orthodontic and restorative challenges faced in the management of such cases.

Author notes: Amarpreet Atwal, BDS (Hons), MJDF, MOrth RCS, Post CCST Orthodontics, University of Sheffield and Royal Derby Hospital, (email: mailto:amarpreet83@hotmail.co.uk), Hannah Cottom, BDS(Hons), MJDF, FRCPath, Specialist Registrar in Oral and Maxillofacial Pathology, Royal London Hospital, Peter Doyle, FDS RCS, FRCS(OMFS), Consultant Oral and Maxillofacial Surgeon, Chesterfield Royal Hospital and Jonathan Sandler, BDS (Hons), MSc, PhD, MOrth RCS, FDS RCPS, Consultant in Orthodontics, Chesterfield Royal Hospital, Calow, Chesterfield S44 5BL, UK.

Objective: To understand the clinical and radiographic features of an OKC and its subsequent management.