The orthodontic-surgical management of a patient with gorlin syndrome: a case report Madeleine Storey Susi Caldwell Simon Watkinson Manu Patel Dental Update 2024 46:11, 707-709.
Authors
MadeleineStorey
BDS(Hons), MFDS, MRes, MOrth, Post CCST Registrar in Orthodontics, Manchester Foundation Trust
This case report describes the management of a patient following the incidental finding of multiple odontogenic keratocysts on an orthopantomogram by the patient's general dental practitioner (GDP). The cysts were extensive and had caused considerable displacement of the unerupted permanent teeth. Following marsupialisation, the teeth were aligned orthodontically. This article describes the features of odontogenic keratocysts, the associated Gorlin syndrome, and the management options available. The importance of close collaboration between the Oral and Maxillofacial Surgical and Orthodontic teams is highlighted.
CPD/Clinical Relevance: Odontogenic keratocysts are benign but locally aggressive jaw cysts. They occur most commonly as solitary lesions in the jaws of healthy individuals, but may also be a feature of Gorlin syndrome. In young patients there is potential for severely displaced teeth to improve their position spontaneously and erupt.
Article
Odontogenic keratocysts (OKCs) were first described in the literature by Philipsen in 1956.1 They are thought to arise from the remnants of the dental lamina which persists after the completion of odontogenesis.2 OKCs are benign but locally aggressive. They occur most commonly as solitary lesions in the jaws of healthy individuals and show a high incidence of recurrence if not adequately removed.
Epidemiological data vary considerably: OKCs account for between 2% and 11% of all jaw cysts and can occur at any age. They are more common in males than females with a male:female ratio of approximately 2:1. However, this is closer to unity in Caucasian populations and greater in Afro-Caribbean patients.3
Odontogenic keratocysts are usually asymptomatic and are, therefore, commonly diagnosed as incidental findings on dental radiographs, often whilst investigating the cause and location of unerupted teeth. When they do cause symptoms, these can be in the form of pain, swelling and discharge, often as a result of secondary infection. The majority (over 70%) occur in the mandible with approximately half of these occurring at the angle of the mandible.3
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