Radiographic features of odontogenic KERATOCYST WITH DIFFERENT

DIAGNOSTIC appeal
2.1 Overview Radiography odontogenic Keratocyst
Keratocyst odontogenic lesions can appear as unilocular, lobulated lesion and
multilocular lesions. In radiogarafi picture, most often appears in the form of the picture
radiolucent unilocular lesion surrounded by a layer of radio - opaque sclerotic form very thin.
In lobulated lesion and multilocular lesions, the presence of cortical bone is irregularly with
scalloping shape. 1,5,16
Odontogenic maxillary keratocyst the smaller size of the mandible. When enlarged,
these cysts tend to expand so that the radiographic bone expansion jawbone.

1,5,16

Normal size follicular space of less than 2.5 mm on intraoral radiographs and 3 mm on the
panoramic radiograph ; Larger spaces are considered an important diagnostic finding the
dentigerous cyst as a cyst. attached to the cemento - enamel junction. Some dentigerous cyst
looks eccentric, evolved from the lateral aspect of the follicle so that the cyst instead occupies
an area next to the crown , not on top of the crown. Cysts associated with the maxillary third
molars often grow into the maxillary antrum and its size is usually large enough before being
discovered. Cyst attached to the crown of the third molar can be extended to the mandibular
ramus.

Cysts involving the ramus of the mandible . 16

Dentigerous cyst causes a shift in the canine into space maxilary insisif antrum and lateral
shift and first premolars. 14

(Coronal CT image) Using a bone algorithm shows maxillary third molars are shifted into the
maxillary antrum space. 16
Dentigerous cyst usually has a clear cortex bounded by curved or circular outline. If
there is an infection, korteksnya lost. Shaped unilocular lesions, but the effects can result
from ridge multilocular bone wall. Dentigerous cysts are usually solitary, when seen multiple
may be accompanied with nevoid basal cell carcinoma syndrome. Radiographically, the
internal aspect of the cyst visible radiolucent except for the crown of the tooth involved.
Cysts looks translucent and compressible when the expansion of cysts causing cortical bone
resorption.
Dentigerous cysts have a tendency to shift and meresorpsi neighboring teeth. 50 %
reported no cases of dentigerous cyst that causes tooth root resorption neighbors. Cysts
usually involved teeth will shift to the apical direction. The level shift may vary. For example,
maxillary third molars or canines can be pushed to the bottom of the orbit, and mandibular
third molars can be shifted to the region kondil or coronoid or even to the inferior cortex of
the mandible. The basis of the maxillary antrum can be shifted if the cyst menginvaginasi
antrum. Cysts can also shift the inferior alveolar nerve canal toward the inferiorly. Slowgrowing cysts are also often able to expand beyond the boundaries of the cortical jaw
involved.

Distal root resorption second molar. 16

2.2 Comparison of odontogenic Keratocyst With dentigerous cyst

In the radiographic picture, shows radiolucent unilokuler dentigerous cyst associated
with the crown of unerupted tooth. The radiolucent picture clear boundary with sclerotic
border, just as odontogenic keratokista unilokuler. 1,7,9,11,12
Odontogenic keratokista derived from remnants of the growth of dental lamina or
basal epithelial cells of the oral cavity (60%) and the rest comes from the reduced enamel
dental follicle growth (40%). While dentigerous cyst of dental follicle grows on unerupted
tooth or teeth that are growing. So that these cysts are always encountered in the impacted
tooth or in infancy. 1,7,9,11,12
2.3 Comparison of odontogenic Keratocyst With Ameloblastoma
Ameloblastoma cells develop from epithelial odontogenic ameloblast which is
responsible for the formation of enamel. In certain cases of odontogenic keratokista can cause
pain while ameloblastoma is painless and slow growth.
Ameloblastoma have a higher recurrence rate (45-90%) of the odontogenic
keratokista (30-60%). Just as odontogenic keratokista, ameloblastoma is also common in the
mandibular ramus. 7,9,11,13
In the radiographic picture, often appear multilocular ameloblastoma with clear lobes.
If unilocular, it is difficult to distinguish from dentigerous cyst or jaw bone abnormalities
which gives an overview of radiolucency. 7,9,11,13
2.4 Comparison With Keratocyst odontogenic odontogenic cyst calcified
Calcifying odontogenic cyst is a type of cyst that resembles odontogenic odontogenic
keratocysts but not as aggressive as recurrent keratokista and not easy. These cysts lined by a

layer of calcification, in contrast to the keratokista odontogenic cyst wall lined by keratin.
1,7,9,11,14

Odontogenic keratokista often occurs in the posterior mandible whereas calcified

odontogenic cysts often occur in the maxilla. Odontogenic keratokista more common in
males whereas calcified odontogenic more common in women. 1,7,9,11,14
At the beginning of the growth of calcified odontogenic picture has completely radiolucent.
At the moment of maturation, will grow a calcification process which will be shown with
clear boundary picture and description of a mixed radiolucent and radio - opaque. In the
picture in the form of calcified odontogenic unilokuler, it can lead to the diagnosis of
odontogenic keratokista and ameloblastoma.
1. Dentigerous cyst
Dentigerous cyst growing from the dental follicle in tooth eruption of teeth or being in
its infancy. Most often grown in the posterior region of the mandible aik and maxillary and
generally associated with third molar teeth. These cysts are found at all ages with the greatest
incidence at age 20 years. 1,7,9,11,12
2 . Ameloblastoma
Ameloblastoma is also known by the name of adamantinoma. ameloblastoma
developing of ameloblast cell odontogenic epithelium which is responsible for the formation
of enamel. Ameloblastoma has a high recurrence rate and usually occurs near the corner of
mandibular third molar region despite the fact ameloblastoma may arise along the alveoli,
either the mandible ( 80 % ) or the maxilla ( 20 % ). Ameloblastoma develops slowly and
occurs at age 30-50 years. 1,7,9,11,12
3 . Calcified odontogenic cyst
Calcified odontogenic cyst is a non -neoplastic cystic lesion in which the epithelial
lining showing any n layer columnar cells thick and a collection of ghost cells contained in
the cyst wall. Ghost cells can be calcified. These cysts can grow at any age with the greatest
incidence in adolescence and often grow in women and is often the maxillary region. This
cyst is a cyst the only one that has a picture of a mixed calcified Lusen radio and radio
opaque. 1,7,9,11,13

REFERENCES
1. Danudiningrat CP. Kista Odontogen dan Nonodontogen. Surabaya: Airlangga
University Press, 2006: 14-24, 32-34
2. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral&Maxillofacial Pathology.
Second Edition . An imprint of Elseiver: Saunders, 2007: 594-597
3. Whaite SE et al. Essential of Dental Radiography and Radiology. Third Edition.
London : Elsevier, 2003: 296-297, 300-302, 324
4. Pogrel MA. The History of The Odontogenic Keratocyst. WB Saunders 2003: 311315
5. Rivera V, Ghanee N, Kenny EA, Dawson KH. Odontogenic Keratocyst :
Northwestern USA Experience. The Journal Contemporary Dental Practice. 2000
6. El-hajj G, Anneroth G. Odontogenic keratocysts a retrospective clinical and
histologic study. Journal Oral maxillofacial Surgery. 1996: 124-129
7. Sudiono J, Kurniadhi B, Hendrawan A. Djimantoro B. Ilmu Patologi. Jakarta : EGC,
2003 : 153-155, 171-175
8. White DK, Jenkins WS, Ford JE. Panoramic radiograph in Pathology. Atlas Oral
Maxillofacial Surgery Clinics. 2003: 25-26
9. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation. Fifth Edition.
An imprint of elseiver: Saunders 2004: 388-419
10. Gaillard
F.
Odontogenic
Keratocysts.

Mei

<http://staging.radiopaedia.trike.com.au/articles/odontogenic_keratocyst>

2008
(4

mei

2014)
11. Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology Clinical Pathology Correlations.
Fourth Edition. W.B. saunders Company, 2003 : 53-59
12. Gaillard
F.
Dentigerous
Cysts.

mei

2014

<http://staging.radiopaedia.trike.com.au/articles/dentigerous_cysts> (4 Mei 2014)

13. Gaillard
F.
Ameloblastoma.
2
Mei
2014
<http://radiopaedia.org/articles/ameloblastoma> (4 Mei 2014)
14. Pistia GD, Gerlach RF, Santos JCB, Filho AM. Odontoma-Producing Intraosseous
Calcifying

Odontogenic

Cyst:

Case

Report.

Mei

2014

<http://www.forp.usp.br/bdj/bdj12(1)/trab14121/trab14121.html> (4 mei 2014)

15. Smith IM, Harvey N, Logan RM, David DJ, Anderson PJ. Odontogenic keratocyst in
a 5-year-old child: a rare cause of maxillary swelling in children. Journal of Surgical
reconstruktion : Elseiver. 22 january 2007: 189-191
16. Rensburg LJ, paquette M, Nortje CJ. Correlative MRI and CT imaging of odontogenic
keratocyst : a review of twenty-one case. WB Saunders: Elsevier. 2003: 363-382

17. Ghali GE, Connor MS. Surgical Management of The Odontogenic Keratocyst.
Division of Oral surgery, Lousiana State University School of Medicines : Elseiver,
2003: 383-392
Asjnbdfjasbfjsdngvksdfnkgbdnfkbndkfbnk
5. Amin ZA., Amran M., Khairudin. Removal of extensive maxillary dentigerous
cyst via a CaldwellLuc procedure. Arch Orofac Sci 2008;3(2):4851.
6. Neville BW, Dam DD, Allen CM, Bouquet JE. Oral and Maxillofacial Pathology.
2nd ed. Saunders; c2001. 768p.
7. Srinivasa PT, Sujatha G, Thanvir MN, Rajesh P. Dentigerous cyst associated with
an ectopic third molar in the maxillary sinus: A rare entity. Indian J Dent Res
2007:18(3):1413.
8. Thiagarajan Balasubramanian., Dentigerous Cyst from Supernumenary Teeth. Ent
Schoolar 2012.
9. Dunlap Charles., Cysts of the Jaws. University of Missouri-Kansas City School of
Dentistry.
10. Danudiningrat CP. Kista Odontogen dan Nonodontogen. Surabaya: Airlangga
University Press, 2006: 14-24, 32-34 .
11. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral&Maxillofacial Pathology.
Second Edition . An imprint of Elseiver: Saunders, 2007: 594-597.
12. Whaite SE et al. Essential of Dental Radiography and Radiology. Third Edition.
London : Elsevier, 2003: 296-297, 300-302, 324.
13. Pogrel MA. The History of The Odontogenic Keratocyst. WB Saunders 2003:
311-315.
14. Rivera V, Ghanee N, Kenny EA, Dawson KH. Odontogenic Keratocyst :
Northwestern USA Experience. The Journal Contemporary Dental Practice. 2000.
15. El-hajj G, Anneroth G. Odontogenic keratocysts a retrospective clinical and
histologic study. Journal Oral maxillofacial Surgery. 1996: 124-129.
16. Sudiono J, Kurniadhi B, Hendrawan A. Djimantoro B. Ilmu Patologi. Jakarta :
EGC, 2003 : 153-155, 171-175.
17. White DK, Jenkins WS, Ford JE. Panoramic radiograph in Pathology. Atlas Oral
Maxillofacial Surgery Clinics. 2003: 25-26.
18. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation. Fifth
Edition. An imprint of elseiver: Saunders 2004: 388-419.
19. Gaillard
F.
Odontogenic
Keratocysts.
2
Mei
2008
<
http://staging.radiopaedia.trike.com.au/articles/odontogenic_keratocyst > (diakses
pada 4 mei 2014)
20. Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology Clinical Pathology
Correlations. Fourth Edition. W.B. saunders Company, 2003 : 53-59
21. Gaillard
F.
Dentigerous
Cysts.
2
mei
2014
<
http://staging.radiopaedia.trike.com.au/articles/dentigerous_cysts > (diakses pada
4 Mei 2014)
22. Gaillard
F.
Ameloblastoma.
2
Mei
2014
<
http://radiopaedia.org/articles/ameloblastoma > (diakses pada 4 Mei 2014)
23. Pistia GD, Gerlach RF, Santos JCB, Filho AM. Odontoma-Producing
Intraosseous Calcifying Odontogenic Cyst: Case Report. 1 Mei 2014 <
http://www.forp.usp.br/bdj/bdj12(1)/trab14121/trab14121.html > (diakses pada 4
mei 2014)

24. Smith IM, Harvey N, Logan RM, David DJ, Anderson PJ. Odontogenic keratocyst
in a 5-year-old child: a rare cause of maxillary swelling in children. Journal of
Surgical reconstruktion : Elseiver. 22 january 2007: 189-191.
25. Rensburg LJ, paquette M, Nortje CJ. Correlative MRI and CT imaging of
odontogenic keratocyst : a review of twenty-one case. WB Saunders: Elsevier.
2003: 363-382.
26. Soon Jae Hwang, HeungMan Lee, Dae Hyung Kim, Dong Jin Lee, Jang Hyeog
Lee, Jin Ho Choi, Sang Hag Lee. Dentigerous Cyst Involving the Maxillary Sinus.
J Rhinol November 2001;8(1,2):547.
27. Al-Talabani NG, Smith CJ: Experimental dentigerous cysts and enamel
hypoplasia: their possible significance in explaining the pathogenesis of human
dentigerous cysts. Journal of Oral Pathology, 1980; 9: 8291.
28. Shear M, Speight P: Cysts of the Oral and Maxillofacial Regions. 4th Edn.;
Blackwell Publishing Ltd., 2007:pp 59- 78.
29. Browne RM, Smith AJ: Pathogenesis of odontogenic cysts. In: Investigative
Pathology of the Odontogenic Cyst. CRC Press Boca Raton, 1991;pp. 88109.
30. Edamatsu M, Kumamoto H, Ooya K, Echigo S: Apoptosisrelated factors in the
epithelial components of dental follicles and dentigerous cysts associated with
impacted third molars of the mandible. Oral Surgery, Oral Medicine, Oral
Pathology, Oral Radiology and Endodontics, 2005; 99: 1723.
31. Main DMG: The enlargement of epithelial jaw cysts.Odontologisk Revy, 1970(b);
21: 2949. as cited in Shear M, Speight P, (2007) vide infra.
32. Kavita R, Smitha, Umadevi HS, Priya NS. Clinicopathological study of 100 odontogenic
cysts reported at V S Dental College- a retrospective study. J Adv Dental Research. 2011 Jan;
2(1): 51-57.
33. Dunfee BL, Sakai O, Pistey R et-al. 2006. Radiologic and pathologic
characteristics of benign and malignant lesions of the mandible. Radiographics. 26
(6): 1751-68.