Evaluating histopathological factors of predicting the recurrence rate of odontogenic keratocyst

Gholam Reza Jahanshahi, Forooz Keshani, Zahra Mirkazemi, Hossein Mirkazemi


Background: Odontogenic keratocyst (OKC) is one of the most common jaw cysts with high
recurrence rate. Some possible factors affecting recurrence that have not been evaluated in previous
studies are examined in this study. This study aimed to predict the recurrence rate of OKC and more viable treatment of OKC.
Materials and Methods: In this descriptive, analytical, and cross‑sectional study, 10 recurrent
OKCs, which both slides before and after recurrence were accessible, were collected from oral
and maxillofacial pathology department’s archive. First, they were evaluated based on common
histopathologic features. In the second phase, the frequency of these findings in 36 OKCs
(24 samples with recurrence and 12 without recurrence after 5 years) was evaluated based on
clinical, radiological, and histopathologic features. Data were analyzed by SPSS, Wilcoxon signed‑rank
test, McNamara, t‑test, Chi‑square, Mann–Whitney, Fisher’s exact test, Cohen’s kappa coefficient,
and odds ratio (P < 0/05).
Results: According to this study, OKC in women, with multilocular radiolucency and mitosis
in basal layer of epithelium as well as diffused inflammation, were statistically associated with
probability of recurrence (P = 0.05, 0.035, 0.033, and 0.045, respectively). The corrugated surface,
reverse polarity, hypercellularity in parabasal, and satellite cysts can affect the recurrence of OKC
with odds ratios = 2.364, 2.364, 1.190, and 1.500, respectively).
Conclusion: Gender (women), multilocular radiolucency, diffused inflammation in stroma, and
mitosis in basal layer of epithelial lining, can statically predict the possibility of recurrence rate. In
addition, findings regarding the age (in younger patients), corrugated surface, reverse polarity, and
sub‑basal cleft can be helpful in predicting recurrence.
Key Words: Odontogenic cysts, pathology, recurrence

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