Page 71 - 7. FINAL draft Compendium 2019 2020_22072022

CONSERVATIVE SURGICAL APPROACH TO ODONTOGENIC KERATOCYST IN CHILDREN: A
CASE REPORT

Kuppusamy R, Sharif JM, Raja Shahardin RZ, Sockalingam G

Introduction: Odontogenic keratocyst (OKC) is classified as a developmental odontogenic
cyst and is thought to originate from the dental lamina. It is considered a benign unicystic
or multicystic intraosseous neoplasm with aggressive behaviour, able to invade adjacent
tissue and high recurrence rate. OKC comprises approximately 11% of all cysts of the jaws
and involvement with impacted tooth has been reported in 25% to 40% of cases. Case
report: A 12-year-old Malay girl presented with painful right facial swelling which increased
in size for the past one month. Extraoral examination revealed facial asymmetry with
diffuse, painful swelling on the right cheek. Intraorally noted a diffused swelling of the
buccal vestibule extending from 12 to 15 with palatal expansion. Tooth 53 was retained
and firm. Orthopanthomogram (OPG) radiograph showed a well defined unilocular
radiolucency associated with impacted 13. Complete enucleation of the lesion together
with the impacted 13, chemical curettage with Carnoy’s solution and placement of bismuth
iodoform paraffin paste (BIPP) was done under general anaesthesia. The histopathological
examination confirmed OKC. Second operation was carried out for further exploration,
followed by changed of BIPP on monthly basis, until the cavity was finally closed up. Patient
was reviewed closely for the past 2 years and no sign of recurrence. Conclusion: This
present case enlightened on a conservative approach with low morbidity of managing OKC
in growing children. Since OKC has a high recurrence rate, long term follow-up with
radiograph investigation is highly suggested of at least duration of 5 years.

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Presented at the 5 MAPD Biennial Scientific Conference & Trade Exhibiton on 13 April 2019
Dr Radhadevi Kuppusamy
Dr Raja Zarina Raja Shahardin
Dr Ganasalingam A/L Sockalingam
Department of Paediatric Dentistry
Tunku Azizah Hospital
Kuala Lumpur
Dr Jama’iah Mohd Shariff
Dental Centre
Sunway Medical Centre Sdn. Bhd
Selangor Malaysia

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