Conservative Management of a Parakeratinized Odontogenic Keratocyst in the Anterior Maxilla: A Case Report

Hamed  Gheibollahi; Hamed  Moradi

doi:10.18502/ssu.v33i8.20045

Hamed Gheibollahi Department of Oral and Maxillofacial Surgery, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Hamed Moradi Department of Oral and Maxillofacial Surgery, Dental School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ssu.v33i8.20045

Keywords: Odontogenic keratocyst، Parakeratinized، Marsupialization، Enucleation، Maxilla، Conservative treatment.

Abstract

Introduction: The odontogenic keratocyst (OKC) is a highly aggressive lesion that exhibit a significant recurrence rate. Its occurrence in the anterior maxilla is rare and presents distinct treatment difficulties due to its proximity to vital anatomical structures.

Case Report: A 57-year-old male patient presented with a chronic، painless swelling in the anterior maxilla. Radiographic and histopathological examinations confirmed the diagnosis of a parakeratinized OKC. Given the large size of the lesion and its sensitive location، a conservative two-stage treatment approach was implemented. This included initial marsupialization، then a postponed enucleation with peripheral ostectomy after 8 months. Marsupialization resulted in a significant reduction in lesion size and notable bone density improvement، as evidenced on the 6-month follow-up panoramic radiograph. The second-stage enucleation was subsequently performed without any complications.

Conclusion: Staged management of parakeratinized OKCs in anatomically sensitive areas، such as the anterior maxilla، can serve as an effective and minimally invasive treatment option، preserving adjacent structures. Long-term follow-up is essential to monitor for potential recurrence.