Sub-epithelial hyalinization, incomplete cystic lining, and corrugated surface could be a predictor of recurrence in Odontogenic Keratocysts

Dominic Augustine; Roopa S Rao; Surendra Lakshminarayana; Kavitha Prasad; Shankargouda Patil

doi:10.1016/j.jobcr.2021.05.003

Sub-epithelial hyalinization, incomplete cystic lining, and corrugated surface could be a predictor of recurrence in Odontogenic Keratocysts

J Oral Biol Craniofac Res. 2021 Jul-Sep;11(3):423-429. doi: 10.1016/j.jobcr.2021.05.003. Epub 2021 May 12.

Authors

Dominic Augustine¹, Roopa S Rao¹, Surendra Lakshminarayana¹, Kavitha Prasad², Shankargouda Patil³

Affiliations

¹ Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, 560054, Karnataka, India.
² Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, 560054, Karnataka, India.
³ Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Abstract

Background: Odontogenic Keratocysts (OKCs) are known for their rapid growth and tendency to invade the adjacent tissues. Its high recurrence rate (2.5%-62%) has attracted many kinds of research to identify new parameters to predict recurrence that would enable better treatment outcomes for such patients. The present study aims to correlate Sub-Epithelial Hyalinization (SEH) that has not been explored in an Asian population to date and other histopathologic features of OKC to its recurrence propensity.

Materials & methods: A total of 60 OKCs were analyzed for histopathologic correlation of thickness of lining, complete/incomplete lining, corrugated surface, ortho/para keratinization, intercellular edema, reversed polarity, basilar hyperplasia, the palisading arrangement of basal cells, presence/absence of rete pegs, folding of the epithelium, epithelial/connective tissue separation, SEH, basal offshoots, daughter cysts and inflammation with recurrence to arrive at the most significant histologic feature predicting recurrence.

Results: The most significant histologic parameter differentiating recurrent and non-recurrent OKCs was the presence of SEH (p = 0.004), incomplete lining epithelium (p = 0.023), and a corrugated surface (p = 0.049). Several other histologic parameters evaluated did not statistically correlate with recurrence, this can be attributed to the smaller sample size considered in the present study.

Conclusion: SEH is a reliable histologic parameter to predict recurrence in OKCs. The presence of SEH is indicative of a higher recurrence potential in OKCs. Evaluation of histological parameters and their correlation with recurrence in OKCs on a larger sample size could validate the results of the current study undertaken and potentially unravel more insights on predicting recurrence.

Key messages: Sub-epithelial hyalinization is a significant feature for predicting recurrence in OKC.

Keywords: Corrugated; Daughter cyst; Odontogenic keratocyst; Recurrence; Subepithelial hyalinization.