Based on a literature review, we analyzed the World Health Organization (WHO) classification and the treatment algorithm for the odontogenic keratocyst (OKC), formerly referred to as keratocystic odontogenic tumor (KCOT). The KCOT reclassification from benign odontogenic tumors to odontogenic developmental cysts resulted from the emergence of new evidence regarding their morphogenesis and biological behavior. The authors of the most recent 2017 classification do not provide specific guidelines for OKC. Nevertheless, it has been observed that conservative surgical management is not necessarily associated with recurrences characteristic of neoplastic disease. The aim of this paper was to present the effective management strategy for a local recurrence that developed following conservative OKC enucleation in a 53-year-old patient. The treatment for recurrence consisted of enucleation, marginal osteotomy and augmentation with a cancellous bone graft harvested from a tibial tuberosity. A 6-year observation period (clinical and radiological monitoring) revealed normal bone regeneration and no evidence of recurrence. The algorithm applied in our center for the treatment of OKC/KCOT was compared with the management strategies proposed by other authors.
Keywords: WHO classification; autogenic bone graft; odontogenic keratocyst; recurrence.