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The odontogenic keratocyst (OKC), which makes up approximately 10% of odontogenic cysts, is a locally-aggressive cystic lesion that affects the maxilla or the mandible and is capable of causing major destruction. OKCs have been a topic of debate ever since they were discovered and named. The origin of OKC is still debatable, the OKC mostly occur intraosseusly and is thought to be derived from odontogenic epithelium as the dental lamina and its remnants after the organ has served its purpose. The WHO had classified OKC under 'developmental odontogenic cysts of jaw' in the 1971 and 1992 classifications . Nevertheless, the 2005 WHO classification controversially considered OKC an odontogenic neoplasm and gave it the name 'keratocystic odontogenic tumor' (KCOT) . The reasons for this change were the lesion's high recurrence rate, aggressive clinical behavior, association with nevoid basal cell carcinoma syndrome and mutations in the PTCH tumor suppressor gene. The designation of OKC changed once again in the 2017 WHO classification, reverting back to the more accepted term 'odontogenic keratocyst'. OKCs grow in an antero-posterior direction, infiltrating the cancellous bone of the jaws, often without obvious bone expansion, so it is commonly asymptomatic despite its aggressive nature. The presence of multiple OKCs is especially correlated to nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome, the radiographic appearance of OKC ranges from well-defined unilocular lesions to extensive multilocular lesions with ill-defined borders. This review will cover the history of this lesion's classification, nomenclature, as well as its histogenesis, clinical presentation, histopathology, radiography, genetics, treatment, prognosis and complications. [ABSTRACT FROM AUTHOR]

Background: Fine-needle aspiration cytology (FNAC) involves puncturing a lesion for microscopic analysis. Smears are prepared using aspirated material for cytology and for cell block (CB) preparation. FNAC is a preoperative technique and does not provide sufficient information for precise diagnosis, and the risk of false diagnosis or intermittent diagnosis always exists. To overcome the deficiencies of FNAC, the CB technique (CBT) is considered a novel innovative technique for odontogenic lesions. The present study is carried out to evaluate the efficacy of CBT in diagnosing odontogenic cystic lesions and ameloblastoma of the jaw and comparing it with aspiration cytology and histopathology. Methods: In this prospective study, 17 patients with clinical diagnosis of odontogenic cysts and ameloblastoma are obtained. FNAC smears and CBs are prepared and compared with cytology and histopathology. Results: A total of 17 cases of odontogenic cysts and ameloblastoma are divided into seven odontogenic keratocyst (OKC), three dentigerous cysts, three radicular cysts and four ameloblastoma. In seven cases of OKC, five cases (71.4%) are showing positive features and two cases (28.6%) are showing negative features. Three dentigerous and three radicular cysts are showing three positive CB features (66.7%) and three negative features (33.3%). Among four cases of ameloblastoma, two cases (50%) are showing positive CB features and two cases (50%) are showing negative features. Conclusion: CB is a novel diagnostic technique in oral pathology for odontogenic cysts, tumors, metastatic tumors and bony lesions. Compared to FNAC, it gives accurate diagnostic architecture and apparent histopathological features. This technique can be used alternative to FNAC. [ABSTRACT FROM AUTHOR]