Abstract

PATHOGENESIS OF KERATOCYSTIC ODONTOGENIC TUMOR - A REVIEW

Dr. Himanshu Thukral*, Praveen Kumar Singh, Rashi Jaiswal, Rahul Kukreja, Jayant Kumar Gahlot and Anuridhi Choudhary

ABSTRACT

Cyst formation, like the development of neoplasms, involves a dysregulation of the balance between cell proliferation and cell death. Induced proliferation of epithelial cell rests (rests of Serres or Malassez) in the jaw region plays an important role in the pathogenesis of odontogenic cysts. Factors such as inflammation or trauma stimulate epithelial rests to proliferate sealing off the inflamed or traumatized region from the surrounding healthy tissues. Odontogenic Keratocyst, another common cyst arising from dental lamina or remnants of the dental lamina, has been deeply studied due to its aggressive clinical behavior with high recurrence rates, distinct histopathologic features, singular growth mechanism, and genetic alterations. It may also be associated with the Nevoid Basal Cell Carcinoma Syndrome (NBCCS), an autosomal-dominant disease characterized by several developmental abnormalities and a predisposition to neoplasm development. The potential for aggressive clinical behaviour and local recurrence resulted in its recent classification as a benign odontogenic tumor with a new nomenclature: keratocystic odontogenic tumor. Several studies have demonstrated the higher proliferation activity of the epithelial lining in keratocystic odontogenic tumors (KCOTs) in relation to odontogenic cysts. Thus a review of the histopathological features, biological behaviour and a contemporary outline of the molecular (growth factors, p53, PCNA and Ki-67, bcl-2) and genetic (PTCH, SHH) alterations associated with this odontogenic neoplasm was done, providing a thorough understanding of the physiopathological mechanisms involved in the development of this neoplasm of the jaws. There are, indeed, significant differences on the molecular level between KCOT and other odontogenic cystic lesions, suggestive of a different biological behaviour.

Keywords: Apoptosis, Keratocystic Odontogenic Tumor, Odontogenic Cysts.