FROM INCIDENTAL FINDING TO DEFINITIVE DIAGNOSIS: MULTIMODAL RADIOGRAPHIC ASSESSMENT OF A PARAKERATINIZED ODONTOGENIC KERATOCYST OF THE MANDIBULAR RAMUS: A CASE REPORT

Abstract

Background: Odontogenic Keratocyst (OKC) is a developmental odontogenic cyst characterized by a distinctive parakeratinized epithelial lining and a tendency to grow extensively within the medullary spaces of the jaws. It demonstrates a predilection for the posterior mandible and ramus and may remain clinically silent despite considerable radiographic extension. Case presentation: A 54-year-old male presented for routine dental evaluation, during which an asymptomatic multilocular radiolucency was incidentally detected in the right mandibular ramus. Panoramic, periapical and Donovan’s radiographs demonstrated a well-defined corticated lesion with buccal cortical expansion associated with impacted 48. CBVI revealed cortical thinning and lingual breach. Histopathology confirmed Parakeratinized Odontogenic keratocyst. Conclusion: This case emphasizes that OKC may remain asymptomatic and be discovered incidentally on routine radiographic examination. Careful interpretation of conventional radiographs supplemented by specialized intraoral projections such as Donovan’s technique can provide useful information regarding lesion extent and cortical expansion. Histopathological examination remains essential for definitive diagnosis.