The Structure of Odontogenic Cysts

The macroscopic appearances of cyst walls are very variable and in general do not help in distinguishing between the different types. The surgical removal of cysts lying in bony cavities — as do the majority of odontogenic cysts — is usually accomplished by the process of enucleation whereby the fibrous tissue wall of the cyst is cleared by ‘blunt’ instrumentation from the bony wall. The epithelial lining of the odontogenic keratocyst is quite characteristic. The epithelium is composed of a layer some six to ten cells thick, although occasionally it is thicker or thinner. An outstanding feature is the remarkable consistency of the thickness of the epithelium throughout each cyst lining, in particular in those lesions which have no clinical record of inflammation. The epithelial surface is keratinized and the transition from the suprabasal cells to the keratin layer is somewhat abrupt. Mitotic figures are a prominent feature of the epithelium in odontogenic keratocysts.