A. Hertwig's epithelial root sheath
B. The reduced enamel epithelium
C. Remnants of the dental lamina
D. A pre-existing osteoma
The correct answer is: B. Reduced enamel epithelium.
Keratocysts differ from other odontogenic cysts in their microscopic appearance and clinical behavior.
They may resemble periodontal, primordial, or follicular cysts. Usually, they cannot be distinguished
radiographically.
Clinical features:
• Wide age range. peak occurrence in 2nd and 3rd decades
• Lesions found in children are often reflective of multiple odontogenic keratocysts as a component
of the nevoid basal cell carcinoma syndrome
• More common in males than females
• The chief site of involvement is the mandible, in approximately a 2 to 1 ratio
• In the mandible. most occur within the posterior portion of the body and ramus region
• Typically asymptomatic
Radiographic features:
• Well-demarcated area of radiolucency with a scalloped, radiopaque margin
• Unilocular or multilocular
Microscopicall y:
• The lining epithelium is thin and parakeratinized.
• The basal layer is palisaded with prominent, polarized, and intensely staining nuclei of uniform
diameter
• The lumen may contain large amounts of keratin debris or clear fluid similar to serum transudate
• The parakeratotic type fonns 85 to 95% of all odontogenic keratocysts; the balance is made
up of the orthokeratinized variant.
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