Keratocyst Coexistent with Dentigerous Cyst of the Mandible: Diagnostic Challenging and Treatment Approach-Rare Two Cases

Abstract

This case report discusses the diagnostic challenges and treatment approaches for two patients presenting simultaneously with odontogenic keratocyst (OKC) and dentigerous cyst (DC) in the mandible. A 9-year-old female with hemophilia C and a 21-year-old healthy male exhibited painless mandibular swellings. Radiographic examinations revealed well-defined radiolucent lesions associated with impacted teeth, posing diagnostic difficulties. Histopathological analysis confirmed the coexistence of OKC and DC. Treatment strategies were determined based on lesion characteristics; marsupialization was performed for OKC, while enucleation was preferred for DC. The first case showed complete healing without recurrence over three years, whereas the second showed OKC recurrence after two years, necessitating reoperation. Healing was more favorable on the DC side in both cases. This report highlights the necessity of histopathological examination for accurate diagnosis and suggests that marsupialization may reduce OKC recurrence. Clinicians should carefully evaluate symmetrically located lesions, which may require individualized treatment approaches. © 2025, Selcuk University. All rights reserved.