Calcifying odontogenic cyst (COC) is a form of odontogenic cyst. There is some disagreement on the terminology and classification of this lesion.
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Epidemiology
It may represent around 0.3-0.8% of all odontogenic cysts 2. Although the age range of COC is wide, approximately one-third of cases are seen in childhood and adolescence 5.
Associations
Unerupted teeth (especially canine) are seen in about 10-32% of the cases and an odontoma is seen in about 20-25% of cases 5.
Clinical presentation
Slowly growing asymptomatic swelling with cortical expansion with or without root resorption/displacement 5,6.
Pathology
It can show extreme diversity in its clinical and histopathological features, as well as in its biological behaviour. A notable histopathological feature includes a cystic lining demonstrating characteristic "ghost-cells" epithelial cells with a propensity to calcify.
Although its origin is related to the remnants of the dental lamina, new evidence suggests that most COC carry a mutation in the CTNNB1 gene, responsible for the beta-catenin protein synthesis 5.
Location
Of all the lesions involving the mandible, approximately 65% of lesions are located in the anterior mandible in between the canines 5.
Radiographic features
Well-circumscribed unilocular radiolucency of variable size and shape, displaying peripheral foci of calcification 5,6.
Treatment and prognosis
Treatment options include enucleation and curettage.
History and etymology
It was described by the American oral pathologist Robert James Gorlin in 1962 4,7.
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