Aim: The purpose of this retrospective study was to evaluate the clinicopathological features of 64 patients with keratocystic odontogenic tumor (KCOT). Materials and Methods: The patients ranged in age at the time of diagnosis from 8 to 74 years (mean: 38.20 ± 16.71). Postoperative follow-up period was 3-8 years (mean time 4.76 ± 1.10). This research was carried out on panoramic radiographs and histopathological samples. Data such as gender, age, treatment methods, location of the tumor, presence of impacted teeth and its histological features were subjected to descriptive statistical analyses with the statistical software program. Results: Of the 64 analyzed cases of KCOT, 68.8% of them were men and 31.2% were females (male-to-female ratio was 2.2:1). It was observed that KCOT peaked in the third and fifth decade of life (23.4%-20.3%). The incidence of KCOT was higher in the mandible than in the maxilla (76.6%-23.4%). There was recurrence in nine out of 64 subjects (14.1%) in the follow-up period. The recurrence was more often found in posterior mandible. It is noteworthy that in 9 recurrent subjects, 7 lesions were parakeratotic and 4 lesions were associated with daughter cysts. Conclusion: Although there are several studies about KCOT in the literature, the choice of treatment modalities remains controversial. In recurrent subjects, more aggressive therapy approaches should be considered. Periodic controls and aggressive treatment approaches may be effective in the prevention of recurrences.

These findings suggest that odontoma is a hard keratin-expressing tumor-like lesion, and that the Wnt signaling pathway may be involved in the formation of ghost cells in odontomas.

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