Odontogenic keratocyst is a developmental odontogenic cyst that is usually diagnosed in routine radiographs in the early stages. This fact increases the dentist’s responsibility for its diagnosis, and the professional should pay attention to all maxillomandibular complex and not only to the teeth. There is no standard protocol for the treatment of odontogenic keratocyst. However, surgical resection is recommended because of its high recurrence rate, especially in those cases with extensive bone destruction. The enucleation followed by Carnoy’s solution application has been shown to be a good alternative to resection and pointed out as the conservative method associated with the lowest recurrence rates in the treatment of odontogenic keratocyst. This study aimed to report a case of an extensive odontogenic keratocyst with more than 14 years of evolution that had not been diagnosed in three previous different panoramic radiographs and was treated with enucleation and application of Carnoy’s solution.

Odontogenic keratocyst is a developmental odontogenic cyst that is usually diagnosed in routine radiographs in the early stages. This fact increases the dentist’s responsibility for its diagnosis, and the professional should pay attention to all maxillomandibular complex and not only to the teeth. There is no standard protocol for the treatment of odontogenic keratocyst. However, surgical resection is recommended because of its high recurrence rate, especially in those cases with extensive bone destruction. The enucleation followed by Carnoy’s solution application has been shown to be a good alternative to resection and pointed out as the conservative method associated with the lowest recurrence rates in the treatment of odontogenic keratocyst. This study aimed to report a case of an extensive odontogenic keratocyst with more than 14 years of evolution that had not been diagnosed in three previous different panoramic radiographs and was treated with enucleation and application of Carnoy’s solution.