One of the common cystic lesion seen in oral cavity is Odontogenic keratocyst. Initially given as cystic lesion later on WHO classified it as being lesion, Now in 2017 WHO reclassified as cyst. We present a case report of 45 year old male patient having huge odontogenic keratocyst in maxillary left posterior region involving maxillary sinus without any specific clinical and radiological presentation of OKC which made it more difficult to diagnose and treat. 7. Cioffi GA., et al. "Odontogenic keratocyst of the maxillary sinus".

OKC was classified as cystic lesion by WHO in 1971WHO in & 1991, based on aggressive nature, growth pattern, clinical, histological and immunohistochemical nature in 2005 they again classified it as benign lesion, however in 2017 WHO head and neck pathology reclassified it as cystic lesion. It more commonly occurs in posterior mandible and rarely occurs in maxilla, in this case occurrence of OKC in maxillary posterior region is very rare with distinctive expansion and lifting of maxillary sinus floor without perforating in edentulous area makes it more difficult to detect and justify from residual cyst. Here a 65 years old patient came with chief complaint of pus discharge from upper left posterior region since 7 months, having a small opening in edentulous ridge, which provisional diagnosis was given as residual cyst later after excision of lesion and histopathological analysis it was given as OKC.

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Background: Oral leukoplakia is a condition commonly associated with tobacco use. The literature also has documentation pertaining to likely cancerous transformation of leukoplakia. It is always a challenge to discover a therapeutic modality to prevent this transformation. Imiquimod is an immune response modifier possessing antiviral and anti-tumor activity which is being explored as an off label use in many cancerous conditions. Aim: To show any regression in oral leukoplakia and to test its safety and tolerability. Setting and Design: This is a randomized, open-label, single-centered clinical pilot study carried out with Imiquimod. Material and Methods: Two groups OPD of dental college with topical 5% Imiquimod and Topical Vitamin A (50,000 IU) were compared for their efficacy in the management of oral leukoplakia, pre- and post-treatment clinically and regression of oral dysplasia was observed histopathologically. Unit of improvement was noted for assessing the effectiveness of treatment. Statistical Analysis: Quantitative data were analyzed by Wilcoxon signed test. Results: Topical 5% Imiquimod application resulted in good clinical response +1, +2 unit of improvement with more regression of lesion noted in non-homogeneous leukoplakia and areas with less salivary contamination. Topical Imiquimod 5% is the best alternative to conservative management of moderate to severe dysplasia cases where we can offer more to the patient than just observation, and it is also better than a surgical option where surgery leads to more morbidity, in recurrent cases.

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