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Abstract
Keratocystic odontogenic pathologies are rare compared to other odontogenic genesis cysts and usually develop in the lower jaw bone, which is why some authors consider it a pathology of the lower jaw. The development of a keratocyst in the maxillary bone is so rare that the authors felt it appropriate to demonstrate their own clinical case.
The patient, a 42-year-old woman, came to our clinic 1.5 years after the manifestation of symptoms of the disease. The disease was first manifested by facial asymmetry, on the background of an increase in the volume of the tissues of the infraorbital area of the right side, which was recently accompanied by periodic pains and swelling of the soft tissues of the tooth ridge on the projection of the right upper molars due to secondary infection. A CT scan of the facial bones revealed a large-sized cystic mass, which, from the periapical space of 16 teeth, had grown into the maxillary sinus and almost completely filled its internal space. Because the process was localized in the maxillary bone, the contours of the periodontal fissure of 16 teeth could not be visualized. At the same time, it was complicated by an inflammatory process, which is usually less characteristic of keratocysts, the formation was evaluated as an inflammatory radicular cyst of the upper jaw with growth in the sinus cavity. Uneven bone resorption detected intraoperatively and the gray caseous contents of the formation allowed us to make a diagnosis of keratocyst, after which, in order to prevent recurrence, the operation was performed as radical as possible, with sanitation of the pathological focus within healthy tissue. The final verification of the diagnosis was made by the morphological study of the operative material.