ABSTRACT
Odontogenic keratocyst [keratocystic odontogenic tumor] is a destructive jaw lesion with the propensity to recurrence. The atypical symphyseal odontogenic keratocyst was managed with a defined protocol which entailed diagnosis, treatment with enucleation along with peripheral ostectomy and rehabilitation. A long term follow-up schedule was provided to the patient to observe the recurrence behavior of this cyst. In post operative phase, no complication was noticed regarding wound healing and recurrence. Therefore, defined treatment protocol and long term follow-up may provide better means to manage cysts with such indistinct recurrence behavior. Future treatment may involve molecular-based modalities which may reduce or eliminate the need for aggressive surgical management