Minimally invasive decompression and long-term follow-up of an orthokeratinized odontogenic cyst of the mandible: A 7-year case report

Introduction: Orthokeratinized odontogenic cyst (OOC) is a rare developmental jaw lesion with indolent behavior and low recurrence potential. Case presentation: A 33-year-old healthy male was referred after incidental discovery of a mandibular radiolucency. Cone-beam CT revealed a well-defined unilocular lesion in close relation to the inferior alveolar canal. Aspiration confirmed its cystic nature, and a conservative decompression was performed using a rubber drain to reduce lesion size and preserve adjacent structures. Histopathologic examination identified orthokeratinized epithelium consistent with OOC. After seven months of decompression, the lesion showed marked ossification, allowing safe enucleation and peripheral curettage. Radiographic follow-ups at 19 months and seven years confirmed complete bone healing and absence of recurrence. Conclusion: This case demonstrates that a staged, minimally invasive approach combining decompression and delayed enucleation can be effective for large OOCs, minimizing surgical morbidity and providing stable long-term results.