Odontogenic keratocyst

General features:
Arise from dental lamina and odontogenic epithelium
5%–15% of jaw cysts
20-40 years
Contains cheesy material
50% recur as daughter cysts are present outside primary
Multiple odontogenic keratocysts with basal cell carcinomas and bifid ribs constitute basal cell nevus syndrome (Gorlin-Goltz syndrome)

Location:
Common in body and ramus of mandible
Also anterior mandible or maxilla.

Imaging:
Unilocular, lucent lesion with smooth, corticated borders associated with impacted tooth
Aggressive growth than other odontogenic cysts
May have multilocular appearance (indistinuisable from ameloblastoma)
May cause cortical thinning, tooth displacement, root resorption

Management:
Surgical enucleation with wide bone margins or marsupialization
Most recur in the first 5 years

Reference:
Scholl, RJ et al. Cysts and Cystic Lesions of the Mandible: Clinical and Radiologic-Histopathologic Review. Radiographics. 1999;19:1107-1124