Introduction: Odontogenic Keratocyst (OKC) represents a distinctive developmental odontogenic cyst that requires special consideration because of its unique histopathological features and distinct aggressive clinical behaviour. These cysts also have marked tendency to recur. It is also suggested to be a benign cystic neoplasm rather than cyst. In view of the marked recurrence rate, treatment of OKC has always been challenging. A single line aggressive protocol in management of OKC is unacceptable to the patients in general and surgeon in particular.

A single line aggressive protocol in management of OKC is unacceptable to the patients in general and surgeon in particular.

Background: As with most cysts, OKC is often treated aggressively by enucleation and resection. Complete enucleation, however, is difficult, because of the thin, friable nature of the cyst wall. Resection, also, is not popular owing to the significant morbidity associated with it. The invasive nature of resection and reconstruction of the mandible or maxilla and the resultant nerve paraesthesia and increased morbidity cannot necessarily be justified in all clinical situations.

Purpose: This paper is a very welcome and timely attempt to provide an evidence-base for the various conservative treatments modalities employed to treat OKC in North Indian population over last 30 years and our need based protocol on OKC management.

Conclusion: There is no single management approach that would give the best treatment and prognosis for patients with OKC and treatment should be customized to patient needs.

Conflict of interest: None declared.