Introduction: Keratocyst (QQO), is considered one of the most prevalent alteration at the maxillo-mandibular, mainly distributed in the region of the angle and ramus. Special consideration is the high rate of recurrence.

Case report: We refer to a 26 years old male patient, who came to the Oral and Maxillofacial Surgery Dental Unit of The Chilean Air Force.

The panoramic radiograph revealed a large lesion in the left mandibular ramus with the 4.8 tooth included. When biopsied, histological results were obtained as odontogenic keratocyst. Treatment was planned in two stages. In the first instance, decompression was performed by irrigating with 0.12% CHX through previously installed collars. In a second stage the treatment was maintained until the reduction in size of the lesion allowed the enucleation with the 4.8 tooth. He underwent surgery for removal of a satellite focus on the ramus, under sigmoid notch 3 years later. The patient has been controlled over 6 months post intervention without any complications.

Discussion: With regard to treatment, various therapies have been advocated as enucleation, aggressive curettage, marsupialization, secondary enucleation, decompression, etc. However, unless extensive removals of the bone segment, is a high relapse rate. The radical treatment is generally reserved for lesions with specific characteristics, seeking the introduction of lower-cost therapies functional and aesthetic, such as decompression and subsequent enucleation.

Conclusions: The not conventional treatment is considered very important. For the success of the treatment, the monitoring and the adherence are essential, with a functional lowest cost and aesthetic.

Conflict of interest: None declared.