| Introduction. The odontogenic keratocyst (QQO) is a cyst lesion with histopathological characteristics and aggressive biological behavior. Considered the third most frequent cyst lesion in the maxillofacial region, preceded by the periapical and dentigerous cysts, and mainly located in the posterior area of mandibular body, angle and ascending ramus. Two treatment modalities exist: 1. Conservative approaches complemented with adjuvant methods such as Carnoy´s solution or 5-Fluorouracil (5-FU) and 2. Radical treatment or resection. Case report. A 44-year-old female presented with an abscess and chronic pain in the right mandibular angle, with a surgical history seven months prior for the extraction of tooth 4.7 due to a cyst-like lesion, whose postoperative histopathological diagnosis reported QQO with no subsequent management. Panoramic radiography showed a radiolucent area with well-defined borders at the socket of tooth 4.7 in contact with the inferior alveolar canal and a distal radiopaque area corresponding to a previously bone grafting. Treatment: under general anesthesia, removal of graft and adjacent cyst tissue was performed, applying 5-FU for one hour, irrigating thoroughly and placing gauze impregnated with 0.12% chlorhexidine gel, replacing it weekly for two months. Biopsy showed tissue with cavity surrounded by epithelial lining. Diagnosis: Recurrence of QQO. |