As the condition is quite rare, opinions among experts about how to treat OKCs differ.
A 2015 Cochrane review found that there is currently no high quality evidence to suggest the effectiveness of specific treatments for the treatment of odontogenic keratocysts.
Treatment depends on extent of multilocularity and cyst.
Small multilocular and unilocular cysts can be treated more conservatively through enucleation and curretage.

Treatment options:
Wide (local) surgical excision to remove the whole cyst lining.

Curettage involving simple excision and scraping-out of cavity.

Carnoy's solution fixative (ethanol, chloroform and acetic acid) which is usually used in conjunction with excision and curretage.
Cavity wall can be treated with the fixative either before enucleation to kill the lining of the wall or added after curretage to bony walls, killing any residual epithelial cells to a depth of 1-2mm.
Used with care near mandibular canal and the neurovascular bundle within.

Marsupialization which involves the surgical opening of the cyst cavity and a creation of a marsupial-like pouch.
This allows the cavity to be in contact with the outside of the cyst for an extended period of time.
Marsupialisation results in slow shrinkage of the cyst allowing later enucleation.
However, resolution can take up to 20 months and patients are required to clean the open cavity and irrigate it.

Peripheral ostectomy after curettage and/or enucleation.
Extensive cysts may require a bone graft after bone resection and reconstruction of the area.

Simple excision
Enucleation and cryotherapy.
Decompression followed by enucleation has been shown to be most successful with lowest recurrence rates.

Topical application of 5FU after enucleation
As the condition is quite rare, opinions among experts about how to treat OKCs differ. A 2015 Cochrane review found that there is currently no high quality evidence to suggest the effectiveness of specific treatments for the treatment of odontogenic keratocysts. Treatment depends on extent of multilocularity and cyst. Small multilocular and unilocular cysts can be treated more conservatively through enucleation and curretage.
Treatment options:
Wide (local) surgical excision to remove the whole cyst lining.
Curettage involving simple excision and scraping-out of cavity.
Carnoy's solution fixative (ethanol, chloroform and acetic acid) which is usually used in conjunction with excision and curretage. Cavity wall can be treated with the fixative either before enucleation to kill the lining of the wall or added after curretage to bony walls, killing any residual epithelial cells to a depth of 1-2mm. Used with care near mandibular canal and the neurovascular bundle within.
Marsupialization which involves the surgical opening of the cyst cavity and a creation of a marsupial-like pouch. This allows the cavity to be in contact with the outside of the cyst for an extended period of time. Marsupialisation results in slow shrinkage of the cyst allowing later enucleation. However, resolution can take up to 20 months and patients are required to clean the open cavity and irrigate it.
Peripheral ostectomy after curettage and/or enucleation. Extensive cysts may require a bone graft after bone resection and reconstruction of the area.
Simple excision
Enucleation and cryotherapy. Decompression followed by enucleation has been shown to be most successful with lowest recurrence rates.
Topical application of 5FU after enucleation
Odontogenic keratocyst