Is odontogenic keratocyst an endodontic enigma? A rare case report of management of odontogenic keratocyst in anterior mandible

Odontogenic keratocyst (OKC), a rare, locally aggressive developmental cyst, is found incidentally on dental radiographs, most commonly in the posterior mandible. When it occurs in the periapical region in association with nonresponding teeth to pulp sensibility tests, it is often misdiagnosed as other endodontic lesions such as radicular cyst, lateral periodontal cyst and dentigerous cyst. This case report describes the rare occurrence of OKC in the anterior mandibular region managed successfully with endodontic treatment and re-interventional surgery in a conservative approach. This case report also emphasizes on the importance of histopathological examination of the surgically excised tissue specimens as the clinical, radiographic and histopathological correlations are essential for successful treatment.