Molecular alterations in odontogenic keratocysts as potential therapeutic targets

The odontogenic keratocyst ( OKC ) is a cystic lesion, lined by uniformly thickened parakeratinized epithelium. Some lesions are large and tend to recur after surgical treatment. The neoplastic nature of OKC s remains a matter of dispute. It is known that some sporadic OKC s harbor PTCH 1 mutations, and via the dissection of cyst epithelium, these mutations were demonstrated to occur much more frequently than previously thought. In addition to the classical PTCH 1 mutations, Hedgehog pathway disturbance and Bcl‐2 protein overexpression, as detected via genome‐wide expression analysis of OKC s, have been published. Changes in DNA methylation patterns and alterations in micro RNA expression levels have recently been reported in these lesions. We reviewed the molecular mechanisms that underlie the pathogenesis of OKC s as described over the past few years and explored the molecular alterations that can be therapeutically targeted.