About, 40% of KOTs presented with inflammations. in this cases, aspiration and incisional biopsies would not give a reliable results. Its assume that the clinician should know a definitive diagnosis of KOT preoperatively, because the treatment for KOT is different form others cystic lesions . What can We do in inflamed cases?
In case of inflamed KCOTs the radiograph is the choice for the diagnostic purpose. On radiographs these lesions are typically presented as round or ovoid radiolucencies with smooth or scalloped margins i.e. three distinct radiographic types are recognized – unilocular, multilocular and multilobular lesions.However, some of more sophisticated radiographic techniques, including computerized tomography (CT) and magnetic resonance imaging (MRI), may be useful for this purpose. It was shown that in CT scans an area of increased attenuation maybe observed in the lumen of KCOTs, being the result of keratin accumulation and having a potential role in diagnosis of these lesions. AND it was shown that MRI may be useful in differentiating KCOTs from ameloblastomas, since T2 relaxation times of cystic components were significantly shorter in KCOTs compared to ameloblastomas, and no overlap of these values
were observed for these two lesions.
However, the clinical use for cone-beam computed tomography (CBCT) in oral and maxillofacial surgery increases and provides additional information about the contents and borders of the KCOTS and are superior to Periapical and Panoramic radiographs.
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