# Clinical manifestations and treatment of peripheral odontogenic keratocysts: two cases and a literature review

## TL;DR

This paper reports two cases of peripheral odontogenic keratocysts in the buccal mucosa and suggests that complete microscopic excision reduces recurrence.

## Contribution

The study is the first to report primary and recurrence cases of POKCs in the buccal mucosa with long-term follow-up.

## Key findings

- Complete excision of POKCs is effective, especially when the cyst wall is hard to separate from surrounding tissue.
- Using a surgical microscope improves separation accuracy and reduces damage to adjacent tissue.

## Abstract

Peripheral odontogenic keratocyst (POKC) is a rare extraosseous manifestation of odontogenic keratocyst (OKC). Because of their anatomical locations, OKCs and POKCs necessitate slightly different treatment approaches. However, the reported literature has not yet reached a definitive conclusion on this matter.

This study included 2 patients who experienced postoperative recurrence of POKCs in the right buccal mucosa from 2018 to 2020. Additionally, we reviewed the reported cases and summarized the clinical features, treatment and prognosis of the POKCs.

The two patients with POKCs in this report experienced recurrence after the first surgery, and the second operation involved microscopic excision of the lesion with its adherent tissue. No recurrence was observed.

Because POKCs are located in the soft tissue, they are difficult to remove and therefore prone to recur. In the treatment of POKCs, the surrounding adhesions can also be removed. Microscopic excision should be performed as well.

The online version contains supplementary material available at 10.1186/s13023-025-04087-3.

This is the first report on the primary and recurrence of POKCs in the buccal mucosa, with a long follow-up period.Complete excision is effective for POKCs, especially when the cyst wall is hard to separate from the surrounding tissue. Using a surgical microscope can improve separation accuracy and reduce damage to adjacent tissue.

This is the first report on the primary and recurrence of POKCs in the buccal mucosa, with a long follow-up period.

Complete excision is effective for POKCs, especially when the cyst wall is hard to separate from the surrounding tissue.

Using a surgical microscope can improve separation accuracy and reduce damage to adjacent tissue.

The online version contains supplementary material available at 10.1186/s13023-025-04087-3.