Odontogenic keratocyst and ameloblastoma: radiographic evaluation



To describe the radiographic features of odontogenic keratocysts (OKCs) and ameloblastomas and to compare the radiographic findings between these 2 lesions.


Radiographs of OKCs and ameloblastomas were retrospectively reviewed. Location, border, shape, association with impacted tooth, tooth displacement, root resorption, and bone expansion were evaluated. Chi-squared or Fisher’s exact tests were used for statistical analysis. A p value < 0.05 was considered to indicate statistical significance.


One hundred OKCs and 101 ameloblastomas were reviewed. The ratios of maxilla to mandible were 1:1.4 and 1:9.1 in OKCs and ameloblastomas, respectively. All evaluated features significantly differed between OKCs and ameloblastomas (p ≤ 0.001). Most OKCs showed smooth border (60%) and unilocular shape (82%), while most ameloblastomas showed scalloped border (77.2%) and multilocular shape (68.3%). Association with impacted tooth was found in 47% of OKCs and 18.8% of ameloblastomas. Adjacent tooth displacement was found in 33.7% of OKCs and 55.8% of ameloblastomas. Root resorption was more common in ameloblastomas (66.7%) than in OKCs (7%). Bone expansion was also more common in ameloblastomas (96.3%) than in OKCs (63.6%).


A unilocular radiolucent lesion with smooth border, no adjacent tooth displacement, no root resorption and causing mild or no bone expansion is suggestive of an OKC rather than an ameloblastoma.

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Corresponding author

Correspondence to Jira Kitisubkanchana.

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Conflict of interest

Jira Kitisubkanchana, Nor Hidayah Reduwan, Sopee Poomsawat, Suchaya Pornprasertsuk-Damrongsri, and Chanchai Wongchuensoontorn declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (the Institutional Review Board of the Faculty of Dentistry/Faculty of Pharmacy, Mahidol University, COA No. MU-DT/PY-IRB 2017/007.0902) and with the Helsinki Declaration of 1975, as revised in 2008. According to the Institutional Review Board of our university, for this retrospective study, formal consent is not required.

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Kitisubkanchana, J., Reduwan, N.H., Poomsawat, S. et al. Odontogenic keratocyst and ameloblastoma: radiographic evaluation. Oral Radiol 37, 55–65 (2021). https://doi.org/10.1007/s11282-020-00425-2

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  • Ameloblastoma
  • Differential diagnosis
  • Odontogenic keratocyst