Introduction:

Keratocyst is a developmental odontogenic cyst originating from dental lamina residues. Its biological behavior is similar to that of a benign neoplasm. Furthermore, it is aggressive and has a high recurrence rate, causing massive bone destruction. It can appear in any area of the jaw and is associated with impacted teeth. On imaging, it appears as a multilocular or polycystic radiolucent lesion with a thin cortical border.

Objective:

To show the importance of a precise diagnosis, an early and accurate detection, and to determine the use and appropriate time of the application of Carnoy's solution as first-line treatment.

Case presentation:

A 34-year-old man, with no relevant personal history, who 3 years ago presented with a radiolucent lesion located at the level of teeth 34 and 35. He underwent endodontic treatment and lesion removal. Approximately 8 months later, cone-beam computed tomography revealed a hypodense lesion larger than the initial lesion at the level of the lower left hemi-arch.

Conclusion:

Marsupialization; enucleation along with adjuvant therapy; and correct evaluation of clinical, radiographic, and histopathological characteristics enabled a conservative surgical treatment to be performed without using Carnoy's solution; nevertheless, postoperative follow-up is recommended. However, in the long term, the use of Carnoy's solution is not eliminated in isolated cases and will be based on the operator's criteria.

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