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Case Report | DOI: https://doi.org/10.31579/2641-0419/528
1Associate Professor, Head of department of oral and maxillofacial surgeon Patan Academy of Health Sciences Nepal.
2Md-Community Medicine, Dhulikhel Hospital,Kathmandu Univeristy.
*Corresponding Author: Bikash Desar, Associate Professor, Head of department of oral and maxillofacial surgeon Patan Academy of Health Sciences Nepal.
Citation: Bikash Desar, Rajani Shakya, (2025), Odontogenic Keratocyst: Accidental findings and Imaging Features of a Benign Lesion with an Aggressive Behaviour -Treatment and Follow up done at Tertiary Center in Kathmandu, J Clinical Cardiology and Cardiovascular Interventions, 8(15); DOI:10.31579/2641-0419/528
Copyright: © 2025, Bikash Desar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 07 November 2025 | Accepted: 19 November 2025 | Published: 28 November 2025
Keywords: odontogenic keratocysts; panoramic radiography; computed tomography; magnetic resonance imaging; basal cell nevus syndrome
The latest (4th) edition of the World Health Organization (WHO) Classification of Head and Neck Tumours, published in January 2017, has reclassified keratocystic odontogenic tumour as odontogenic keratocyst. The 2022 5th edition is not conceptually very different from the previous 2017 classification of odontogenic lesions. Therefore, odontogenic keratocysts (OKCs) are now considered benign cysts of odontogenic origin that account for about 10% of all odontogenic cysts. OKCs arise from the dental lamina and are characterised by a cystic space containing desquamated keratin with a uniform lining of parakeratinised squamous epithelium. The reported age distribution of OKCs is considerably wide, with a peak of incidence in the third decade of life and a slight male predominance. OKCs originate in tooth-bearing regions and the mandible is more often affected than the maxilla. In the mandible, the most common location is the posterior sextant, the angle or the ramus. In our study we found mandibular anterior are involved in few cases, which was accidently found during OPG. Later, CBCT was done to see the extent of cortical plates and inner expect of mandible. Conversely, the anterior sextant and the third molar region are the most common sites of origin in the maxilla. OKCs are characterised by an aggressive behaviour with a relatively high recurrence rate, particularly when OKCs are associated with syndromes. Multiple OKCs are typically associated with the nevoid basal cell carcinoma syndrome (NBCCS), an autosomal dominant multisystemic disease. Radiological imaging, mainly computed tomography (CT), plays an important role in the diagnosis and management of OKCs. Therefore, the main purpose of this pictorial review is to present the imaging appearance of OKCs underlining the specific findings of different imaging modalities and to provide key radiologic features helping the differential diagnoses from other cystic and neoplastic lesions of odontogenic origin.
Key Points
• Panoramic radiography is helpful in the preliminary assessment of OKCs.
• CBCT is considered the tool of choice in the evaluation of OKCs.
• Ameloblastoma, dentigerous and radicular cysts should be considered in the differential diagnosis.
• The presence of multiple OKCs is one of the major criteria for the diagnosis of NBCCS.
Odontogenic keratocysts (OKCs), first described by Philipsen in 1956 [1], are benign intraosseous lesions of odontogenic origin that account for about 10% of jaw cysts. They are characterised by an aggressive behaviour with a relatively high recurrence rate [2]. Histologically, OKCs arise from the dental lamina and are constituted by a cystic space containing desquamated keratin, lined with a uniform parakeratinised squamous epithelium of 5 to 10 cell layers, with a distinct basal layer of palisaded columnar or cuboidal cells, whose nuclei tend to be vertically oriented. The interface with the adjacent connective tissue is normally flat with a potential for budding of the basal layer and the formation of small satellite cysts [3]. The mitotic activity is higher than other cysts of odontogenic origin [4].
Because of this histologic feature, the aggressive behaviour and the fact that a large proportion of lesions are associated with a mutation or inactivation of the tumour suppressor gene, also called the protein patched homolog (PTCH) gene, in the 3rd edition of the World Health Organization (WHO) Classification of Head and Neck Tumours, this pathological entity was included in the group of odontogenic neoplasms with the name of keratocystic odontogenic tumour (KCOT) [5].
In the latest (4th) edition of the WHO Classification of Head and Neck Tumours published in January 2017 [6], the consensus group concluded that, at the present time, there is insufficient evidence to support a neoplastic origin of this cystic lesion and that further research is needed [7]. Consequently, the name OKC has been reinserted, replacing the term KCOT that was removed from the classification.
Preoperative assessment is important for planning treatment and management, as OKCs require a more aggressive treatment than other low-attenuating lesions having similar radiological appearance.
The aim of this pictorial review is to present the imaging appearance of OKCs underlining the specific findings of different imaging modalities and to provide key radiologic features helping the differential diagnoses from other cystic and neoplastic lesions of odontogenic origin.
Incidence, clinical presentation and natural history
OKCs represent approximately 10% of odontogenic cysts and the reported age distribution is considerably wide (from 8 to 82 years), with a peak of incidence in the third decade of life [3, 8, 9]. Most series have shown a slight preponderance in males [10].
The presence of multiple OKCs, also occurring in different moments during the lifetime of the patients, is typically associated with the nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin–Goltz syndrome, an autosomal dominant multisystemic disease. In these patients, the mean age of incidence decreases to about 25 years old [11–13].
Similarly to other entities having an odontogenic origin, OKCs originate in tooth-bearing regions. They occur twice as often in the mandible as in the maxilla [14]. When OKCs originate from the mandible, the most common location is the posterior sextant, the angle or the ramus [15, 16]. Conversely, the anterior sextant, mainly between canine and lateral incisor, and the third molar region are the most common sites of origin in the maxilla [17, 18]. Large size lesions are particularly common at the angle and ramus of the mandible [19]. According to the literature, OKCs may be located in a periapical position, in a pericoronal position or in a lateral root position. In about 30% of cases, they have no relationships with any dental structures [10, 17]. In spite of their aggressive behaviour, OKCs, in most cases, cause minimal bone expansion because of their propensity to spread along the intramedullary space “growing in the length of the bone” [20]. Large lesions, causing significant erosion of cortical plates and involvement of surrounding structures, may be seen in asymptomatic patients [21]. Consequently, especially in western countries, the presence of OKCs may be found at a later stage as an incidental finding during routine radiological investigations. A systematic review of the literature published in 2011 by MacDonald-Jankowski showed that patients of East Asian origin may present symptoms early, characterised by swelling and pain, while discharge and numbness of the inferior alveolar nerve are described more frequently in Latin Americans [22]. Unlike other odontogenic lesions having similar aggressive behaviour such as ameloblastomas, OKCs infrequently cause root resorption of adjacent teeth [10].
The reported recurrent rate of OKCs after surgery is wide, up to 30%, with most recurrences occurring after conservative treatments of simple lesion’s enucleation [2, 19, 23].
Higher recurrence rates are reported in patients affected by NBCCS and in multilocular lesions [24, 25]. The recurrences might be explained by different causes: incomplete removal of highly active basal layer of the epithelial cyst lining, growth of small intramedullary satellite cysts left behind by conservative treatment and development of lesions localised in the adjacent region of the jaws [13, 19, 26]. The type of surgery may not be the only factor and some authors suggested that recurrence may be related with the biological nature of the lesion itself and the expression of proliferative markers such as Ki-67 [27, 28].
Imaging techniques
The radiological imaging techniques most commonly used in the study of OKCs are conventional radiography (mainly panoramic radiography), computed tomography (CT) and magnetic resonance imaging (MRI). These imaging modalities differ significantly in their technical characteristics, acquisition modalities, indications and information provided.
Panoramic radiography
Panoramic radiography is a flat representation of the curved surfaces of the maxillary and mandibular dental arches and is helpful in the preliminary assessment of the location, size, shape, margins and extension of odontogenic lesions, such as OKCs. However, this radiographic technique has a limited role because it provides a two-dimensional view of maxillofacial structures with magnification, geometric distortion and overlapping. Therefore, to overcome the limitations of panoramic radiography, a three-dimensional imaging modality is often required for preoperative planning, particularly in larger lesions.
Radiographically, OKCs appear as a well-defined unilocular or multilocular radiolucency bounded by corticated margins (Figure. 1). Unilocular lesions are predominant, whereas the multilocular variant is observed in approximately 30% of cases, most commonly in the mandible (Figure. 1b) [9, 29]. On panoramic radiography, mandibular unilocular OKCs may show few and incomplete septa within the lesions; this finding is more common in larger than in smaller OKCs (Figure. 2).
Andibular odontogenic keratocysts (OKCs). a Cropped panoramic radiograph shows a unilocular lesion in the posterior mandible and ramus that determines mesial displacement of the impacted third molar (curved arrow). b Cropped panoramic radiograph demonstrates a multilocular lesion occupying the posterior mandible and ramus with a soap-bubble pattern
Cropped panoramic radiograph shows a large OKC with well-defined and lobulated margins (arrowheads) occupying the body of the mandible. Note an incomplete internal septum within the lesion (opposing arrows)
Approximately 30% of OKCs are associated with at least one unerupted tooth, most commonly the third molars (Figure. 1a) [9, 29]. This association occurs particularly in younger patients [15].
The radiographic features of OKCs are not pathognomonic, particularly in smaller unilocular lesions [15]. When a small unilocular OKC occurs in the anterior sextant of the maxilla, it may simulate other odontogenic and non-odontogenic cysts, such as radicular cyst (Figure 3), lateral periodontal cyst or nasopalatine cyst [17, 30].
Histologically proven OKCs. Cropped panoramic radiographs (a and b) show two unilocular radiolucent lesions (asterisks) with well-defined and
corticated margins (arrowheads) located in the anterior maxilla, between the roots of the adjacent teeth. The radiographic aspect of these radiolucent lesions may simulate a radicular cyst
Large mandibular OKCs tend to grow predominantly along the length of the bone with minimal bucco-lingual expansion, especially within the body [15]. On panoramic radiography, this peculiar pattern of growth may determine an extensive radiolucent lesion with considerable mesiodistal dimensions and without a significant cortical expansion (Figs. 1a and 2). On the other hand, large maxillary OKCs display a significant expansion of the alveolar bone and tend to involve adjacent structures. In particular, when a maxillary OKC originate from the molar region, an extension into the maxillary sinus is frequently seen (Figure. 4) [22].
Cropped panoramic radiograph of the posterior left maxilla demonstrates a large OKC extending into the maxillary sinus (arrows). The posterior wall of the maxillary sinus (curved arrow) and the pterygopalatine fossa (asterisk) are also displayed
Radiographically, OKCs may show tooth displacement and root resorption; this latter finding is an uncommon radiographic feature of OKCs, with a reported incidence varying from 1.3 to 11% [9]. The literature reported that the perforation of the cortical bone is not an unusual feature of OKCs, with an intraoperative incidence varying from 39 to 51% [9]. However this finding is detected very rarely on panoramic radiography and is generally limited to the alveolar crest.
Cone beam and multidetector computed tomography
In clinical routine, there are two main CT techniques commonly used for the evaluation of maxillofacial diseases: cone beam CT (CBCT) and multidetector CT (MDCT). Both CT modalities are usually considered adequate for diagnosing OKCs and preoperative planning, owing to their ability to generate high-quality multiplanar reconstruction (MPR) images in different planes. In addition, using a dedicated reconstruction software for dental arches (DentaScan), the three-dimensional dataset produced by both modalities can be further processed in MPR images that are either parallel (panoramic) or perpendicular (cross-sectional) to the curvature of the alveolar bones. These high-resolution MPR images allow three-dimensional views of the jaws and provide detailed information about the OKC and its relationship with surrounding structures (teeth, sinonasal cavities, canals, foramina and soft tissue).
The main advantage that makes CBCT a particularly attractive technique in the evaluation of maxillary and mandibular lesions is its higher spatial resolution compared with MDCT. Conversely, the main disadvantage of CBCT is the poor contrast resolution, which is not suitable for soft tissue contrast discrimination. Hence, CBCT is not able to evaluate the extension into soft tissues and precludes the possibility of contrast medium injection [31]. In the assessment of an OKC, CBCT is considered more effective to demonstrate the bony changes of the cortical plates of jaws (buccal, palatal or lingual cortices), whereas MDCT is more effective at evaluating internal density and extension into soft tissue.
As with panoramic radiography, CT is able to display the main radiological features of an OKC, such as size, shape (hydraulic or scalloping), margins (well-defined and corticated), internal appearance (uni- or multilocular) and effects on adjacent structures (tooth displacement, root resorption, maxillary sinus floor elevation, inferior displacement of mandibular canal) [32]. In addition, CT demonstrates other features of OKCs, such as bony changes (expansion in buccolingual/palatal direction and erosion), internal density and extension into soft tissue (Figure. 5).
Maxillary OKC. Panoramic radiograph (a) shows a large radiolucency with a well-defined and corticated rim in the maxilla (white arrows). Axial multidetector computed tomography (MDCT) images with bone window (b) and soft tissue window (c) clearly demonstrate the hydraulic expansion of the maxillary alveolar bone (black arrows) with thinning (wavy arrows) and perforation (curved arrows) of the buccal cortex. Posterior bowing of the floor of the maxillary sinuses (arrowheads) and inflammatory material within the left maxillary sinus (asterisks) are also shown
Therefore, CT is considered superior to conventional radiography in differentiating OKCs from other unilocular or multilocular osteolytic lesions and in the preoperative assessment (Figure. 5).
In the mandible, the OKCs have a tendency to grow predominantly mesiodistally along the length of the bone, causing minimal expansion of the buccal and lingual cortical plates (Figure. 6) [33]. However, in some cases, the OKC may expand and erode the cortices (Figures. 7 and 8).
Mandibular OKC. Panoramic (a) and cross-sectional (b) cone beam computed tomography (CBCT) images display an osteolytic odontogenic lesion in the posterior left mandible and ramus, with a growth predominantly along the length of the bone (double-headed arrow) and minimal expansion of the buccal and lingual cortices (curved arrows). Note mesial displacement of the impacted third molar (38) and inferior displacement of the mandibular canal (arrowheads and dots). Small and incomplete internal septum (small black arrows) due to the endosteal scalloping of the cortical plate are also shown. Wavy arrow, mandibular foramen
Panoramic CBCT image with 20-mm slice thickness (a) shows a mandibular OKC with a septum (opposing arrows) which seems to divide the lesion into two large loculations. Note the displacement of adjacent teeth. Panoramic (b) and axial (c) CBCT images reconstructed as 0.5- and 0.2-mm-thick sections demonstrate that the septum is incomplete (arrows). Perforation of the buccal cortex in the anterior portion of the lesion is also shown (curved arrows)
Panoramic (a) and cross-sectional (b) CBCT images show an OKC with well-defined and lobulated margins located in the interforaminal region of the mandible (asterisk). The lesion grows mesially by crossing the midline (white arrows). Note root resorption (arrowheads) and perforation of the cortices (curved arrows). Scalloping of the endosteal surface of the cortical plates (small black arrows) and small internal septum (wavy arrow) are also seen. Large black arrow, left mental foramen; 33, left canine; 34, left first premolar; 35, left second premolar; 36, left first molar
In contrast, large OKCs in the maxilla more frequently present a hydraulic expansion of the alveolar bone with remodelling, thinning, scalloping and perforation of the cortices (Figure. 5) [32]. In addition, when OKCs originate from the alveolar bone subjacent to the maxillary sinus, its floor is lifted and lumen is reduced (Figure. 9).
Panoramic CBCT images of a maxillary OKC (asterisks) originating from the molar region distally to the second molar tooth. The OKC causes significant sinus floor elevation (arrowheads). Curved arrows, posterior wall of the maxillary sinus; arrows, lateral pterygoid lamina]
The difference between the growth pattern of mandibular and maxillary OKCs may be partly due to the higher cortical thickness of the mandible compared to that of the maxilla [15]. On CT images, OKCs typically manifest as osteolytic lesions that exhibit a unilocular (Figures. 9 and 10) or a predominantly unilocular morphology with few and incomplete septa (Figures. 7 and 8). The multilocular presentation with adjacent satellite cysts (daughter cysts) is possible, particularly in large lesions (Figure. 11). In these cases, loculations are usually large and few (soap-bubble appearance)
Panoramic CBCT images with 20-mm (a) and 0.5-mm (b) slice thickness of an OKC show a unilocular lesion with well-defined and corticated margins located in the posterior sextant and ramus of the right mandible (arrows), near the distal root of the second molar (arrowheads). Note the interruption of the superior border of the retromolar region (curved arrow) and inferior displacement of the mandibular canal (opposing arrows and dots). c Histological image shows the typical parakeratinised stratified squamous epithelial lining with corrugated surfaces (H-E 10×)
Panoramic CBCT image with 20-mm slice thickness (a) shows a multilocular OKC. On this reconstruction, septa seem to divide the lesion into multiple loculations. Cross-sectional CBCT images reconstructed as 0.5-mm-thick sections (b) demonstrate that some of these septa are complete (arrowheads) and some are incomplete (wavy arrows). Note that certain small loculations shown by the panoramic CBCT image (black asterisk, white and black stars) actually correspond to a single large loculation with scalloped borders. Compression and lingual displacement of the mandibular canal, deep to the root of the third molar (48), is also shown (opposing arrows). Curved arrow, mandibular foramen; arrows, mandibular canal
OKCs may be associate with an impact tooth (Fig. 6); this finding, similar to dentigerous cyst, is more common in younger patients [14, 15].
Internal high-density areas are frequently found and reflect the presence of keratinised material within the OKC (Fig. 12) [14]. This peculiar internal feature is detectable mainly on MDCT scan due to its better soft tissue contrast discrimination compared to CBCT scan (Fig. 12). Although rare, calcifications may occur within OKCs; this finding is mostly observed in histological examinations (Figure. 13). Finally, at MDCT, the OKCs typically do not show enhancement after contrast administration [32].
Axial MDCT image with bone window (a) shows an OKC in the posterior region of the right mandible (asterisk). Axial MDCT image with soft tissue window (b) clearly demonstrates a high-density area within the mandibular lesion (ellipse ROI) with a mean attenuation value of 80 HU
Panoramic (a) and axial (b) MDCT images show an osteolytic lesion located in the interforaminal region of the mandible. The lesion, histologically proven to represent an OKC, causes expansion and thinning of the buccal cortex (arrowheads). MDCT images demonstrate numerous punctate high-density foci (calcification) within the lesion (arrows). One of these high-density foci shows extension into adjacent soft tissue (curved arrow). Dots, mesial portion of the mandibular canal. c Histological images show the characteristic epithelial lining and calcifications (large black arrows) within the underlying connective tissue (H-E 10×)
Magnetic resonance imaging
In the evaluation of cystic lesions of the jaws, MRI is mainly performed as a complementary technique to CT (CBCT or MDCT), and it may be useful in selected cases to provide a better demonstration of the internal features and soft tissue involvement (Figures. 14 and 15).
Unilocular OKC in the left maxillary tuberosity. a Axial MDCT image with bone window demonstrates remodelling and thinning of the adjacent cortices (arrows). b Note thin rim enhancement within the lesion on enhanced T1-weighted fat-saturated sequence (arrowheads)
Axial magnetic resonance imaging (MRI) images demonstrate the typical signal pattern of OKC. The lesion, located in the posterior left mandible (arrows), shows intermediate-high signal intensity on T1-weighted sequence (a) and heterogenous high signal intensity on T2-weighted sequence (b). No enhancement is observed within the lesion on enhanced T1-weighted fat-saturated sequence (c). Diffusion-weighted imaging demonstrates restricted diffusion with high signal on b0 (d) and b1000 (e) images and low signal intensity on apparent diffusion coefficient (ADC) map (f)
OKCs typically show various signal intensity on MRI images, which reflect the materials contained inside the lesions. They are represented by a large amount of keratin sometimes associated with hyaline bodies in the presence of inflammation [34].
Various authors reported that most of the OKCs present intermediate or high signal intensity on T1-weighted sequences and heterogeneous signal intensity (from low to high) on T2-weighted sequences (Fig. 15) [20, 32, 34, 35]. Some studies have outlined that these MRI signal features are useful in discriminating between OKCs and ameloblastomas [34–37]. In a retrospective study including 19 ameloblastomas and 14 OKCs, Fujita et al. [37] compared signal intensity uniformity values of the cystic components of the two types of odontogenic lesions. In agreement with other authors, they observed that the cystic components of ameloblastomas and OKCs displayed significantly different uniformity values on all sequences. In particular, both unicystic and multicystic ameloblastomas show a more homogeneous signal intensity that is low on the T1-weighted images and high on the T2-weighted images [35, 36]. Moreover, cystic ameloblastomas typically have a thick and irregular enhancing wall, with or without papillary projections or intralesional nodules [36]. On the other hand, OKCs tend to be associated with thin and regular rim-enhancement on T1-weighted images (Fig. 14) [10, 36].
MRI with diffusion-weighted imaging (DWI) and calculation of apparent diffusion coefficient (ADC) is sensitive to physiological parameters such as tissue cellularity, nucleus-to-cytoplasm ratio and integrity of cell membranes, thus providing information about the microstructure of living tissues [38]. DWI may be useful as an adjunct tool for differentiation between OKCs and other odontogenic tumours, which may have overlapping imaging findings on conventional MRI sequences [39, 40].
In particular, as first demonstrated by Sumi et al. [39], the ADC value of OKCs is usually significantly lower than that of cystic/predominantly cystic ameloblastomas (Fig. 15). In a study by Srinivasan et al., the mean ADC value of OKCs was 1.019 ± 0.07 × 10− 3 mm2 s− 1 and the optimum cut-off for the differentiation with predominantly cystic ameloblastomas was 2.013 × 10− 3 mm2 s− 1 [40]. These findings reflect the higher viscosity of the content of OKCs determined by the presence of floating desquamated keratin, while the cystic spaces of ameloblastomas usually contain slightly proteinaceous fluids, sometimes with colloidal materials [39]. On the other hand, benign odontogenic cysts may present a wide range of ADC values due to the varying degrees of inflammatory cells infiltration [41].
Sakamoto et al., in a retrospective study including 35 odontogenic cystic lesions, showed that diffusion kurtosis imaging (DKI) could represent a quantitative evaluation tool for better differentiating OKCs from other cystic lesions [41]. Indeed, DKI provides deeper information about tissue’s structural complexity and the combination of its parameters seems to have the potential to distinguish between simple fluid viscosity and the degree of restricted diffusion caused by floating substances and, as a consequence, to increase the diagnostic accuracy for differentiating between OKCs and odontogenic cysts, compared with ADC [41].
Image interpretation keys and differential diagnosis
Radiological imaging, mainly CT (CBCT or MDCT) and, in selected cases, MRI, plays an important role in the diagnosis of OKCs. However, OKCs, in particular smaller lesions, may exhibit imaging features almost indistinguishable to other osteolytic jaw lesions. Hence, in order to obtain a definitive diagnosis, a histopathological examination is required [14]. From this point of view, radiological imaging is considered to be more useful in evaluating the extent and the effects on adjacent structures, rather than in characterising a lesion.
It is reported that, in some OKCs, the combination of clinical and radiological findings allows narrowing the differential diagnosis and, in some cases, making the correct diagnosis [18].
The imaging findings which are more effective for making a provisional diagnosis of OKC are:
However, when an OKC is associated with an impacted tooth, it may simulate a dentigerous cyst. Similarly, when an OKC is multilocular and located in the posterior sextant or the ramus of the mandible, it may mimic an ameloblastoma. Finally, when an OKC has a periapical position or involves an edentulous area, it may be mistaken for a radicular cyst. As a result, dentigerous cyst, ameloblastoma and radicular cyst are considered the most common odontogenic lesions in the differential diagnosis of an OKC [32].
The imaging features which are more effective for suggesting a diagnosis of dentigerous cyst rather than of OKC are [14, 32]:
The imaging features which are more effective for suggesting a diagnosis of ameloblastoma rather than of OKC are [14, 32]:
Finally, the imaging features which are more effective for suggesting a diagnosis of radicular cyst rather than of OKC are [14, 15, 32, 33]:
The typical features of OKCs, dentigerous cysts, radicular cysts and ameloblastomas are summarised in Table 1.
| Odontogenic lesion | Age (decade) | Gender | Predominant jaw | Predominant location | Image interpretation keys |
|---|---|---|---|---|---|
| Odontogenic keratocysts | 3rd | M > F | Mandible | Posterior | Unilocular osteolytic lesion with few septa and growth along the length of the bone with minimal buccolingual expansion |
| Dentigerous cysts | 2nd–3rd | M > F | Mandible | Posterior | Unilocular osteolytic lesion around the crown of impacted tooth with buccolingual expansion and no septa |
| Ameloblastomas | 3rd–5th | M > F | Mandible | Posterior | Multilocular osteolytic lesion with thick septa, root resorption and buccolingual expansion |
| Radicular cysts | 3rd–5th | M ~ F | None | None | Unilocular osteolytic lesion around the apex of a non-vital tooth |
Table 1: Typical characteristics of odontogenic keratocysts (OKCs), dentigerous cysts, ameloblastomas and radicular cysts Open in a new tab
Syndromic and non-syndromic multiple OKCs
The presence of multiple OKCs is considered one of the major criteria for the diagnosis of NBCCS, and their occurrence may be the first sign of the disease [42]. NBCCS, also known as Gorlin–Goltz syndrome, is an autosomal dominant multisystemic disease characterised by multiple nevoid basal cell carcinoma, multiple OKCs, palmar or plantar pits, calcifications of falx cerebri and skeletal abnormalities, such as bifid, fused or splayed ribs [43, 44].
Other features associated with NBCCS include craniofacial, neurological, sexual, ophthalmic and cardiac anomalies [45]. The literature reported that NBCCS is associated with mutations of a tumour suppressor gene, also called the PTCH gene. Mutations within the PTCH gene are also observed in some non-syndromic OKCs. Therefore, certain authors indicate that the abnormalities of the PTCH gene may be involved in the pathogenesis of OKCs [46].
Multiple OKCs are also observed in other syndromes, such as Noonan syndrome, Ehlers–Danlos syndrome and oral-facial-digital syndrome.
In syndromic OKCs, the cysts occur at an early age (first or second decades of life), originate more often in the posterior sextants of the maxilla (Figure. 16), have more aggressive behaviour and their recurrence rate is higher than non-syndromic OKCs [44].
Panoramic CBCT image (1 mm thick) shows two unilocular OKCs on both sides of the maxilla (asterisks) in a young male patient with nevoid basal cell carcinoma syndrome (NBCCS). Both lesions, located in the posterior sextants, extend into the maxillary sinuses (MS)
In rare case, multiple OKCs can be observed without any evidence of systemic disease [47].
However, it should be noted that the occurrence of multiple OKCs should indicate, until proven otherwise, the presence of a syndrome, and a patient with multiple OKCs should be followed regularly to assess the possible appearance of any other systemic manifestations.
Treatment and follow-up
The management of OKCs aims to reduce the risk of recurrence while minimising, at the same time, the morbidity for the patient. At the present moment, there is no consensus about the best treatment modality.
Different factors take part in the choice of the more appropriate treatment, including size and location of the lesion, unilocularity or multilocularity, presence of cortical perforation or soft tissue involvement and the patient’s age.
Various surgical options have been considered, including enucleation alone or associated with adjunctive measures (ostectomy, Carnoy’s solution, cryotherapy), marsupialisation and decompression, marginal or segmental resection [19].
In a systematic review of the literature, Johnson et al. showed that enucleation is associated with the highest recurrence rate of about 30%, followed by marsupialisation alone (approximately 18% recurrence rate). The association of lesion’s enucleation with adjunctive technique of chemical cauterisation with Carnoy’s solution, a mixture of chloroform, absolute ethanol, glacial acetic acid and ferric chloride, significantly reduced the recurrence rates to about 8% [23].
Surgical resection, both marginal and segmental, is related to the lowest recurrence rate but, because of its morbidity, is not recommended as a primary treatment modality and should be reserved for retreatment of patients suffering from multiple recurring lesions [23].
According to the literature, most recurrences of OKC occur within the first 5–7 years after treatment [13].
In a paper by Apajalahti et al., the mean recurrence time was relatively shorter (about 2 years). This can be explained by the systematic use of CT in the follow-up of large OKCs (Figure. 17), thus helping the radiologist to depict very small lesions that not clinically detectable [48].
Panoramic CBCT images (20 mm thick) at baseline (a) and at the first follow-up (b). At baseline (a), a large unilocular OKC in the posterior mandible and ramus is shown (arrowheads). At the first follow-up (b), performed 2 years after surgery, the CBCT image shows two recurrences in the third molar region (arrows) and ramus of the mandible (curved arrow), respectively. Wavy arrow, mandibular foramen
For this reason, periodic radiographic monitoring of patients with surgically treated OKCs is recommended annually for the first 5 years and at least every 2 or 3 years subsequently [20]. Patients with NBCCS are particularly prone to the formation of new lesions, both in the site of previous surgery and in different sextants of the dental arches (Figures. 18). Consequently, a long-term strict radiological follow-up should be performed in these patients [23].
Periodic follow-up of the same patient in Figure. 16 with NBCCS. a Axial CBCT image shows a new lesion in the third molar region of the right mandible (arrows), which was subsequently surgically treated. b A postoperative axial CBCT image obtained 1 year later demonstrates a very small recurrence at the site of the previous lesion (arrowheads)
Odontogenic keratocysts (OKCs) are benign lesions of odontogenic origin accounting for about 10% of all odontogenic cysts and characterised by an aggressive behaviour.
Radiological imaging, mainly computed tomography (CT) and, in selected cases, magnetic resonance imaging (MRI), plays an important role in the diagnosis and management of OKCs. Although radiological imaging does not always provide a specific diagnosis, the knowledge about typical and atypical radiological features of OKCs is essential for their diagnosis and treatment planning. In particular, the combination of clinical and radiological findings is useful in evaluating the extent of the lesions and the relationships with adjacent structures.
The relatively high recurrence rate, especially after conservative surgery, make it necessary to perform a periodic radiographic monitoring of patients with surgically treated OKCs, at least for the first 5 years.
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Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
