Abstract
BACKGROUND: The postoperative recurrence of mandibular odontogenic keratocyst (OKC) accompanied by secondary actinomycotic osteomyelitis is extremely rare and presents significant challenges in clinical diagnosis and treatment. This case study combines imaging, pathological data, and relevant literature to offer guidance for clinical management. PATIENT INFORMATION: A 21-years-old female patient underwent surgical treatment for a polycystic OKC of the mandible 4 years ago. She was hospitalized again due to sharp subgingival sensation under the labial gums in the mandibular anterior tooth area. Pathological examination revealed OKC and chronic actinomycetic osteomyelitis. Mandibular mass resection and curettage of chronic osteomyelitis were performed. Clindamycin was used continuously for 4 weeks after operation, and the prognosis was good. CONCLUSION: OKC frequently recurs after surgery and can damage the oral mucosal barrier, potentially leading to actinomycotic osteomyelitis. Pathology is crucial for accurate diagnosis. Surgical resection of secondary OKC, and postoperative administration of standard antibiotics are effective treatment methods.