OKC is a rare,benign, locally aggressive developmental cyst which has strong tendency to recur. It was reclassified and renamed as KCOT as it reflects its neoplastic nature. The choice of treatment has always been difficult as the patient's well being is of prime concern, without compromising the chances of recurrence. The conservative treatment is cyst oriented and aggressive treatment is done considering the neoplastic nature of the lesion depending upon the clinical and histopathological reports. Recent advances in genetic and molecular understanding have led to eventually eliminate the need for aggressive treatment modalities.