Background: Odontogenic tumors and cysts are benign lesions that can arise in any site
of the jaws, with Ameloblastomas (ABs) and odontogenic keratocysts (OKCs) being the
lesions characterized by local aggressiveness and a high recurrence rate.

Aim of the study: The current study aimed to validate the efficacy of using the width-to-length ratio as a diagnostic radiographic feature to distinguish mandibular ameloblastomas and odontogenic keratocysts.

Patients and methods: Twenty cases were selected for each lesion type. The axial views from cone-beam computed tomography (CBCT) were retrospectively reviewed to determine the width-to-length ratio, which was calculated by determining the ratio between the utmost buccolingual width and the utmost perpendicular anteroposterior length of the lesion. Student's t-test (unpaired) was used to compare the mean ratios of the two lesion types. Statistical significance was set at P < 0.05.

Results: The mean width-to-length ratios of ameloblastomas and keratocysts were 0.74 and 0.42, respectively. The cutoff point for discriminating the two lesion types was 0.50. The ratios for ameloblastomas were significantly greater than for odontogenic keratocysts (P < 0.001).
Conclusion: The width-to-length ratio is a valid imaging feature that can be used for the differentiation of ABs and OKCs in the body of the mandible.