The protein content of keratocystic odontogenic cyst (KCOT) fluid is typically < 4 gm/dl because the cystic fluid is generally thin and serous, reflecting its origin from epithelial degeneration rather than inflammation or infection. Higher protein levels (>4 gm/dl) are more common in inflammatory cysts or cysts with secondary infection. This low protein content helps differentiate KCOT fluid from other cystic lesions during surgical aspiration and aids in preoperative diagnosis. Understanding this biochemical profile is crucial for accurate diagnosis and appropriate surgical planning, as KCOTs require complete enucleation and sometimes peripheral ostectomy to prevent recurrence.

Reference: Oral and Maxillofacial Pathology, Neville BW et al., 4th Edition.