Marsupialization as an Organ Preservation Measure in Management of Odontogenic Cyst


  • Rozhan N. Saeed Oral and Maxillofacial Surgery Department, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. Author
  • Suha N. Aloosi Oral and Maxillofacial Surgery Department, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. Author



Inferior Alveolar Nerve (IAN), Keratocyst, Marsupialization, Odontogenic cysts, Organ preservation


Objective: Odontogenic cysts are a category of intra-osseous lesions that occur frequently. Marsupialization can be the main
therapeutic option for patients with large cysts or lesions to preserve crucial anatomical structures. The goal of this study was to treat
individuals with odontogenic cystic lesions conservatively using the marsupialization method.

Twenty-two patients participated in this research as part of a cross-sectional study designed for statistical purposes. The
study included males and females between the ages of 6 and 80 with biopsy-proven odontogenic cysts.

After the treatment of 22 patients, data were collected and analyzed statistically. The statistical analysis was performed with
the use of Microsoft Excel and SPSS (Statistical Package for the Social Sciences). The Spearman coefficient was used to evaluate the
correlation between patient age and marsupialization duration and the correlation between cyst size and marsupialization duration, while the Kruskal-Wallis test was used to illustrate the link between cyst type and marsupialization duration. Moreover, the Mann-
Whitney U test was used to assess statistical variations between variables.

Conclusions: Marsupialization is a conservative, noninvasive procedure that is effective in reducing the cyst’s size until it is fully
resolved or reaches a certain point suitable for excision by enucleation. The marsupialization treatment was also advantageous in
preserving teeth, bones, the inferior alveolar nerve, the maxillary sinus, and the nasal cavity. The main purpose of this study was to
preserve the vital structures that were compromised by the different types of odontogenic cysts, and the treatment strategy successfully achieved that goal.


Neville BW, Al E. Oral and maxillofacial

pathology.4th ed. St. Louis: Missouri;2016.

Rajendra Santosh AB. Odontogenic cysts. Dent

Clin North Am. 2020;64(1):105-19.

Mortha N, Uppala D. Pathogenesis of odontogenic

cysts. Oral Maxillofac Surg. 2021;12(1):31.

Ochsenius G, Escobar E, Godoy L, Peñafiel C.

Odontogenic cysts: analysis of 2.944 cases in chile.

Med Oral Patol Oral Cir Bucal. 2007;12(2):85-91.

Yun SU, Jung HW, Cho BY, Choi BJ, Lee BS,

Kwon YD, et al. Conservative treatment using

marsupialization for cysts occurring in the jaw of

adolescents: a case report. J Korean Dent Sci.


Buchbender M, Neukam FW, Lutz R, Schmitt CM.

Treatment of enucleated odontogenic jaw cysts: a

systematic review. Oral Surg Oral Med Oral

Radiol. 2018;125(5):399-406.

Ghandour L, Bahmad HF, Bou-Assi S.

Conservative treatment of dentigerous cyst by

marsupialization in a young female patient: a case

report and review of the literature. Case Rep Dent.


Ghali GE, Connor MS. Surgical management of

the odontogenic keratocyst. Oral and Maxillofacial

Surgery Clinics. 2003;15(3):383-92.

De Moraes AT, Soares HA, Pinheiro JD, Ribeiro

AL. Marsupialization before enucleation as a

treatment strategy for a large calcifying

odontogenic cyst: Case report. Int J Surg Case Rep.


Emam HA, Smith J, Briody A, Jatana CA. Tube

decompression for staged treatment of a calcifying

odontogenic cyst—a case report. JOMS.


Wushou A, Zhao YJ, Shao ZM. Marsupialization

is the optimal treatment approach for keratocystic

odontogenic tumour. J Craniomaxillofac Surg.


Lee ML, Prepageran N, Subha ST. Dentigerous

cyst of the maxillary sinus in a child. Med J

Malaysia. 2004;59(4):550-1.

Pogrel MA, Jordan RC. Marsupialization as a

definitive treatment for the odontogenic

keratocyst. J Oral Maxillofac Surg.


Gao L, Wang XL, Li SM, Liu CY, Chen C, Li JW,

et al. Decompression as a treatment for

odontogenic cystic lesions of the jaw. J Oral

Maxillofac Surg. 2014;72(2):327-33.

Anavi Y, Gal G, Miron H, Calderon S, Allon DM.

Decompression of odontogenic cystic lesions:

clinical long-term study of 73 cases. Oral Surg

Oral Med Oral Pathol Oral Radiol.


Oliveros-Lopez L, Fernandez-Olavarria A, Torres-

Lagares D, Serrera-Figallo MA, Castillo-Oyagüe

R, Segura-Egea JJ, et al. Reduction rate by

decompression as a treatment of odontogenic

cysts. Med Oral Patol Oral Cir Bucal.


Lizio G, Sterrantino AF, Ragazzini S, Marchetti C.

Volume reduction of cystic lesions after surgical

decompression: a computerised three-dimensional

computed tomographic evaluation. Clin Oral

Investig. 2013;17(7):1701-8.

Kubota Y, Imajo I, Itonaga R, Takenoshita Y.

Effects of the patient's age and the size of the

primary lesion on the speed of shrinkage after

marsupialisation of keratocystic odontogenic

tumours, dentigerous cysts, and radicular cysts. Br

J Oral Maxillofac Surg. 2013;51(4):358-62.

Madras J, Lapointe H. Keratocystic odontogenic

tumour: reclassification of the odontogenic

keratocyst from cyst to tumour. J Can Dent Assoc.


Demir E, Günhan Ö. Treatment results of

dentigerous cysts managed by marsupialisation,

enucleation or enucleation with platelet rich

plasma-a retrospective study. Meandros med.

dental j. 2021;22(2):116.

Bodner L, Bar-Ziv J. Characteristics of bone

formation following marsupialization of jaw cysts.

Dentomaxillofac Radiol. 1998;27(3):166-71.

Lizio G, Ferraioli L, Melini M, Marchetti C. Long-

term investigation of decompression as a definitive

treatment for mandibular cysts associated with

impacted third molars. J Am Dent Assoc.


Takagi S, Koyama S. Guided Eruption of an

impacted second premolar associated with a

dentigerous cyst in the maxillary sinus of a 6-year-

old child. J Oral Maxillofac Surg.


Buyukkurt MC, Omezli MM, Miloglu O.

Dentigerous cyst associated with an ectopic tooth

in the maxillary sinus: a report of 3 cases and

review of the literature. Oral Surg Oral Med Oral

Pathol Oral Radiol. 2010;109(1):67-71.

Girish G, Kumar M, Umashankar DN, Sharma R,

Veeresh M, Bhandari A. Case report dentigerous

cyst in maxillary sinus: A Rare Occurrence. J Oral

Maxillofac Pathol. 2011;2(1):19-23.

Miyawaki S, Hyomoto M, Tsubouchi J, Kirita T,

Sugimura M. Eruption speed and rate of angulation

change of a cyst-associated mandibular second

premolar after marsupialization of a dentigerous

cyst. Am J Orthod. 1999;116(5):578-84.

Waly S. Marsupialization of a large pediatric

mandibular cyst with a multipurpose space

maintainer, a prospective study. Egypt J Oral

Maxillofac Surg. 2019;10(4):118-22.

Meningaud JP, Oprean N, Pitak-Arnnop P,

Bertrand JC. Odontogenic cysts: a clinical study of

cases. J Appl Oral Sci. 2006;48(2):59-62.

Weber AL, Kaneda T, Scrivani SJ, Aziz S. Jaw:

cysts, tumors, and nontumorous lesions. Head and

neck imaging, 4th edn. Mosby, St. Louis.


Kadam NS, De Ataide ID, Raghava P, Fernandes

M, Hede R. Management of large radicular cyst by

conservative surgical approach: a case report. J

Clin Diagnostic Res. 2014;8(2):239-41.

Nakamura N, Mitsuyasu T, Mitsuyasu Y,

Taketomi T, Higuchi Y, Ohishi M.

Marsupialization for odontogenic keratocysts:

long-term follow-up analysis of the effects and

changes in growth characteristics. Oral Surg Oral

Med Oral Pathol Oral Radiol. 2002;94(5):543-53.

Öztan MD. Endodontic treatment of teeth

associated with a large periapical lesion. Int Endod

J. 2002;35(1):73-8.

Neaverth EJ, Burg HA. Decompression of large

periapical cystic lesions. J Endod. 1982;8(4):175-82.

Samuels HS. Marsupialization: Effective

management of large maxillary cysts: report of a

case. Oral Surg Oral Med Oral Pathol Oral Radiol.




How to Cite

Marsupialization as an Organ Preservation Measure in Management of Odontogenic Cyst. (2023). Sulaimani Dental Journal, 10(2), 8.