Marsupialization as an Organ Preservation Measure in Management of Odontogenic Cyst
Keywords: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.
Methods: 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.
Results: 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
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
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
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
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.
Copyright (c) 2023 Rozhan N. Saeed, Suha N. Aloosi
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.