Optimal time to definitive enucleation of large cysts following marsupialization: A single center, retrospective study - 27/03/24

Doi : 10.1016/j.jormas.2024.101837

Pierantonio Bellini ^a, Angelo Ricci ^a, Giacomo Setti ^a,^⁎ , Federica Veneri ^b, Luca Losi ^a, Johanna Chester ^c, Ugo Consolo ^a
^a Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology, and Regenerative Medicine Relevance, Unit of Dentistry and Oral-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Largo del Pozzo, 71, Modena 41125, Italy
^b Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Largo del Pozzo, 71, Modena 41125, Italy
^c Department of Dermatology, University of Modena and Reggio Emilia, Largo del Pozzo, 71, Modena 41125, Italy

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 27 March 2024

Highlights

•	Marsupialization cannot be considered definitive therapy for large jaw cysts.
•	Optimal time to enucleation of large jaw cysts is 8 months after marsupialization.
•	Time to CBCT follow-up is the only variable influencing cyst volume reduction.
•	Cyst volume reduction is assessed by semi-automatic segmentation algorithm.

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Abstract

Objectives

Optimal time to enucleation following marsupialization of large odontogenic mandibular cysts is undefined. We aim to assess volume reduction throughout follow-up, to indicate optimal time to enucleation. Secondary objectives include the identification of factors influencing cyst reduction.

Study design

We retrospectively enrolled 15 patients with mandibular cysts of different histological types treated with marsupialization at our center between 2018 and 2022. Cyst volume was assessed with cone-beam computed tomography (CBCT) and a semi-automatic segmentation algorithm, at baseline and between 6 and 8 months post marsupialization.

Results

The overall mean cyst volume reduction percent (VR%) was 57.7 % or 0.2 % per day. VR% at 8 months was significantly higher than those assessed at 6 and 7 months (67.1% vs 47.1 %, p = 0.003). Time to CBCT was the only independent variable influencing cyst VR%.

Conclusion

Our study proves that the optimal time to enucleation for mandibular cyst is 8 months, independent of histological cyst type, patient age, baseline cyst volume and the number of pre-operative residual bone walls.

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Keywords : Marsupialization, Odontogenic cysts, Decompression, Enucleation, Cyst volume, CBCT