Marsupialization for Treatment of Jaw Cysts: Indications and Limitations

Background: Removal of jaw cysts that reach large sizes, result in facial deformity, injury to the adjacent neurovascular bundles or jaw fracture. Marsupialization means creating a window into the cyst for decompression and is an adjuvant treatment. Limitations of this technique are not explained completely. Materials and Methods: Patients suffering from a variety of jaw cysts that were managed by marsupialization with or without subsequent enucleation were included in this study between 2007 and 2014. At the 3rd and 6th month, follow-up radiographs were ordered. Results: There were 16 patients (20 cysts) that were included in this study. There were two cases (2/16) that decision was made to change the treatment planning. Half the cysts were histologically proven odontogenic keratocyst. Two-thirds of the patients, who needs to enucleation subsequent to the successful marsupialization, were managed under general anesthesia. Conclusion: Limitations of this technique are: Inability to examine the whole cyst microscopically, questionable eruption of the permanent tooth involved with the cyst, dependency on the patient cooperation, and difficulty of irrigation fluid circulation in multilocular jaw cysts, and finally, if the created window has large dimensions then soft tissue closure after final cyst enucleation is the problem.