Evaluation on the Decision and Timing of Cyst Enucleation after Marsupialization of Large Sized Cystic Lesion on the Jaws

ABSTRACT

OBJECTIVE: The purpose of this study was to determine whether cyst enucleation would be done after marsupialization of large cystic lesion on the jaws or not, and if so, when it should be done. PATIENTS & METHODS: 12 patients with cystic lesion treated by marsupialization only and 10 patients with cystic lesion treated by marsupialization followed by enucleation were examined in this study. Postoperative clinical and radiographic examinations were performed at 1, 4, 7, 10, 13, 16, 19 months on 22 patients. Bone regeneration and reduction rate of the residual cystic cavities and bone density were evaluated with a analysis of digital panoramic radiographs. Also histological evaluation of the healing process was performed on 1 patient. RESULTS: Uneventful healing and spontaneous bony filling of the residual cavities were observed in all cases. Postoperative radiographs showed that the size of the lesions was reduced for a few months, but the reduction rate of the residual cavity was minimized for 13~16 months after marsupialization. The bone density was increased 22.5 % after 19 months. CONCLUSION: This results suggest that the appropriate timing to perform enucleation would be 13~16 months after marsupialization. The state of healing process could be confirmed by histological examination and radiographic evaluation of bone density. Enucleation after marsupialization could be applied appropriately to reduce the periods of bone healing in large cystic lesion on the jaws.