Three-dimensional volumetric analysis of the efficiency of marsupialization in patients with mandibular dentigerous cysts involving impacted third molars

Abstract

Oral and maxillofacial surgeons commonly encounter dentigerous cysts (DCs) in clinical practice. If the DC is large and involves vital structures, such as the inferior alveolar nerve, marsupialization can be a useful treatment option to reduce the cyst size, ensuring safer enucleation later. However, the process of postoperative cyst shrinkage remains largely unknown. We used three-dimensional (3D) computed tomography (CT) to analyze volumetric changes occurring in DCs after marsupialization. In addition, we evaluated several parameters that might influence the efficiency of volume reduction. This retrospective cohort study included 21 patients with mandibular DCs in the third molar region. Using 3D CT data obtained before and after marsupialization, we measured cyst volumes at approximately 6 and 12 months after marsupialization. All lesions gradually shrank after marsupialization. The relative velocity of volume reduction differed significantly between 6 and 12 months after marsupialization. Age was significantly related to the efficiency of cyst shrinkage at 12 months after marsupialization. The efficiency of cyst shrinkage was not correlated with sex, smoking status, tooth extraction, or CT values around the lesion. Marsupialization was effective in reducing cyst size in all patients. The efficiency of volume reduction caused by marsupialization was associated with marsupialization duration and patient age. These factors should be considered during marsupialization and subsequent follow-ups.