title: Marsupialization for odontogenic keratocysts: long-term follow-up analysis of the effects and changes in growth characteristics.
abstract: OBJECTIVE
  This study evaluated the effects of marsupialization on odontogenic keratocysts (OKCs) and its role in conjunction with enucleation and curettage.
  
  
  METHODS
  Twenty-eight primary OKCs, treated by marsupialization before enucleation and curettage, were examined in this study. The effect of marsupialization and recurrence data after a follow-up period of at least 3 years were evaluated. The changes of growth characteristics during marsupialization were analyzed by means of histopathologic and immunohistochemical studies with monoclonal anti-Ki-67 antibody.
  
  
  RESULTS
  The effect of marsupialization was evaluated as extremely effective (64.3%), moderately effective (32.1%), and poorly effective (3.6%). In 5 lesions, the cysts disappeared macroscopically and further surgery was not done. Recurrence was observed in 6 lesions (21.4%), and there was no significant difference in recurrence rates between the lesions treated with or without marsupialization. There appeared to be a predilection for recurrence in the lesions in the mandibular ramus region and also for radiographically multilocular lesions. Microscopic examination showed substantial changes from a parakeratinized or orthokeratinized epithelium into a hyperplastic, stratified, nonkeratinizing squamous epithelium after marsupialization in many cases. There was no significant difference in labeling index between premarsupialization (20.2% +/- 12.0%) and postmarsupialization (15.3% +/- 10.3%).
  
  
  CONCLUSIONS
  Marsupialization was found to be effective as a preliminary treatment for large OKCs. This procedure does not appear to affect the recurrence tendency of OKCs, and the probable changes in growth characteristics become rather less aggressive.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kyushu University Dental Hospital, Fukuoka, Japan. nakamura@dent.kyusyu-u.ac.jp
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mitsuyasu
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Mitsuyasu
authors.forename: Takaharu
authors.initials: T
authors.lastname: Taketomi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ohishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008336:Mandibular Diseases / Q000503:physiopathology / Q000601:surgery*; D008439:Maxillary Diseases / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D009807:Odontogenic Cysts / Q000503:physiopathology / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D019394:Ki-67 Antigen