Conservative Management of a Large Radicular CystUsing Marsupialization Followed by Enucleation: A Case Report

Various treatment options are available for odontogenic cysts depending on lesion size, location, and patient-related factors, including curettage, enucleation, radical surgery, and marsupialization. Marsupialization (decompression) is a conservative technique that creates a surgical opening between the cyst cavity and the oral cavity, thereby reducing intracystic pressure and promoting gradual reduction in lesion volume. A drain may be placed to allow regular irrigation and cleaning. First described by Partsch in the late 19th century for cystic lesions of the jaws, this approach is particularly useful for large lesions or those located close to vital anatomical structures. Compared with primary enucleation, marsupialization may reduce surgical morbidity and help preserve adjacent structures, including developing permanent teeth. However, it requires prolonged treatment time, strict patient compliance, and may leave pathological tissue in situ. This report presents a 16-year-old systemically healthy patient with a large radicular cyst located in the posterior region of the left mandible. The lesion was initially managed with marsupialization for four months, followed by complete enucleation. Postoperative follow-up was continued for an additional four months, demonstrating favorable clinical and radiographic outcomes.