Analysis of changes in buccolingual width and cyst cavity depth at the stoma site during marsupialization for jaw cystic lesions.
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OBJECTIVES: To assess changes and factors influencing in buccolingual width and cyst cavity depth at the stoma site during marsupialization with cyst plug decompression for jaw cystic lesions. MATERIALS AND METHODS: Data were collected from patients who underwent marsupialization and cyst plug decompression for mandibular cystic lesions. A total of 15 cases were analyzed, including 10 odontogenic keratocysts (OKC), 1 unicystic ameloblastoma (UA), and 4 dentigerous cysts (DC). Cone beam computed tomography (CBCT) scans were conducted pre-surgery (T0), three months post-surgery (T1) and at the end of marsupialization (T2, > 2 months post-T1). Three-dimensional models were created to analyze bone dimensional changes in buccolingual width, vertical depth, and cyst volume. RESULTS: The Friedman two-way rank analysis and subsequent pairwise comparisons demonstrated the cyst volume significantly decreased from T0 to T1, T1 to T2, respectively (p < 0.05). The buccolingual width remained basically unchanged from T0 to T1 (p = 0.423), but gradually decreasing from T1 to T2 (p < 0.001). Meanwhile, the cyst cavity depth consistently decreased throughout the study (p < 0.05). The Spearman rank correlation coefficient test indicated the final change in buccolingual width positively correlated with the initial width of the stoma site (p < 0.001). CONCLUSIONS: Buccolingual width remains stable before decreasing, whereas cyst cavity depth and cyst volume decreases continuously. The larger the initial width of the stoma site, the greater change in width at the end of marsupialization. CLINICAL RELEVANCE: During marsupialization, cyst plug modifications should align with bone remodeling patterns in jaw cystic lesions. Initially, only the plug's depth is adjusted, while in later stages, both stoma width and depth are gradually reduced. This understanding can contribute to the digital prefabricated series of cyst plugs by integrating clinical insights to develop more minimally invasive treatment strategies and to appropriately lengthen the decompression period during marsupialization.