Management of benign osteolytic jaw lesions: a systematic review of marsupialization versus enucleation
Authors
Sofia Rastelli, Gian Luca Pancrazi, Giulia Santamaria, Alfredo De Rosa, Paolo La Torre, Giulia Polli, Raffaele Vinci
Abstract
Background: Benign osteolytic lesions of the jaws include odontogenic cysts and selected benign odontogenic tumors. Enucleation and marsupialization/decompression are commonly used surgical approaches, but their relative morbidity and recurrence remain debated.
Objective: To describe lesion characteristics and compare author-reported outcomes after enucleation and marsupialization, with or without subsequent surgery or adjunctive treatment.
Methods: A PubMed search, supplemented by reference-list screening, Google Scholar, and manual searching, identified studies meeting predefined eligibility criteria. The review was prepared with reference to the PRISMA statement [7].
Results: Ninety-two articles describing 4,059 jaw lesions were included. Initial treatment was enucleation in 2,690 lesions, marsupialization in 1,336, and another procedure in 33. Adequate follow-up (≥6 months) was available for 2,401 lesions. Crude recurrence proportions were 87/538 (16.2%) after marsupialization and 285/1,840 (15.5%) after enucleation. Reported infections, immediate postoperative paresthesia, and fractures were less frequent after marsupialization; however, denominators varied substantially across outcomes.
Conclusions: The descriptive pooled data suggest similar crude recurrence proportions and fewer reported short-term complications after marsupialization. These findings do not establish equivalence because lesion histology, treatment protocols, follow-up, and study designs were heterogeneous, and no formal comparative meta-analysis or risk-of-bias assessment was reported. Marsupialization may be considered in selected lesions when primary enucleation is expected to carry substantial morbidity, often as the first stage of a planned two-stage approach.
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