Decompression or Marsupialization: which Conservative Treatment is Associated with low Recurrence rate in Keratocystic Odontogenic Tumors? A Systematic Review

Statement of the Problem: Various treatment modalities have been reported for keratocystic odontogenic tumors (KOT), with different recurrence rates. Marsupialization and decompression are two different conservative surgical techniques for the treatment of KOTs. Purpose: This study aimed at comparing the recurrence rate between marsupialization and decompression in the treatment of KOTs with or without adjunctive treatments. Materials and Method: A systematic review was conducted based on the aim of the study. The research sources utilized were PubMed (MEDLINE), Google scholar, Ovid MEDLINE and Cochrane Library. The keywords which were selected based on Medical Subject Heading (MeSH) terms and PICOS criteria were odontogenic keratocyst, keratocyst odontogenic tumor AND marsupialization OR decompression OR cystectomy OR enucleation OR curettage. Statistical analyses were performed to compare the recurrence rate between marsupialization and decompression with or without adjunctive treatments, regarding various follow-up times. Results: The number of subjects that underwent marsupialization was 182. There was a significant difference for the recurrence rate between the marsupialization and decompression groups without considering adjunctive treatments ( p = 0.001). However, considering adjunctive treatments, there was no difference between marsupialization and the decompression groups ( p = 0.18). Conclusion: It appears that decompression without any adjuvant treatment may have a lower recurrence rate than marsupialization. The recurrence rate was not different wh-en enucleation or cystectomy was performed after decompression and marsupialization.