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Year : 2022  |  Volume : 25  |  Issue : 9  |  Page : 1548-1556

Investigation of the effects of marsupialization on histomorphological and immunohistochemical markers of odontogenic keratocysts

1 Department of Oral Pathology, Gazi University Faculty of Dentistry, Ankara, Turkey
2 Department of Medical Microbiology, Gulhane Institute of Health Sciences, University of Health Sciences, Ankara, Turkey

Correspondence Address:
Dr. E Baris
Department of Oral Pathology, Gazi University Faculty of Dentistry, Bişkek Cd. (8.Cd.) 1.Sk. No: 4 06490 Emek, Ankara
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_103_22

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Background: Despite its extensive bone resorption and high recurrence rate, marsupialization is the preferred option in the treatment of odontogenic keratocysts (OKCs). Aim: We aimed to assess the effect of marsupialization on histomorphological and biochemical markers of OKCs. Materials and Methods: The study is conducted on 48 paraffin blocks of 24 OKC cases between the years 2012 to 2018. The main clinical, radiographic, and histomorphometric measurements were recorded. Immunohistochemical staining with E-cadherin, Ki67, IL1α, TNFα, Slug, and Snail were performed and compared for pre-marsupialization and post-marsupialization values. Results: OKCs mostly located in the mandibular posterior region. The mean marsupialization period was 8.8 ± 6.5 (3-25) months. The mean radiographic size of OKC (57.1 ± 53.5 mm) was significantly reduced after marsupialization (22.6 ± 19.9 mm, P = 0.002). Histologically, significantly increased thickness of the OKC epithelium (p = 0.002) and collagen production (p = 0.034) was detected after marsupialization. The post-marsupialization group showed positive correlation of inflammation score to both TNFα (r: 0.69, P < 0.001) and IL-1α (r: 0.58, P = 0.008) expressions in connective tissue. Among immunohistochemical parameters, only Slug expression was significantly higher after marsupialization (p = 0.019). Conclusion: Our study suggests that increased Slug expression may enable the second surgery by increasing fibrosis in the cyst wall.

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