Comparison of Decompression vs Enucleation Using Fractal Analysis with Panoramic Radiography for Odontogenic Cysts

BACKGROUND Odontogenic cysts cause a decrease in bone trabeculation. This retrospective study of 37 patients with odontogenic cysts aimed to compare outcomes from treatment by decompression (marsupialization) versus enucleation, including the degree of trabeculation evaluated by fractal analysis (FA) using panoramic radiography (OPG). MATERIAL AND METHODS A total of 37 patients diagnosed with odontogenic cysts between January 2012 and January 2024 were included in the study. Patients were divided into 2 groups based on treatment: enucleation or decompression. Bone healing was assessed by the FA method, expressed as fractal dimension. The measurement times were defined as baseline (T0), 3 months postoperatively (T1), and 6 months postoperatively (T2). Statistical analyses were performed using the Shapiro-Wilk test for normality, followed by the Mann-Whitney U test and the t test for intergroup comparisons. P<0.05 was considered statistically significant. RESULTS A total of 37 patients were included in the study (mean age: 30.43±17.8 years), of whom 21 underwent decompression and 16 underwent enucleation. The mean FA values at T0, T1, and T2 for both groups demonstrated an increase in trabecular bone complexity over time. However, no statistically significant difference was found in bone healing between the enucleation and decompression groups at 3 months or at 6 months. CONCLUSIONS The findings of this study indicate that both approaches lead to trabecular bone recovery over time, with no statistically significant difference in bone healing at 3 and 6 months postoperatively. FA is a valuable method for assessing the skeletal effects of enucleation and marsupialization.