This study aimed to evaluate the efficacy of decompression followed by enucleation in treating large odontogenic lesions of the mandible and to compare the clinical, radiographic, and histopathological characteristics between odontogenic keratocyst (OKC) and unicystic ameloblastoma. Case 1 involved an 18-year-old male with a 3.5cm odontogenic keratocyst in the left mandible, treated with decompression followed by enucleation. At 27 months follow-up, no recurrence was observed with favorable bone regeneration. Case 2 involved a 22-year-old male with a 5.5cm cystic lesion in the left mandible, treated with the same staged approach. Final histopathological diagnosis revealed ameloblastoma with cystic space lined by odontogenic epithelium with fibrous connective tissue wall and intraluminal extending tumor showing plexiform pattern. At 37 months follow-up, no recurrence was noted with preservation of adjacent teeth. Decompression followed by enucleation is an effective conservative treatment for large mandibular odontogenic lesions, preserving vital anatomical structures. Although OKC and ameloblastoma share similar clinical and radiographic features, definitive histopathological diagnosis and long-term follow-up are essential.

• 정태영(인제대학교 부산백병원 구강악안면외과학교실) | Tae Young Jung (Department of Oral and Maxillofacial Surgery, Busan Paik Hospital, Inje University) Corresponding author