Odontogenic keratocysts (OKCs), first described by Philipsen in 1956, are benign but aggressive cysts of odontogenic origin with high recurrence rates ？[1]. The choice of treatment for keratocysts, depends on factors such as size, location, patient age, cortical perforation, and proximity to critical structures like teeth, the inferior alveolar nerve, the pterygomaxillary fossa, and the maxillary sinus. Current treatment modalities include curettage, marsupialization, enucleation, and surgical resection, frequently followed by reconstruction. For large cysts or those near vital structures, conservative treatments are recommended to preserve oral tissues and limit surgical damage to important anatomical structures ？[2] ？[3]. This paper presents two cases of odontogenic keratocyst treated with a conservative approach, combining marsupialization and subsequent enucleation. Marsupialization was initially performed to decrease the size of the cysts, allowing the preservation of critical anatomical structures and reducing the need for more extensive surgery. Once the cysts had sufficiently regressed, enucleation was carried out to fully remove the remaining lesion. This conservative method proved effective in managing the lesions while minimizing surgical risks. These cases highlight the potential advantages of a conservative management strategy for large OKCs.
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