Zhongrui Li, Aili Xing, Xiangxiang Lu, Yuwen Lai, Mingjie Wu, Bin Zhao, Bin Sun
Odontogenic myxoma is a benign yet locally aggressive tumor. Its management often requires a balance between conservative surgical approaches, which are associated with a higher risk of recurrence, and radical resection, which can result in substantial anatomical defects. This study describes a function-preserving treatment strategy for a large mandibular odontogenic myxoma (5.0×3.0 cm) in a 28-year-old woman. The approach combined curettage with immediate fenestration of the bone cavity. Postoperatively, a custom-made cyst plug was placed to maintain the patency of the cavity, thereby facilitating drainage and modulating the local microenvironment. During a 5-year follow-up period, no clinical or radiographic evidence of recurrence was detected. Cone-beam computed tomography (CBCT) demonstrated complete healing of the cavity and restoration of normal bone density. By the fifth year, sufficient bone regeneration had occurred to allow successful dental implant placement. In general, this approach effectively minimized the risk of recurrence while preserving mandibular continuity and function, avoiding the defects and complex reconstructive procedures associated with radical surgery, and ultimately achieving complete functional rehabilitation.