Molecular Insights Into Epithelial Detachment in Odontogenic Keratocyst: The Role of Matrix Metalloproteinases and Effects of Marsupialization.

INTRODUCTION Odontogenic keratocyst (OKC) is a developmental odontogenic cyst characterized by a fragile epithelial lining attachment to the capsula and high recurrence rates. Matrix metalloproteinases (MMPs) and adhesion-related proteins (TLN1, FBLN1) may contribute to epithelial detachment, which could facilitate lesion recurrence. This study investigated the mRNA expression of MMP2, MMP9, TLN1, and FBLN1 in OKCs and their association with epithelial detachment, including the impact of marsupialization.

METHODS Gene expression was analyzed by RT-qPCR in samples from OKCs (n = 10), marsupialized OKCs (n = 5), and oral mucosa controls (n = 4). Gelatinase activity was assessed by gelatin zymography in fresh samples (OKCs n = 7; oral mucosa n = 4). Histological sections were digitally measured to quantify areas of epithelial detachment. Correlation analyses were performed between mRNA expression levels and epithelial separation.

RESULTS MMP2 and MMP9 mRNA levels were significantly higher in OKCs compared to oral mucosa (p < 0.05), with decreased mRNA levels after marsupialization. Gelatin zymography confirmed elevated gelatinase activity, particularly for MMP9, in OKC tissues. TLN1 and FBLN1 mRNA expressions were also elevated in OKCs, consistent with previous proteomic data, though not statistically significant. A significant correlation was observed between MMP9 mRNA expression and the total area of detached epithelium.

CONCLUSION MMP9 may play a critical role in epithelial detachment in OKCs and could serve as a therapeutic target or prognostic marker. Marsupialization appears to modulate matrix metalloproteinases expression, suggesting a molecular mechanism for its clinical benefits.