BACKGROUND: To spare important anatomical structures from damage during treatment of cystic odontogenic lesions, decompression has become a conservative alternative to enucleation. Marsupialization, in combination with the use of a custom-made decompression prosthesis, is an effective method of inducing reduction and bony infill of cystic lesions of the jaw. METHODS: In this case series and review of the literature, we describe three patients with odontogenic cysts of the mandible who were treated with custom-made decompression obturator prostheses (DOP) at the Memorial Sloan Kettering Cancer Center Dental Service. RESULTS: At the conclusion of treatment, all patients demonstrated complete resolution of their respective bony defects. CONCLUSION: DOP provide effective means of keeping the cyst opening patent following marsupialization, which allows for adequate, if not complete, resolution of defects, often without need for subsequent enucleation.