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Kim and Lee: Spontaneous bone regeneration after enucleation of jaw cysts: a comparative study of panoramic radiography and computed tomography
Original Article

J Korean Assoc Oral Maxillofac Surg 2010;36(2):100-107.

Published online: 10 January 2010

DOI: https://doi.org/10.5125/jkaoms.2010.36.2.100

Spontaneous bone regeneration after enucleation of jaw cysts: a comparative study of panoramic radiography and computed tomography

Taek-Sung Kim, Jae-Hoon Lee

Department of Oral and Maxillofacial surgery, College of Dentistry, Dankook University, Cheonan, Korea

Jae-Hoon Lee Department of Oral and Maxillofacial surgery, Dental Hospital, College of Dentistry, Dankook University San 7-1 Sinbu-dong, Cheonan, Chungnam, 330-716, Korea TEL: +82-41-550-1995 FAX: +82-41-551-8988 E-mail: lee201@dankook.ac.kr

Received 4 March 2010       Revised 15 March 2010       Accepted 31 March 2010

Copyright © 2010 Korean Association of Oral and Maxillofacial Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction

A cyst is a closed pathologic sac containing fluid or semi-solid material in central region. The most common conventional treatment for a cyst is enucleation. It was reported that spontaneous bone healing could be accomplished without bone grafting. We are trying to evaluate bone reconstruction ability by analyzing panorama radiograph and computed tomography (CT) scan with retrograde studying after cyst enucleation. In this way we are estimating critical size defect for spontaneous healing without bone graft.

Materials and Methods

The study comprised of 45 patients who were diagnosed as cysts and implemented enucleation treatment without bone graft. After radiograph photo taking ante and post surgery for 6, 12, 18, 24 months, the healing surface and volumetric changes were calculated.

Results

1. Spontaneous bone healing was accomplished clinically satisfying 12 months later after surgery. But analyzing CT scan, defect volume changes indicate 79.24% which imply incomplete bone healing of defect area. 2. Comparing volume changes of defect area of CT scan, there are statistical significance between under 5,000 mm3 and over 5,000 mm3. The defect volume of 5,000 mm3 shows 2.79×1.91 cm in panoramic view.

Conclusion

Bone defects, which are determined by a healed section using a panoramic view, compared to CT scans which do not show up. Also we can estimate the critical size of defects for complete healing.

Keywords: Spontaneous bone regeneration, Critical size of defect

References

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Fig. 1.
Demarcation of the lesion under panoramic view. (A: bone, B: lesion)
jkaoms-36-100f1.tif
Fig. 2.
Volume measurement of the lesion under CT view. (CT: computed tomography)
jkaoms-36-100f2.tif
Fig. 3.
Case distribution of age.
jkaoms-36-100f3.tif
Table 1.
Cases of follow-up
Type Total Sex Location Age Size and volume
Male Female Maxilla Mandible Above 20's Below 20's Above 4×3 cm, 8,000 mm3 Below 4×3 cm, 8,000 mm3
Radicular cyst 6 4 2 4 2 3 3 3 3
Dentigerous cyst 19 12 7 2 17 4 15 11 8
Odontogenic keratocyst 18 11 7 4 14 7 11 7 11
Nasopalatine duct cyst 1 1 0 1 0 1 0 0 1
Traumatic bone cyst 1 0 1 0 1 1 0 0 1
Sum 45 28 17 11 34 16 29 21 24

(Values: the number of cases)

Table 2.
Rate of change according to size of the lesion under panoramic view
Duration Below 4×3 cm Above 4×3 cm P value
6 months 65.41±4.44 62.79±5.21 0.724
12 months 96.54±2.29 92.67±2.33 0.0451
18 months 98.86±1.94 94.71±2.43 0.0311
24 months 99.26±1.43 96.21±2.16 0.0251

(Values: Mean±SD (%)) (1: P<0.05)

Table 3.
Rate of change according to size of the lesion under CT
Duration Below 8,000 mm3 Above 8,000 mm3 P value
6 months 55.74±6.42 55.38±3.85 0.564
12 months 79.24±2.69 76.1±3.14 0.221
18 months 90.9±1.42 85.93±4.02 0.0271
24 months 93.65±1.80 90.73±1.51 0.0091

(Values: Mean±SD (%)) (1: P<0.05) (CT: computed tomography)

Table 4.
Rate of change according to size of the lesion: comparison of CT and panoramic view
Duration Below 4×3 cm Below 8,000 mm3 P value
6 months 65.41±4.44 55.74±6.42 0.050
12 months 96.54±2.29 79.24±2.69 0.0111
18 months 98.86±1.94 90.9±1.42 0.0061
24 months 99.26±1.43 93.65±1.80 0.0061

(Values: Mean±SD (%)) (1: P<0.05) (CT: computed tomography)

Table 5.
Rate of change according to size of the lesion under CT
Duration Below 4,000 mm3 Above 4,000 mm3 P value Below 6,000 mm3 Above 6,000 mm3 P value
6 months 48.33±2.14 57.99±3.08 0.143 55.74±6.42 57.02±3.93 0.827
12 months 79.90±3.19 77.49±3.22 0.149 79.24±2.70 76.92±3.46 0.286
18 months 91.25±1.88 88.91±2.34 0.197 90.90±1.42 88.90±2.80 0.117
24 months 96.81±3.83 91.89±2.53 0.120 93.81±2.04 91.35±1.73 0.0491

(Values: Mean±SD (%)) (1: P<0.05) (CT: computed tomography)

Table 6.
Rate of change according to size of the lesion under CT
Duration Below 5,000 mm3 Above 5,000 mm3 P value
6 months 53.71±7.61 57.71±3.49 0.355
12 months 81.52±0.59 76.34±2.61 0.041
18 months 91.91±1.20 88.34±2.80 0.0431
24 months 98.41±2.25 91.75±1.76 0.0461

(Values: Mean±SD (%)) (1: P<0.05) (CT: computed tomography)

Table 7.
Rate of change according to sex
Duration Male Female P value
6 months 56.03±5.29 58.11±3.77 0.770
12 months 77.36±2.60 77.66±4.32 0.624
18 months 89.9±1.37 91.02±1.24 0.142
24 months 92.47±2.49 94.01±1.01 0.131

(Values: Mean±SD (%))

Table 8.
Rate of change according to age
Duration Below 5,000 mm3 P value Above 5,000 mm3 P value
Below 20's Above 20's Below 20's Above 20's
6 months 55.81±1.74 52.78±4.43 0.248 59.21±3.10 55.98±1.63 0.149
12 months 82.76±1.07 80.90±1.58 0.083 77.21±3.10 75.82±2.08 0.309
18 months 92.60±1.28 89.18±1.73 0.0431 88.91±2.95 86.53±2.46 0.248
24 months 98.78±1.28 94.08±2.25 0.0211 92.93±1.42 90.36±2.05 0.058

(Values: Mean±SD (%)) (1: P<0.05)

Table 9.
Rate of change according to location
Duration Maxilla Mandible P value
6 months 52.66±3.24 57.12±4.98 0.380
12 months 77.95±2.07 77.36±3.61 0.770
18 months 89.66±2.43 89.65±2.75 0.827
24 months 92.27±2.86 92.59±2.14 0.850

(Values: Mean±SD (%))

Table 10.
Rate of change according to types of cyst
Duration Radicular cyst Dentigerous cyst OKC P value
6 months 52.66±2.14 58.61±0.70 56.13±6.76 0.651
12 months 76.48±1.98 76.44±6.60 78.77±2.10 0.717
24 months 92.83±2.54 92.51±2.33 92.47±3.72 0.913

(Values: Mean±SD (%)) (OKC: odontogenic keratocyst)

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