Calculation of postoperative bone healing of cystic lesions of the jaw—a retrospective study

Abstract

Objectives There is a long history of studies into cystic lesions of the jaws. However, there is little data on postoperative bone regeneration. The aim of the study was to calculate the size of the residual bone lesions after cystostomies and cystectomies to predict the postoperative bone healing. Material and methods This retrospective study focused on patients undergoing cystectomy (n = 114) or cystostomy (n = 86), who were treated for cystic lesions between 2010 and 2015. New formulas were developed to measure the decrease in lesion sizes using the craniocaudal and mesiodistal diameters from preoperative as well as postoperative radiographs (panoramic radiographs, CT scans, CBCT). With these predictive models (calculated by linear regression analyses), it is possible to calculate how the lesions would shrink using initial size of the cyst and time after surgery for both dimensions. Results After cystostomy, the mesiodistal size was initial size 6.0 + 0.7 × initial size − 9.4 × time. The craniocaudal size was 5.1 + 0.7 × initial size − 7.3 × time. After cystectomy, the mesiodistal size was 0.4 + 0.7 × initial size − 8.4 × time. The craniocaudal size was 0.4 + 0.5 × initial size − 6.4 × time (R 2 = 0.59 and 0.67, respectively). Conclusion These formulas are suggested to be used to calculate residual size of bone lesion after cystostomy and cystectomy to predict postoperative bone healing. Clinical relevance The formulas are based on deliberately simple measurement using only panoramic radiographs to encourage their application in daily clinical practice.

Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study

“…Both imaging protocols have observed the underestimation of actual cystic lesion size, whereby recent reports indicate that automated volume determination of osseous lesions is faster but not superior to the manual acquisition, supporting this study's evaluation method [41]. Nevertheless, accurate volumetric assessment of the mandibular lesions is crucial, as the size of the cyst and its proximity to vulnerable structures, such as the inferior alveolar nerve or adjacent teeth, are essential in choosing the most suitable surgical treatment option for the patient [42,43].…”

Accuracy of formula-based volume and image segmentation-based volume in calculation of preoperative cystic jaw lesions’ volume

“…However, the use of such a mathematical formula can be cumbersome in multi-locular lesions. Also, Sacher et al [ 20 ] who used OsiriX software, concluded that using the formula is easy to use and allows for an accurate and precise prediction of the amount of time needed for bone regeneration after both cystostomy and cystectomy. This means that the formula can be used for comparable conditions.…”

A volumetric prediction model for postoperative cyst shrinkage

“…Despite extensive research into changes in cyst areas and volumes [ 10 , 11 ], few prediction models exist today. A recently proposed linear regression approach for cyst diameters [ 12 ] can be easily implemented in a clinical setting but shows several shortcomings from physiological and statistical perspectives. Most importantly, cyst shrinkage is not linear [ 13 ].…”