Use of Cone Beam Computed Tomography in the Differential Diagnosis of Jaw Bone Lesions

Abstract

Background/Objective: This study aims to describe in detail the characteristics of the different jaw bone lesions seen in cone beam computed tomography examinations, from a retrospective analysis. Methods: All the preoperative examinations of cone beam computed tomography of intraosseous lesions of the jaws were retrospectively reviewed from patients treated at the Department of Stomatology of a Brazilian University, from 2008 to 2017. The following data were collected: sex, age, location, density and size of the lesion, relation to an unerupted tooth, margins, cortical and/or perforation, tooth displacement, root resorption, presence of calcifications, and proximity to anatomical structures. Fisher's exact test was used to verify associations between the variables. Results: We identified 28 lesions, all of which were benign: 14 odontogenic keratocysts, 5 odontomas, 3 dentigerous cysts, 2 ameloblastomas, 1 ameloblastic fibro-odontoma, 1 cementoblastoma, 1 adenomatoid odontogenic tumour, and 1 calcifying epithelial odontogenic cyst. Of these lesions, 23 affected the mandible, and 5 the maxilla. The lesions were subdivided into aggressive and non-aggressive, and when compared, there was a difference only for the cortical cone perforation variable (p <0.05), which was more prevalent in aggressive lesions, suggesting that this characteristic is an important indicator of pathological behaviour. Conclusions: An accurate identification of the characteristics of bone lesions of the buccomaxillofacial complex, using cone beam computed tomography, can guide diagnostic hypotheses, in addition to guiding the management, thus, providing a more appropriate treatment for each individualized case.

Challenges in the Surgical Management of Large Osteoma in the Maxillary Sinus: Case Report

“…Computed tomography is the imaging examination of choice for the diagnosis of osteomas due to its accuracy and the possibility of different cuts (axial, coronal, and sagittal), which assists in surgical planning [11]. Radiographically, osteomas are characterized by a dense and well-defined mass [6].…”