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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Injectable Filler | Research

Volumetric reduction in large cystic jaw lesions postoperative enucleation: a longitudinal clinical study

Authors: Sarah Al-Qurmoti, Mueataz A. Mahyoub, Mohamed Elhoumed, Essam Ahmed Al-Moraissi, Zhuo‑Ying Tao, Xiaoru Hou, Jing Li, Sisi Bi, Haiyan Wu, Jing Zhang, Huanhuan Lv, Lina Jiao, Sokina Al-Karmati, Kiran Acharya, Xiaoyi Hu, Jinfeng Li

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Enucleation, a surgical procedure, is commonly used to treat large jaw cysts, unicystic ameloblastomas and keratocysts. However, it remains unclear to what extent the jaw bone regenerates after enucleation. We aimed to evaluate the percentage and the survival analysis of jaw bone regeneration, in terms of cavity volume residual (CVR), in patients who underwent enucleation of large jaw cysts, unicystic ameloblastomas and keratocysts.

Methods

We collected data longitudinally from 75 patients who underwent jaw cystic lesions enucleation at the Stomatological Hospital of Xi’an Jiaotong University, between January 2015 and June 2021. All patients had both preoperative and postoperative cone-beam computed tomography (CBCT) imaging data. CBCT images were analyzed using Image J. Changes in the CVR were assessed at various follow-up time points, and the Kaplan-Meier method was utilized to evaluate the CVR over time.

Results

The patients had a mean age of 31.7 years (range: 5.5–72 years) with 58.66% of them being male. The postoperative CVR was 32.20% at three months, 21.10% at six months, 15.90% at 12 months, and 5.60% at 24 months. The percentage of CVR during follow-up periods for the initial size Quartile (Q)1 (212.54-1569.60 mm3) was substantially lower than those of Q2 and Q3 at and after seven months of follow-up and became statistically significant at the 12-month mark.

Conclusion

This study demonstrates that spontaneous bone regeneration can occur after enucleation of large jaw cysts, unicystic ameloblastomas and keratocysts, even without the use of filler materials. The initial size of the lesion had a significant impact on the outcome of cystic lesion enucleation over time. To minimize the risks associated with radiation exposure and expenses, we recommend reducing the frequency of CT imaging follow-ups for patients with small initial cavity sizes (ranging from 212.54 to 1569.60 mm3).
Literature
1.
go back to reference Ackermann G, Cohen MA, Altini M. The paradental cyst: a clinicopathologic study of 50 cases. Oral Surg Oral Med Oral Pathol. 1987;64(3):308–12. CrossRefPubMed Ackermann G, Cohen MA, Altini M. The paradental cyst: a clinicopathologic study of 50 cases. Oral Surg Oral Med Oral Pathol. 1987;64(3):308–12. CrossRefPubMed
2.
go back to reference Franklin JR, Vieira EL, Brito LN, Castro JF, Godoy GP. Epidemiological evaluation of jaw cysts according to the new WHO classification: a 30-year retrospective analysis. Braz Oral Res. 2021;35:e129. Franklin JR, Vieira EL, Brito LN, Castro JF, Godoy GP. Epidemiological evaluation of jaw cysts according to the new WHO classification: a 30-year retrospective analysis. Braz Oral Res. 2021;35:e129.
3.
go back to reference Buchbender M, Koch B, Kesting MR, Matta RE, Adler W, Seidel A, Schmitt CM. Retrospective 3D analysis of bone regeneration after cystectomy of odontogenic cysts. J Xray Sci Technol. 2020;28(6):1141–55.PubMed Buchbender M, Koch B, Kesting MR, Matta RE, Adler W, Seidel A, Schmitt CM. Retrospective 3D analysis of bone regeneration after cystectomy of odontogenic cysts. J Xray Sci Technol. 2020;28(6):1141–55.PubMed
4.
go back to reference Krishnan U, Al Maslamani M, Moule AJJCR. Cone beam CT as an aid to diagnosing mixed radiopaque radiolucent lesions in the mandibular incisor region. BMJ Case Rep 2015, 2015:bcr2014207617. Krishnan U, Al Maslamani M, Moule AJJCR. Cone beam CT as an aid to diagnosing mixed radiopaque radiolucent lesions in the mandibular incisor region. BMJ Case Rep 2015, 2015:bcr2014207617.
5.
go back to reference Stoelinga PJ. The treatment of odontogenic keratocysts by excision of the overlying, attached mucosa, enucleation, and treatment of the bony defect with carnoy solution. J Oral Maxillofac Surg. 2005;63(11):1662–6.CrossRefPubMed Stoelinga PJ. The treatment of odontogenic keratocysts by excision of the overlying, attached mucosa, enucleation, and treatment of the bony defect with carnoy solution. J Oral Maxillofac Surg. 2005;63(11):1662–6.CrossRefPubMed
6.
go back to reference Al-Moraissi EA, Kaur A, Gomez RS, Ellis E. 3rd: effectiveness of different treatments for odontogenic keratocyst: a network meta-analysis. Int J Oral Maxillofac Surg. 2023;52(1):32–43.CrossRefPubMed Al-Moraissi EA, Kaur A, Gomez RS, Ellis E. 3rd: effectiveness of different treatments for odontogenic keratocyst: a network meta-analysis. Int J Oral Maxillofac Surg. 2023;52(1):32–43.CrossRefPubMed
7.
go back to reference Taysi M, Ozden C, Cankaya AB, Yildirim S, Bilgic L. Conservative approach to a large dentigerous cyst in an 11-year-old patient. J Istanb Univ Fac Dent. 2016;50(3):51–6.CrossRefPubMedPubMedCentral Taysi M, Ozden C, Cankaya AB, Yildirim S, Bilgic L. Conservative approach to a large dentigerous cyst in an 11-year-old patient. J Istanb Univ Fac Dent. 2016;50(3):51–6.CrossRefPubMedPubMedCentral
8.
go back to reference Asutay F, Atalay Y, Turamanlar O, Horata E, Burdurlu MC. Three-Dimensional Volumetric Assessment of the Effect of Decompression on large mandibular odontogenic cystic lesions. J Oral Maxillofac Surg. 2016;74(6):1159–66.CrossRefPubMed Asutay F, Atalay Y, Turamanlar O, Horata E, Burdurlu MC. Three-Dimensional Volumetric Assessment of the Effect of Decompression on large mandibular odontogenic cystic lesions. J Oral Maxillofac Surg. 2016;74(6):1159–66.CrossRefPubMed
9.
go back to reference Song IS, Park HS, Seo BM, Lee JH, Kim MJ. Effect of decompression on cystic lesions of the mandible: 3-dimensional volumetric analysis. Br J Oral Maxillofac Surg. 2015;53(9):841–8.CrossRefPubMed Song IS, Park HS, Seo BM, Lee JH, Kim MJ. Effect of decompression on cystic lesions of the mandible: 3-dimensional volumetric analysis. Br J Oral Maxillofac Surg. 2015;53(9):841–8.CrossRefPubMed
10.
go back to reference Yim J-H, Lee J-HJMP, Surgery R. Panoramic analysis about spontaneous bone regeneration after enucleation of jaw cyst. J Clin Diagn Res. 2009;31(3):229–36. Yim J-H, Lee J-HJMP, Surgery R. Panoramic analysis about spontaneous bone regeneration after enucleation of jaw cyst. J Clin Diagn Res. 2009;31(3):229–36.
11.
12.
go back to reference Myoung H, Hong SP, Hong SD, Lee JI, Lim CY, Choung PH, Lee JH, Choi JY, Seo BM, Kim MJ. Odontogenic keratocyst: review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(3):328–33.CrossRefPubMed Myoung H, Hong SP, Hong SD, Lee JI, Lim CY, Choung PH, Lee JH, Choi JY, Seo BM, Kim MJ. Odontogenic keratocyst: review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(3):328–33.CrossRefPubMed
13.
go back to reference Rubio E. Mombrú CJCt, reconstruction: spontaneous bone healing after cysts enucleation without bone grafting materials: a randomized clinical study. Craniomaxillofac Trauma Reconstr. 2015;8(1):14–22.CrossRefPubMed Rubio E. Mombrú CJCt, reconstruction: spontaneous bone healing after cysts enucleation without bone grafting materials: a randomized clinical study. Craniomaxillofac Trauma Reconstr. 2015;8(1):14–22.CrossRefPubMed
14.
go back to reference Chiapasco M, Rossi A, Motta JJ. Crescentini MJJoo, surgery m: spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral Maxillofac Surg. 2000;58(9):942–8.CrossRefPubMed Chiapasco M, Rossi A, Motta JJ. Crescentini MJJoo, surgery m: spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral Maxillofac Surg. 2000;58(9):942–8.CrossRefPubMed
15.
go back to reference Lim HK, Kim JW, Lee UL, Kim JW, Lee H. Risk factor analysis of graft failure with concomitant cyst enucleation of the Jaw bone: a retrospective Multicenter Study. J Oral Maxillofac Surg. 2017;75(8):1668–78.CrossRefPubMed Lim HK, Kim JW, Lee UL, Kim JW, Lee H. Risk factor analysis of graft failure with concomitant cyst enucleation of the Jaw bone: a retrospective Multicenter Study. J Oral Maxillofac Surg. 2017;75(8):1668–78.CrossRefPubMed
16.
go back to reference Iatrou I, Theologie-Lygidakis N, Leventis M. Intraosseous cystic lesions of the jaws in children: a retrospective analysis of 47 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(4):485–92.CrossRefPubMed Iatrou I, Theologie-Lygidakis N, Leventis M. Intraosseous cystic lesions of the jaws in children: a retrospective analysis of 47 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(4):485–92.CrossRefPubMed
17.
go back to reference Park HMJPM, Policy Analysis Program GSoIR, International University of Japan. Practical guides to panel data modeling: a step-by-step analysis using stata. Int Univ Japan Public Manage Policy Anal Program. 2011;12:1–52. Park HMJPM, Policy Analysis Program GSoIR, International University of Japan. Practical guides to panel data modeling: a step-by-step analysis using stata. Int Univ Japan Public Manage Policy Anal Program. 2011;12:1–52.
18.
go back to reference Buchbender M, Neukam FW, Lutz R, Schmitt CM. Treatment of enucleated odontogenic jaw cysts: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(5):399–406.CrossRefPubMed Buchbender M, Neukam FW, Lutz R, Schmitt CM. Treatment of enucleated odontogenic jaw cysts: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(5):399–406.CrossRefPubMed
19.
go back to reference Vitale A, Battaglia S, Crimi S, Ricceri C, Cervino G, Cicciù M, De Ponte FS, Leonardi RM, Bianchi AJAS. Spontaneous bone regeneration after enucleation of mandibular cysts: retrospective analysis of the volumetric increase with a full-3D measurement protocol. Appl Sci. 2021;11(11):4731.CrossRef Vitale A, Battaglia S, Crimi S, Ricceri C, Cervino G, Cicciù M, De Ponte FS, Leonardi RM, Bianchi AJAS. Spontaneous bone regeneration after enucleation of mandibular cysts: retrospective analysis of the volumetric increase with a full-3D measurement protocol. Appl Sci. 2021;11(11):4731.CrossRef
20.
21.
go back to reference Shi J, Zhou J, Liu C, Liu Y, Si MJCID, Research R. Radiographic bone volume alteration after jaw cyst enucleation with or without simultaneous bone grafts: a prospective randomized study. Clin Implant Dent Relat Res. 2022;24(4):468–74.CrossRefPubMed Shi J, Zhou J, Liu C, Liu Y, Si MJCID, Research R. Radiographic bone volume alteration after jaw cyst enucleation with or without simultaneous bone grafts: a prospective randomized study. Clin Implant Dent Relat Res. 2022;24(4):468–74.CrossRefPubMed
22.
go back to reference Suei Y, Taguchi A, Tanimoto K. Simple bone cyst of the jaws: evaluation of treatment outcome by review of 132 cases. J Oral Maxillofac Surg. 2007;65(5):918–23.CrossRefPubMed Suei Y, Taguchi A, Tanimoto K. Simple bone cyst of the jaws: evaluation of treatment outcome by review of 132 cases. J Oral Maxillofac Surg. 2007;65(5):918–23.CrossRefPubMed
23.
go back to reference Cheng C-H, Chen L-R, Chen K-HJIJoMS. Osteoporosis due to hormone imbalance: an overview of the effects of estrogen deficiency and glucocorticoid overuse on bone turnover. Int J Mol Sci. 2022;23(3):1376.CrossRefPubMedPubMedCentral Cheng C-H, Chen L-R, Chen K-HJIJoMS. Osteoporosis due to hormone imbalance: an overview of the effects of estrogen deficiency and glucocorticoid overuse on bone turnover. Int J Mol Sci. 2022;23(3):1376.CrossRefPubMedPubMedCentral
24.
go back to reference Pietschmann P, Gollob E, Brosch S, Hahn P, Kudlacek S, Willheim M, Woloszczuk W, Peterlik M, Tragl KH. The effect of age and gender on cytokine production by human peripheral blood mononuclear cells and markers of bone metabolism. Exp Gerontol. 2003;38(10):1119–27.CrossRefPubMed Pietschmann P, Gollob E, Brosch S, Hahn P, Kudlacek S, Willheim M, Woloszczuk W, Peterlik M, Tragl KH. The effect of age and gender on cytokine production by human peripheral blood mononuclear cells and markers of bone metabolism. Exp Gerontol. 2003;38(10):1119–27.CrossRefPubMed
25.
go back to reference Zhang J, Yu Y, Miao R, Ren J, Jiang Y, Jing W. Treatment effect analysis of curettage for jaw cysts based on volumetric assessment and image registration. J Craniomaxillofac Surg. 2022;50(10):790–7.CrossRef Zhang J, Yu Y, Miao R, Ren J, Jiang Y, Jing W. Treatment effect analysis of curettage for jaw cysts based on volumetric assessment and image registration. J Craniomaxillofac Surg. 2022;50(10):790–7.CrossRef
26.
go back to reference Anavi Y, Gal G, Miron H, Calderon S, Allon DM. Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(2):164–9.CrossRefPubMed Anavi Y, Gal G, Miron H, Calderon S, Allon DM. Decompression of odontogenic cystic lesions: clinical long-term study of 73 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(2):164–9.CrossRefPubMed
27.
go back to reference Haffner-Luntzer M, Liedert A, Ignatius A. Mechanobiology of bone remodeling and fracture healing in the aged organism. Innov Surg Sci. 2016;1(2):57–63.PubMedPubMedCentral Haffner-Luntzer M, Liedert A, Ignatius A. Mechanobiology of bone remodeling and fracture healing in the aged organism. Innov Surg Sci. 2016;1(2):57–63.PubMedPubMedCentral
28.
go back to reference Stegen S, Carmeliet GJB. The skeletal vascular system–breathing life into bone tissue. Bone. 2018;115:50–8.CrossRefPubMed Stegen S, Carmeliet GJB. The skeletal vascular system–breathing life into bone tissue. Bone. 2018;115:50–8.CrossRefPubMed
29.
go back to reference Ho-Shui-Ling A, Bolander J, Rustom LE, Johnson AW, Luyten FP, Picart C. Bone regeneration strategies: Engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives. Biomaterials. 2018;180:143–62.CrossRefPubMedPubMedCentral Ho-Shui-Ling A, Bolander J, Rustom LE, Johnson AW, Luyten FP, Picart C. Bone regeneration strategies: Engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives. Biomaterials. 2018;180:143–62.CrossRefPubMedPubMedCentral
Metadata
Title
Volumetric reduction in large cystic jaw lesions postoperative enucleation: a longitudinal clinical study
Authors
Sarah Al-Qurmoti
Mueataz A. Mahyoub
Mohamed Elhoumed
Essam Ahmed Al-Moraissi
Zhuo‑Ying Tao
Xiaoru Hou
Jing Li
Sisi Bi
Haiyan Wu
Jing Zhang
Huanhuan Lv
Lina Jiao
Sokina Al-Karmati
Kiran Acharya
Xiaoyi Hu
Jinfeng Li
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03307-1

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