Deep learning in the diagnosis for cystic lesions of the jaws: a review of recent progress.

Cystic lesions of the gnathic bones present challenges in differential diagnosis. In recent years, artificial intelligence (AI) represented by deep learning (DL) has rapidly developed and emerged in the field of dental and maxillofacial radiology (DMFR). Dental radiography provides a rich resource for the study of diagnostic analysis methods for cystic lesions of the jaws and has attracted many researchers. The aim of the current study was to investigate the diagnostic performance of DL for cystic lesions of the jaws. Online searches were done on Google Scholar, PubMed, and IEEE Xplore databases, up to September 2023, with subsequent manual screening for confirmation. The initial search yielded 1862 titles, and 44 studies were ultimately included. All studies used DL methods or tools for the identification of a variable number of maxillofacial cysts. The performance of algorithms with different models varies. Although most of the reviewed studies demonstrated that DL methods have better discriminative performance than clinicians, further development is still needed before routine clinical implementation due to several challenges and limitations such as lack of model interpretability, multicentre data validation, etc. Considering the current limitations and challenges, future studies for the differential diagnosis of cystic lesions of the jaws should follow actual clinical diagnostic scenarios to coordinate study design and enhance the impact of AI in the diagnosis of oral and maxillofacial diseases.

Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report.

BACKGROUND: Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. CASE PRESENTATION: A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. DISCUSSION: The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. CONCLUSION: The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.

Machine Learning Model Based on Radiomics for Preoperative Differentiation of Jaw Cystic Lesions.

OBJECTIVE: This study aims to use machine learning techniques together with radiomics methods to build a preoperative predictive diagnostic model from spiral computed tomography (CT) images. The model is intended for the differential diagnosis of common jaw cystic lesions. STUDY DESIGN: Retrospective, case-control study. SETTING: This retrospective study was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University (Guangzhou, Guangdong, China). All the data used to build the predictive diagnostic model were collected from 160 patients, who were treated at the Department of Oral and Maxillofacial Surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between 2019 and 2023. METHODS: We included a total of 160 patients in this study. We extracted 107 radiomic features from each patient's CT scan images. After a feature selection process, we chose 15 of these radiomic features to construct the predictive diagnostic model. RESULTS: Among the preoperative predictive diagnostic models built using 3 different machine learning methods (support vector machine, random forest [RF], and multivariate logistic regression), the RF model showed the best predictive performance. It demonstrated a sensitivity of 0.923, a specificity of 0.643, an accuracy of 0.825, and an area under the receiver operating characteristic curve of 0.810. CONCLUSION: The preoperative predictive model, based on spiral CT radiomics and machine learning algorithms, shows promising differential diagnostic capabilities. For common jaw cystic lesions, this predictive model has potential clinical application value, providing a scientific reference for treatment decisions.

A 3-year follow-up clinical study on the preservation for vitality of involved tooth in jaw cysts through an innovative method.

Jaw cysts commonly affect the oral and maxillofacial region, involving adjacent tooth roots. The management of these teeth, particularly regarding root canal therapy and apicoectomy, lacks consensus. This study introduces a novel treatment concept and refined surgical approach to preserve pulp viability in teeth involved in jaw cysts. The objective was to investigate the effectiveness and potential benefits of this approach over a 36-month follow-up period. A conservative management approach prioritized vitality preservation, reserving root canal treatment and apicectomy for cases with post-operative discomfort. A comprehensive follow-up of 108 involved teeth from 36 jaw cyst cases treated with the modified method was conducted. Clinical observation, X-ray imaging, cone-beam computed tomography (CBCT), and pulp vitality testing assessed changes in cyst size, tooth color, pulp vitality, root structure, and surrounding alveolar bone. After 36 months, our modified surgical approach successfully preserved tooth vitality in 84 involved teeth. Adverse symptoms in 19 teeth, such as redness, swelling, fistula, and pain, resolved with postoperative root canal therapy. Follow-up was lost for five teeth in two cases. No cyst recurrences were observed, and in 34 cases, the bone cavity gradually disappeared, restoring normal bone density during long-term follow-up. Our modified surgical method effectively preserves tooth vitality in jaw cysts. This innovative approach has the potential to improve the management of teeth involved in jaw cysts.

Autotransplantation for Restoration of Dentition Defects After Excision of Jaw Cysts.

Bone defect caused by jaw cystectomy has always been the main factor affecting postoperative wound healing and is also the common cause of maxillofacial bone defect, which brings challenges to the subsequent restoration of missing teeth. In this paper, the authors report a 22-year-old young woman who had a mandibular cyst in the left lower posterior tooth area. She underwent mandibular bone cyst excision and simultaneous extraction of teeth 36 and 37. One and two months after the removal of the mandibular bone cyst, autologous tooth transplantation was performed in stages from tooth 28 to tooth 36 and from tooth 18 to tooth 37. The case shows that tooth autotransplantation is a viable option for the restoration of dentition defects after the excision of jaw cysts, which can promote the healing of the bone defect after the operation.

Maxillary Surgical Ciliated Cyst After Orthognathic Surgery.

Surgical ciliated cysts, also known as implantation cysts or postoperative maxillary cysts, are uncommon cystic formations predominantly arising in the posterior maxillary region after radical maxillary sinus surgery. Herein, we present the case of a 28-year-old male patient who had previously undergone orthognathic surgery and later experienced a minor car accident without major consequences. Approximately four years after surgery, the patient sought dental care due to the presence of a painless swelling in the maxillary region. Upon intraoral examination, the swelling extended from the area around the right canine to the upper left molar, covered by red mucosa. Image studies revealed an extensive well-defined osteolytic lesion causing thinning, erosion, buccal cortical plate perforation, and root resorption. An incisional biopsy was performed, and microscopic examination revealed a cystic lesion lined by ciliated respiratory-type epithelium and capsule variably fibrotic with sparse chronic inflammation. The final diagnosis was surgical ciliated cysts. The treatment approach involved decompression followed by enucleation and curettage, with the addition of bone grafting and the application of Leukocyte-Platelet Rich Fibrin (L-PRF). The patient has been under clinical follow-up for approximately 17 months with no signs of recurrence. A careful morphological evaluation is essential to avoid misdiagnosis and ensure a satisfactory treatment approach. In conclusion, this case highlights the importance of accurate diagnosis and appropriate treatment approaches for surgical ciliated cysts to ensure favorable patient outcomes.

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

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).

Jaw Osteomyelitis of Impacted Tooth After Radiotherapy: A Report of a Case.

Maxillofacial radiotherapy has a significant negative impact on oral health and impacted teeth often lead to diseases such as jaw cysts and periapical periodontitis. This article reports a case of jaw osteomyelitis (with both impacted teeth and periodontitis) occurring 10 years after radiotherapy for nasopharyngeal carcinoma. There is no systematic treatment plan for patients with both pathogenic factors in clinical practice, so it is important to develop a systematic and complete treatment plan before radiotherapy and chemotherapy. The periodontal treatment of patients receiving radiotherapy and the timing of extraction of impacted teeth are mainly discussed.

Osteotomia periférica no tratamento de cisto odontogênico glandular / Peripheral osteotomy in the treatment of glandular odontogenic cyst / Osteotomía periférica en el tratamiento del quiste odontogénico glandular

O objetivo deste artigo é relatar um caso de COG em sínfise mandibular, tratado com enucleação e osteotomia periférica. Relato de Caso: Paciente do sexo feminino, 58 anos de idade, foi encaminhada para avaliação de uma lesão mandibular, apresentando-se assintomática no momento da consulta. Foi observado um leve aumento de volume vestibular na região da sínfise mandibular, sem sensibilidade ao toque. Na tomografia foi observada imagem hipodensa, multiloculada, bem delimitada, na região de sínfise, próxima as raízes dentárias e a basilar mandibular, além de um dente incluso intralesional. Foi realizada biópsia incisional e exame histopatológico, através do qual foi estabelecido o diagnóstico de COG. Como forma de tratamento, o paciente foi submetido a enucleação com curetagem de toda lesão e a osteotomia periférica, além da remoção do dente incluso. Após um ano de acompanhamento, a paciente encontra-se livre de recorrências. Conclusão: Por fim, este caso destaca a importância de um tratamento eficaz de COG com a osteotomia periférica, considerando o tamanho da lesão, suas características e sua localização, a fim de reduzir suas chances de recidiva... (AU)

The aim of this article is to report a case of COG in mandibular symphysis, treated with enucleation and peripheral osteotomy. Case Report: A 58-yearold female patient was referred for evaluation of a mandibular lesion, instrument was asymptomatic at the time of consultation. An increase in vestibular volume was observed in the region of the mandibular symphysis, without sensitivity to touch. The tomography showed a hypodense, multiloculated, well-delimited image in the symphysis region, close to tooth roots and a mandibular basilar, in addition to an intralesional impacted tooth. An incisional biopsy and histopathological examination were performed, through which the diagnosis of COG was established. As a form of treatment, the patient underwent enucleation with curettage of the entire lesion and peripheral osteotomy, in addition to removal of the impacted tooth. After a year of follow-up, the patient is free from recurrences. Conclusion: Finally, this case highlights the importance of an effective treatment of COG with peripheral osteotomy, considering the size of the lesion, its characteristics and its location, in order to reduce its chances of recurrence... (AU)

El objetivo de este artículo es reportar un caso de COG en la sínfisis mandibular, tratado con enucleación y osteotomía periférica. Caso Clínico: Paciente femenino, de 58 años de edad, fue remitida para valoración de lesión mandibular, presentándose asintomática al momento de la consulta. Se observa ligero aumento de volumen vestibular en la región de la sínfisis mandibular, sin sensibilidad al tacto. En la tomografía se observó una imagen hipodensa, multiloculada, bien delimitada en la región de la sínfisis, próxima a las raíces dentarias y la base de la mandíbula, además de un diente intralesional. Se realizó biopsia incisional y examen histopatológico, a través del cual se estableció el diagnóstico de GOC. Como forma de tratamiento, el paciente fue sometido a enucleación con curetaje de toda la lesión y osteotomía periférica, además de extracción del diente impactado. Después de un año de seguimiento, un paciente está libre de recurrencias. Conclusión: Finalmente, este caso destaca la importancia de un tratamiento efectivo de la GOC con osteotomía periférica, considerando el tamaño de la lesión, sus características y su ubicación, para reducir sus posibilidades de recurrencia... (AU)

Application of Vacuum-Formed Cyst Plug-in Conservative Treatment of Jaw Cyst in Children.

Fenestration decompression, which can protect important anatomic structures and reduce surgical risk is the most preferred way for the treatment of jaw cysts in children, and wearing a cyst plug after the operation is the key to success. To enhance the retention of the cyst plug and promote the healing of the cyst, our team designed the vacuum-formed cyst plug to replace the classic one. This article presents a case of a jaw cyst in a 6-year-old girl who wore the vacuum-formed cyst plug after the fenestration decompression. Six months later, the cyst healed, and the permanent teeth affected by the cyst returned. This case showed that the vacuum-formed cyst plug offered a more comfortable experience and an explicit prognosis for children with jaw cysts, having high clinical application value.

Stafne's bone defect: a systematic review.

BACKGROUND: This systematic review integrated the available data published in the literature on Stafne's bone defect (SBD), considering the clinical, imaging and histopathological results. MATERIAL AND METHODS: An electronic search was undertaken in six databases. Eligibility criteria were: articles in English, Spanish, and Portuguese describing case reports or case series of SBD, reported up to September/2021. Risk of bias was assessed using the Joanna Briggs Institute tool. RESULTS: A total of 98 articles were retrieved, involving 465 individuals with SBD and were included for quantitative analysis. Mean age was 52.78 years (range: 11-89 years), with male predilection (n=374/80.85%). Radiographs were the most frequent imagiological exams (n=298/64.09%), followed by computed tomography (n=98/21.08%). SBD was more prevalent in the posterior mandible (n=361/93.77%) as a hypodense radiolucent lesion (n=250/77.40%). Mean size was 1.58 cm (range: 0.3-.8.0 cm). Two-hundred-and-two lesions (97.37%) were unilocular and 126 (91.97%) were classified as well-defined. Clinical symptoms were reported in 73 cases, while 68 cases (93.15%) were asymptomatic. Only 34 cases (12.32%) were submitted to histopathological examination. Mean follow-up time was 26.42 ±25.39 months. CONCLUSIONS: SBD is more frequent in male patients in the fifth and sixth decade of life. Classic SBD is radiographically characterized as a single, unilocular and well-defined lesion in the posterior region of the jaw with a radiolucent/hypodense appearance.

Comparative Study of the Efficacy of Autologous Tooth Bone Powder and Inorganic Bovine Bone Powder on the Repair of Jaw Defects.

Context: The main pathological features of jaw cysts are bone defects. Obtaining autologous bone for transplantation repair has been associated with postoperative complications, and the amount of bone that dentist can collect is limited. Studies have found that autologous tooth bone powder is safe and has good bone-formation ability and stability. Objective: The study intended to examine the efficacy of implantation of autologous tooth bone powder and inorganic bovine bone powder, after marsupialization and second-stage curettage for large jaw cysts that dentist can't directly remove by surgery in clinical practice. Design: The research team designed a prospective randomized controlled trial. Setting: The study took place in the Head and Neck Surgery Department at Chongqing University Cancer Hospital in Chongqing, China. Participants: Participants were 60 patients at the hospital between 2016 and 2018 who had mandibular cysts that surgical operation couldn't directly remove by surgery in clinical practice. Intervention: At 4 months after curettage, the research team randomly divided participants into three groups: (1) an intervention group who received implants of autologous tooth bone powder into the bone defects, (2) a positive control group who received implants of inorganic bovine bone powder, and (3) a negative control group who received no implants of any material. Outcome Measures: The research team performed: (1) periodontal probing at a fixed anatomical point for the intervention and both control groups postintervention at one day and 4 months after surgery and recorded the changes in probing depth and (2) computed tomography (CT) scans at baseline one day before and postintervention at 4 months after the implantation to determine changes in the bone mineral density and compared them among the three groups. Results: The change in the height of the intervention group's fixed anatomical point postintervention at 4 months after surgery was significantly smaller than that of the positive control group (P < .05). In the CT scan analysis, the differences between the intervention and negative control groups and between the positive and negative control groups were statistically significant (P < .05); however, the difference between the intervention and positive control groups wasn't significant (P > .05). Conclusions: Autologous tooth bone powder and inorganic bovine bone powder can effectively repair bone defects caused by large jaw cysts and that the repaired effect may be better than that of spontaneous osteogenesis. The autologous tooth bone powder was associated with lower levels of bone loss than those seen with use of inorganic bovine bone powder.

Dexamethasone in preventive analgesia alleviates pain and complications after jaw cyst enucleation: a randomized controlled trial.

BACKGROUND: Dexamethasone is widely used in the prevention of postoperative complications in oral surgery and strengthening the analgesic effect after anesthesia, but the efficacy is controversial, and the relationship between postoperative complications and pain is still unclear. The purpose of this study was to evaluate the analgesic effect of dexamethasone in the treatment of jaw cyst and to explore the relationship between postoperative complications and pain. METHODS: We conducted a prospective, randomized, double-blind clinical trial. 120 patients were divided into two groups, dexamethasone group ( group D) and control group (Group C). All patients were given 0.02 mg·kg-1 of hydromorphone to relieve pain in advance at 10 min before the beginning of operation. Meanwhile, dexamethasone was injected 0.2 mg·kg-1 intravenously in group D and normal saline was injected in group C. The primary endpoint was pain intensity at 2 h, 6 h, 12 h, 24 h and 48 h after surgery. The secondary endpoints were the incidence and extent of complications after surgery, including facial swelling and trismus. RESULTS: Compared with group C, the visual analogue scale (VAS) scores and occurrence of painful event postoperatively in group D were significantly lower both at rest (P < 0.0001 and P = 0.0014) and during mobilization (P < 0.0001 both). The degree of facial swelling and trismus in group D were significantly lower than that in group C at 24 h (P < 0.0001 and P = 0.00022) and 48 h (P < 0.0001 and P = 0.00015) after surgery, but there was no difference at 6 h and 12 h (P = 0.137 and P = 0.083) after surgery. The C-reactive protein (CRP) level at 24 h after operation in group D was lower than group C (P = 0.012), but there was no significant difference in blood glucose concentration between the two groups (P = 0.608). CONCLUSION: Dexamethasone can reduce the degree of facial swelling and trismus after jaw cyst surgery by inhibiting the production of inflammation, which alleviated the postoperative pain of patients significantly. In addition, it did not increase the risk of hyperglycemia. TRIAL REGISTRATION: This study was registered with the Chinese Clinical Trial Registry on May 07, 2020 (URL: http://www.chictr.org.cn/showproj.aspx?proj=53344 . Registry number: ChiCTR2000032693). Registered on 07/05/2020.

Effect of Intracapsular Pressure on Decompression Effectiveness.

AIM: The objective of this research was to analyse the correlation between intracapsular pressure and shrinkage rate of cystic lesion volume at different time points after decompression and to evaluate the relationship between the concentration of interleukin-1α (IL-1α) in cystic fluid and intracapsular pressure. METHODS: Fifty patients with jaw cystic lesions who underwent decompression were included. We measured the intracapsular pressure and IL-1α concentration in the cyst fluid. Moreover, we calculated the rate of shrinkage (RS) of cystic cavity volume at different time points. In addition, data on age, sex, preoperative cystic cavity volume, and lesion location were collected. Linear correlation analysis and variance analysis were used for statistical analysis. RESULTS: Fastest volume decline was observed between 0 and 3 months after surgery; the average RS0-3 was 45.71%. RS3-6 presented the second-fastest volume decline, with an average of 17.46%, and RS6-12 presented the slowest volume decline, with an average of 3.933%. A statistically significant difference in RS was observed amongst the 3 time points (P < .0001). RS0-3 was negatively correlated with intracapsular pressure (r = -0.6326, n = 50, P < .0001). A negative correlation between the preoperative cystic cavity volume and intracapsular pressure (r = -0.6384, n = 50, P < .001) was also observed. A significant positive correlation was observed between preoperative cystic cavity volume and RS0-3 (r = 0.611, n = 50, P < .0001). Moreover, a significant positive correlation was observed between the intracapsular pressure and IL-1α concentration in the cystic fluid (r = 0.03477, n = 50, P < .0001). CONCLUSIONS: Intracapsular pressure and the preoperative volume were the factors that affected the RS during the first 3 months after surgery. Therefore, the effectiveness of decompression can be evaluated by the intracapsular pressure and preoperative volume.

Volumetric analysis of spontaneous bone healing after jaw cyst enucleation.

The purpose of this study is to evaluate the degree of spontaneous bone healing after cyst enucleation as well as its contributing factors. Pre- and post-operative computed tomography (CT) scans of consecutive patients who had undergone jaw cyst enucleation were retrospectively analyzed. The outcome variable was healing ratio, which was calculated using the volume of the cyst before surgery and the volume of the defect in the bone after surgery. Predictor variables including duration of observation, pre-operative cyst size, age, gender, and involved jaw were analyzed to determine their influence. Forty-four subjects (30 Male and 14 Female, average 40.7 ± 15.7 years) were included in this study. Healing ratio was significantly lower during the first year (33.5 ± 32.8%) compared to the second (74.5 ± 24.2%) and subsequent years (74.2 ± 17.8%). In 35 patients who had follow-ups of over 1 year, the healing ratio was not affected by the pre-operative cyst size and upper/lower jaw except gender (p = 0.037, female > male) and age (p = 0.021, younger than 30 years > 30 years and older). The residual defect was significant larger in cysts 3 cc or larger (1.64 ± 1.54 cc) compared to smaller cysts (0.43 ± 0.42 cc, p = 0.006). The residual defect volume of large cysts was similar to those of the pre-operative volume of small cysts (1.47 ± 0.72 cc). In conclusion, spontaneous bone healing ratio of post-enucleation defects was about 73.5% after 12 months. Large cysts (> 3 cc) had larger defect, comparable to the volume of small cysts, but with altered contour. Additional treatment such as a bone graft may be considered especially in large cysts.

Radiographic bone volume alteration after jaw cyst enucleation with or without simultaneous bone grafts: A prospective randomized study.

OBJECTIVE: This study was aimed to evaluate bone healing after jaw cyst enucleation with or without bone substitutes by cone beam computed tomography, and to analyze potential influence factors for bone formation as well. MATERIALS AND METHODS: Sixty seven jaw cyst patients were randomly assigned to two groups. Thirty three patients in control group accepted cystectomy without any filling material. The rest 34 bone cavities which filled with xenograft (DBBM, Bio-Oss®) and covered by absorbable membrane (Bio-Gide®) were included in the guided bone regeneration (GBR) group. All patients were examined with cone bean computerized tomography before operation, 3 and 6 months after surgery. Linear regression analysis was applied to evaluate the influence factors of bone healing. RESULTS: There was no significant difference in bone formation rate at 3 months after enucleation, with shrinkage rate (SR) of cystic lesion in control group and GBR group of 26.43 ± 14.98% and 20.78 ± 10.80%, respectively (p > 0.05). Larger shrinkage area in GBR group was detected on postoperative radiographs after 6 months with SR of 60.11 ± 19.23%, when compared to those in patients without filling (6 months SR: 48.63 ± 19.39%, p = 0.018, <0.05). Linear regression analysis showed that cyst size was negatively correlated with bone formation. CONCLUSION: GBR with bovine xenograft and absorbable membrane showed considerable bone regeneration property in the healing of jaw cystic defects after enucleation of radicular cysts. Cyst size showed a suppressive influence on bone formation.

Cisto ósseo simples: relato de 7 casos / Simple bone cyst: report of 7 cases / Quiste óseo simple: reporte de 7 casos

Introdução: O cisto ósseo simples (COS) é definido como uma cavidade intraóssea de etiologia desconhecida, desprovida de revestimento epitelial e vazia ou preenchida com líquido. Na região facial, o COS é mais comumente observado no corpo da mandíbula. Objetivo: O objetivo deste artigo é relatar uma série de casos de COS, discutindo aspectos relevantes das características clínicas e terapêutica adequada. Relato de caso: A série de casos demonstrou que a presença de lesões radiolúcidas assintomáticas nos maxilares, nos quais os diagnósticos clínico, laboratorial e imaginológico não foram conclusivos, a realização de uma biópsia é sempre indicada. Considerações finais: Os casos de múltiplas lesões de COS, ou quando estão associadas a displasias cemento-ósseas, uma abordagem cirúrgica torna-se imperiosa... (AU)

Introduction: Simple bone cyst (COS) is defined as an intraosseous cavity of unknown etiology, devoid of epithelial lining and empty or filled with fluid. In the facial region, COS is most commonly seen in the body of the mandible. Objective: The aim of this article is to re port a series of COS cases, discussing relevant aspects of the clinical characteristics and adequate treatment. Case report: The case series demonstrated that the presence of asymptomatic radiolucent lesions in the jaws, in which clinical, laboratory and imaging diagnoses were not conclusive, a biopsy is always indicated. Final considerations: In cases of multiple COS lesions, or when they are associated with cemento-osseous dysplasias, a surgical approach is imperative... (AU)

Introducción: El quiste óseo simple (COS) se define como una cavidad intraósea de etiología desconocida, desprovista de revestimiento epitelial y vacía o llena de líquido. En la región facial, la COS se observa con mayor frecuencia en el cuerpo de la mandíbula. Objetivo: El objetivo de este artículo es reportar una serie de casos de COS, discutiendo aspectos relevantes de las características clínicas y el tratamiento adecuado. Caso clínico: La serie de casos demostró que ante la presencia de lesiones radiotransparentes asintomáticas en los maxilares, en las que los diagnósticos clínicos, de laboratorio y de imagen no fueron concluyentes, siempre está indicada una biopsia. Consideraciones finales: En casos de múltiples lesiones de COS, o cuando se asocian a displasias cemento-óseas, es imprescindible un abordaje quirúrgico... (AU)

Deep learning based diagnosis for cysts and tumors of jaw with massive healthy samples.

We aimed to develop an explainable and reliable method to diagnose cysts and tumors of the jaw with massive panoramic radiographs of healthy peoples based on deep learning, since collecting and labeling massive lesion samples are time-consuming, and existing deep learning-based methods lack explainability. Based on the collected 872 lesion samples and 10,000 healthy samples, a two-branch network was proposed for classifying the cysts and tumors of the jaw. The two-branch network is firstly pretrained on massive panoramic radiographs of healthy peoples, then is trained for classifying the sample categories and segmenting the lesion area. Totally, 200 healthy samples and 87 lesion samples were included in the testing stage. The average accuracy, precision, sensitivity, specificity, and F1 score of classification are 88.72%, 65.81%, 66.56%, 92.66%, and 66.14%, respectively. The average accuracy, precision, sensitivity, specificity, and F1 score of classification will reach 90.66%, 85.23%, 84.27%, 93.50%, and 84.74%, if only classifying the lesion samples and healthy samples. The proposed method showed encouraging performance in the diagnosis of cysts and tumors of the jaw. The classified categories and segmented lesion areas serve as the diagnostic basis for further diagnosis, which provides a reliable tool for diagnosing jaw tumors and cysts.

Effect of Application of Platelet-Rich Plasma on Bone Regeneration after Removal of Jaw Cysts.

Platelets are involved in regeneration at sites of bony defect, apart from their function in coagulation. An autologous preparation platelet-rich plasma gel applied to sites of bony defects after surgical treatment of jaw cyst. This case-control study was conducted in Bangabandhu Sheikh Mujib Medical University (BSMMU) in the department of Oral and Maxillofacial Surgery from September 2017 to August 2018. Total 30 patients were chosen having jaw cyst. They were divided into 2 groups; Group A and Group B, where Group A got the platelet rich plasma, after removal of the cystic lesion; and Group B got the normal usual treatment. Platelet rich plasma gel was prepared using a standardized technique and applied to the surgical site of the Group A. The differences of radiographic changes between the two groups at 6th, 12th, 18th and 24th weeks after surgery were analyzed. Study showed significant changes in early bone regeneration in group A at 12th and 18th weeks post operatively. Platelet rich plasma induces early bone regeneration and it has proven successful outcome.