The radiographic study of cortical changes of bone caused by jaw lesions

Yu, Jae Jung; Hwang, Eui Hwan; Lee, Sang Rae

Abstract

PURPOSE: To investigate the diagnostic significance of cortical changes in the bone of diseased jaws utilizing computed tomography (CT).
MATERIALS AND METHODS
Computed tomographic images of 91 patients, consisting of 7 osteomyelitis, 46 cysts, 18 benign tumors, and 20 malignant tumors, were analyzed. The pattern of cortical expansion was classified into three types: no expansion (N), buccal or lingual expansion (B/L), and buccolingual expansion (B and L). The pattern of cortical destruction was classified into four types: no destruction (N), point destruction (PO), gross destruction (GR), and permeative destruction (PE). The pattern of periosteal reaction was classified into four types: parallel, irregular, spicule, and Codmans triangle. The relationship between the pattern of cortical bone changes and diseases of the jaws was assessed.
RESULTS
When the pattern of cortical expansion was compared to diseases of the jaw, N-type was most prevalent in cases of osteomyelitis and malignant tumors, B/L-type with cysts, and BandL-types with benign tumors. Comparison between the pattern of cortical bone destruction with diseases of the jaw showed strong correlations between PO and PE-types to osteomyelitis, N-type with cysts, N and GR-types with benign tumors, and GR-type with malignant tumors. Finally, the relationship between the pattern of periosteal reaction to diseases of the jaw showed a strong correlation between parallel-type to osteomyelitis and spicule-type to malignant tumors.
CONCLUSION
The pattern of cortical expansion and cortical destruction is useful in differentiating diseases of the jaws.