Panoramic analysis about spontaneous bone regeneration after enucleation of jaw cyst

Yim, Jeong Hoon; Lee, Jae Hoon

Abstract

PURPOSE: Some recent literatures report that it is possible to recover defected areas caused by enucleation of relatively large jaw cysts without using bone grafts. The aim was to find out whether spontaneous recovery of defected area with time occurred and what the contributing factors were.
MATERIALS AND METHODS
In total, 194 patients were considered as patients. Out of these 194 patients, 74 patients who had no wound dehiscence and who were available for follow-up studies were selected. They were classified into two groups according to the size of radiolucent area in the preoperative panoramic radiographs: in one group, it was larger than 3x4cm, while in the other group, it was smaller than 3x4cm. Follow-up panoramic radiographs were taken immediately after the surgery, then after 3, 6, 9 and 12 months. On those radiographs, changes in size and density of the defected areas were observed using the Gray-level histogram of Adobe photoshop v7.0. Correlation between bone regeneration and factors such as the type and size of the cysts, age, sex, site of the cysts and systemic disease was evaluated using the General repeated measure and Mann-Whitney Test.
RESULTS
Analyses of panoramic radiographs showed that the recovery of radiopacity after 12 months was more than 97% on average in defected areas that were smaller than 3x4cm. in the defected areas that were larger than 3x4cm, considerable portion showed recovery of radiopacity. No statistically significant change was observed in bone density according to the type of cysts. Young patients under 20 years of age with highly active metabolism presented more significant bone regeneration than patients over 20 years of age. Bone regeneration was more hampered in patients who had medical disease, compared with patients who didn't have any medical problem. No statistically significant change was seen in bone density according to sex. Changes in bone density according to the site of cysts such as maxilla, mandible, anterior or posterior region were not considered to be significant.
CONCLUSION
Analyses of panoramic radiographs suggest that in approximately 12 months after the enucleation of cysts, clinically acceptable spontaneous bone regeneration can be observed even though normal bone graft procedures have not been applied.