The Comparative Analysis of Cone Beam Computed Tomography and Panoramic Radiography in the Radiological Evaluation of Spontaneous Bone Regeneration in Jaw Cysts after Enucleation

Öz

Objective: The aim of this study is to compare the panoramic radiography and cone-beam computed tomography (CBCT) in the evaluation of bone healing after the enucleation of odontogenic cysts.

Methods: Pre-operative and post-operative clinical and radiological data of patients who were successfully treated with enucleation between 01/01/2013 and 01/03/2017 with 1-year follow-up were retrieved from the archives and evaluated retrospectively. The panoramic radiographs and CBCT sections were transferred into a computer program and pre-operative and post-operative measurements were performed on the computer program. The manual segmentation method was used in the volume measurement in CBCT sections. An area index was calculated by multiplying the highest vertical and widest horizontal dimension of the cystic lesion on the panoramic radiography.

Results: Twelve patients included in the study. Eight patients were male and 4 of them were female. The mean age was 45. The volume of the defect at post-operative 1-year control decreased by 83.05% on average. The area measurement showed a decrease of 38.79% at postoperative 1-year control. The volume of the cystic cavities in tomographic sections and cystic area on panoramic radiographs were significantly reduced at the end of 1-year follow-up (p<0.05). There was a significant and moderate positive relationship between the post-operative measurement values of CBCT and OPG (p=0.021, r=0.655).

Conclusion: Panoramic radiography can be used as effective as CBCT to monitor spontaneous bone regeneration after the enucleation of jaw cysts.

Anahtar Kelimeler

• Cone beam computed tomography,bone defect,odontogenic cyst,panoramic radiography

Kist Enükleasyonu Sonrası Oluşan Kemik Rejenerasyonunun Radyolojik Değerlendirmesinde Konik Işınlı Bilgisayarlı Tomografi ile Panoramik Radyografinin Karşılaştırmalı Olarak İncelenmesi

Öz

Amaç: Bu çalışmanın amacı odontojenik kistlerin enükleasyonundan sonra oluşan kemik defektind oluşan kemik iyileşmesinin radyografik incelemesinde panoramik radyografi ve konik ışınlı bilgisayarlı tomografiyi (KIBT) karşılaştırmaktır.

Yöntem: 01/01/2013 ve 01/03/2017 tarihleri arasında başarılı bir şekilde cerrahi enükleasyon ile tedavi edilmiş ve 1 sene boyunca takip edilmiş hastaların klinik ve radyolojik verileri arşivlerden çıkarılıp incelenmiştir. Pre-oepratif ve post-operatif alınmış panoramik radyografiler ve KIBT kesitleri bir bilgisayar programına aktarılarak ölçümler gerçekleştirildi. KIBT kesitlerinde defekt hacminin ölçümü için manuelş segmentasyon metodu kullanıldı. Panoramik radyografilerde ise lezyonun sınırları dahilinde en geniş horizontal ve vertikal boyutu bir işaretçi yardımı ile ölçüldü. Horizontal ve vertikal ölçümler birbiri ile çarpılıp bir panoramik indeks elde edildi.

Bulgular: On iki hasta çalışmaya dahil edildi. Sekiz hasta erkek, 4 hasta kadındı. Ortalama yaş 45 olarak hesaplandı. Post-operatif 1 yılda defektlerin hacmindeki azalma KIBT incelemesinde ortalama %83.05 ve ölçülen panoramik indeksteki azalma panoramik radyografi incelemesinde ortalama %38.79 olarak bulundu. KIBT ve Panoramik değerlendirmelerinde pre-operatif ve post-operatif ölçümler arasında istatistiksel olarak anlamlı fark bulundu (p<0.05). KIBT ve panoramik radyografi post-opertif ölçümleri arasında istatistiksel olarak anlamlı orta dereceli korelasyon tespit edildi (p=0.021, r=0.655).

Sonuç: Panoramik radyografi kist enükleasyonu sonrası kemik iyileşmesini göstermede altın standart olan KIBT’ye benzer etkinlik göstermektedir.

Anahtar Kelimeler

• Kemik defekti,konik ışınlı bilgisayarlı tomografi,odontojenik kist,panoramik radyografi

Kaynakça

1. 1. Jones A, Craig G, Franklin C. Range and demographics of odontogenic cysts diagnosed in a UK population over a 30 year period. Journal of Oral Pathology Medicine (Baltimore). 2006; 35 :500-7.
2. 2. Shear M, Speight P. Classification and Frequency of Cysts of the Oral and Maxillofacial Tissues. Cysts of the Oral and Maxillofacial Regions. (4. Edition). John Wiley & Sons, New Jersey, 2008; p.1-123
3. 3. Reichart P, Philipsen H. Classification of Odontogenic Tumors and Allied Lesions. (1.Edition). Quintessence Publishing Co Ltd, London, 2000; p.1-90
4. 4. Boeddinghaus R, Whyte A. Current Concepts in Maxillofacial İmaging. Eur J Radiol. 2008; 66: 396-418.
5. 5. Suomalainen A, Esmaeili EP, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. J Insights into imaging. 2015; 6 :1-16.
6. 6. Vallaeys K, Kacem A, Legoux H, et al. 3D dento-maxillary osteolytic lesion and active contour segmentation pilot study in CBCT: semi-automatic vs manual methods. The British Institute of Radiology. 2015; 44 :20150079.
7. 7- Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006; 72 :75-80.
8. 8- Shin H, Nam K, Park H, et al. Effective doses from panoramic radiography and CBCT (cone beam CT) using dose area product (DAP) in dentistry. Dentomaxillofac Radiol. 2014; 43 :20130439.

9. 9. Deana NF, Alves N. Cone Beam CT in Diagnosis and Surgical Planning of Dentigerous Cyst. Case Rep Dent. 2017; 2017: 7956041.
10. 10. Prabhusankar K, Yuvaraj A, Prakash CA, et al. CBCT Cyst Leasions Diagnosis Imaging Mandible Maxilla. J Clin Diagn Res. 2014; 8: ZD03-5.
11. 11. Hren NI, Miljavec M. Spontaneous bone healing of the large bone defects in the mandible. Int J Oral Maxillofac Surg. 2008; 37: 1111-16.
12. 12.Chiapasco M, Rossi A, Motta JJ, et al. Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral Maxillofac Surg. 2000; 58: 942-48.
13. 13. Rubio ED, Mombrú CM. Spontaneous Bone Healing after Cysts Enucleation without Bone Grafting Materials: A Randomized Clinical Study. Craniomaxillofac Trauma Reconstr. 2015; 8(1): 14-22.
14. 14. Chacko R, Kumar S, Paul A, et al. Spontaneous Bone Regeneration After Enucleation of Large Jaw Cysts: A Digital Radiographic Analysis of 44 Consecutive Cases. J Clin Diagn Res. 2015; 9: ZC84-9.
15. 15. Lim LZ, Padilla RJ, Reside GJ, et al. Comparing panoramic radiographs and cone beam computed tomography: Impact on radiographic features and differential diagnoses. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126: 63-71.
16. 16. Horner K. “Cone-beam computed tomography for oral surgical applications: where is the evidence?” Oral Surgery. 2013; 6 : 112–128.