Intraosseous Benign Lesions of the Jaws: A Radiographic Study

Our subjects, 61 cases, were selected among 120 patients with a panoramic radiography as well as histopathological reports pertaining to the lesions detected radiographically. These patients were all referred to Hamedan Dental School with a diverse range of complaints between 2009 and 2011. As it was meant to be a case study, data were all elicited from archived reports and files. The subjects, 34 males and 27 females, radiographically had cyst (s), benign tumor (s) or tumor-like lesion (s), in which each lesion affected the bone (intra-osseous) or the peripheral soft tissue plus an extension to the adjacent bone structure.

Tumor like lesions ranged from reactive, such as giant cell granuloma and aneurysmal bone cysts, to fibro-osseous lesions [cemental dysplasia: periapical and florid cement-osseous dysplasia (PCOD and FLCOD), fibrous dysplasia, cemento-ossifying fibroma (COF) and peripheral ossifying fibroma (POF)]. The X-ray apparatus used also differed from case to case: planmeca Model 2002 cc panoramic machine (planmeca Co., Helsinki, Finland), CR system (cassette system with photostimulable phosphor plates) and Digora PCT (Sordex Co, Helsinki, Finland). Two qualified radiologists reviewed the images separately under uniform light on EIZO MX241W monitor (EIZO NANO Corporation, Japan) and view box for digital and analogue images. Images were also subjected to contrast, zoom and density adjustment if necessary. Observers had no knowledge of the histopathological results as well as the objectives of our study. In case they did not concur, a third opinion was sought through consultation with another expert who was also blind to pathology reports.

Lesions were assessed based on their location, periphery and internal structure. As far as the location was concerned, the lesions could be single-focal, multi-focal and generalized. They could also be situated in the anterior (incisor-canine) and posterior (pre-molar/molar/ramus mandible)/tuberosity (maxilla) of the mouth, or even extend from anterior to posterior. The peripheries of the lesions were described as either well-defined or ill-defined. The former could be corticated, sclerotic and non-corticated (punched-out). Ill-defined borders were either blending or invasive. The third variable, internal structure included three categories: radiolucent, radiopaque and mixed (radiolucent-radiopaque). A range of findings were also studied including root resorption, tooth displacement, cortical perforation, pathologic fracture, widening of periodental ligament (PDL), mandibular canal displacement due to mandibular lesions and maxillary sinus and nasal floor displacement owing to maxillary lesions.

Having the findings assessed, already prepared checklists were filled for every individual case that encompassed clinical, radiographic and histopathologic sections. A third observer carried out the latter. If other clinically pertinent variables such as cortical expansion were necessary, the patients records were evaluated. Descriptive statistical analysis was finally carried out using SPSS software, Ver. 16.1 (SPSS Inc., Chicago, IL, USA).

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