Assessment of Bone Regeneration After Maxillary Radicular Cyst Enucleation with or Without Bone Grafting Materials: a Retrospective Cohort Study

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2024 Mar 14

PMID 38480533

Authors

Giusy Rita Maria La Rosa

Carlotta Ylenia Priolo

Roula S Abiad

Virginia Rosy Romeo

Emanuele Ambu

Eugenio Pedulla

Affiliations

Soon will be listed here.

Abstract

Objective: The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT).

Materials And Methods: Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing.

Results: Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05).

Conclusion: Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions.

Clinical Relevance: Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.

References

Santosh A . Odontogenic Cysts. Dent Clin North Am. 2019; 64(1):105-119. DOI: 10.1016/j.cden.2019.08.002. View

Barrios-Garay K, Agudelo-Sanchez L, Aguirre-Urizar J, Gay-Escoda C . Critical assessment of the latest classification of jaw cysts proposed by the World Health Organization (2017). J Clin Exp Dent. 2021; 13(11):e1147-e1153. PMC: 8601698. DOI: 10.4317/jced.58764. View

Elhakim A, Kim S, Kim E, Elshazli A . Preserving the vitality of teeth adjacent to a large radicular cyst in periapical microsurgery: a case report with 4-year follow-up. BMC Oral Health. 2021; 21(1):382. PMC: 8336380. DOI: 10.1186/s12903-021-01738-2. View

Caliskan M, Kaval M, Tekin U, Unal T . Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery. Int Endod J. 2015; 49(11):1011-1019. DOI: 10.1111/iej.12554. View

Johnson N, Savage N, Kazoullis S, Batstone M . A prospective epidemiological study for odontogenic and non-odontogenic lesions of the maxilla and mandible in Queensland. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(4):515-22. DOI: 10.1016/j.oooo.2013.01.016. View

Sukegawa S, Matsuzaki H, Katase N, Kawai H, Kanno T, Asaumi J . Morphological characteristics of radicular cysts using computed tomography. Odontology. 2019; 108(1):74-83. DOI: 10.1007/s10266-019-00443-5. View

Sagit M, Guler S, Tasdemir A, Somdas M . Large radicular cyst in the maxillary sinus. J Craniofac Surg. 2011; 22(6):e64-5. DOI: 10.1097/SCS.0b013e318231e3b1. View

Modaresi J, Nasr N . Nonsurgical Endodontic Management of Large Periapical Lesion with Cold Ceramic: A Literature Review and Case Series. Iran Endod J. 2023; 18(2):113-121. PMC: 10155105. DOI: 10.22037/iej.v18i2.40184. View

Saatchi M . Healing of large periapical lesion: a non-surgical endodontic treatment approach. Aust Endod J. 2007; 33(3):136-40. DOI: 10.1111/j.1747-4477.2007.00061.x. View

10.

Fernandes M, de Ataide I . Nonsurgical management of periapical lesions. J Conserv Dent. 2011; 13(4):240-5. PMC: 3010029. DOI: 10.4103/0972-0707.73384. View

11.

Karamifar K, Tondari A, Saghiri M . Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J. 2020; 5(2):54-67. PMC: 7398993. DOI: 10.14744/eej.2020.42714. View

12.

Lin L, Ricucci D, Lin J, Rosenberg P . Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts. J Endod. 2009; 35(5):607-15. DOI: 10.1016/j.joen.2009.02.012. View

13.

Shi J, Zhou J, Liu C, Liu Y, Si M . Radiographic bone volume alteration after jaw cyst enucleation with or without simultaneous bone grafts: A prospective randomized study. Clin Implant Dent Relat Res. 2022; 24(4):468-474. DOI: 10.1111/cid.13099. View

14.

Chiapasco M, Rossi A, Motta J, Crescentini M . Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases. J Oral Maxillofac Surg. 2000; 58(9):942-8; discussion 949. DOI: 10.1053/joms.2000.8732. View

15.

Chacko R, Kumar S, Paul A, Arvind . Spontaneous Bone Regeneration After Enucleation of Large Jaw Cysts: A Digital Radiographic Analysis of 44 Consecutive Cases. J Clin Diagn Res. 2015; 9(9):ZC84-9. PMC: 4606349. DOI: 10.7860/JCDR/2015/13394.6524. View

16.

Ihan Hren N, Miljavec M . Spontaneous bone healing of the large bone defects in the mandible. Int J Oral Maxillofac Surg. 2008; 37(12):1111-6. DOI: 10.1016/j.ijom.2008.07.008. View

17.

Tessier P, Kawamoto H, Matthews D, Posnick J, Raulo Y, Tulasne J . Autogenous bone grafts and bone substitutes--tools and techniques: I. A 20,000-case experience in maxillofacial and craniofacial surgery. Plast Reconstr Surg. 2005; 116(5 Suppl):6S-24S. DOI: 10.1097/01.prs.0000173862.20563.12. View

18.

Khan S, Tomin E, Lane J . Clinical applications of bone graft substitutes. Orthop Clin North Am. 2000; 31(3):389-98. DOI: 10.1016/s0030-5898(05)70158-9. View

19.

Aludden H, Mordenfeld A, Hallman M, Dahlin C, Jensen T . Lateral ridge augmentation with Bio-Oss alone or Bio-Oss mixed with particulate autogenous bone graft: a systematic review. Int J Oral Maxillofac Surg. 2017; 46(8):1030-1038. DOI: 10.1016/j.ijom.2017.03.008. View

20.

Kim Y, Saiki C, Silva K, Massuda C, Faloni A, Braz-Silva P . Bone Formation in Grafts with Bio-Oss and Autogenous Bone at Different Proportions in Rabbit Calvaria. Int J Dent. 2020; 2020:2494128. PMC: 7049819. DOI: 10.1155/2020/2494128. View