SCAN PROTOCOL: Orthopanoramic – KAVO OP 3D Pro
ACTUAL DOSE: – 1,040 mGycm2 – 16.37 s – 66.00 kV – 10.00 mA
CLINICAL INFORMATION: Examination requested by a specialist for a first, general clinical evaluation, for Implantology purposes, at the level of the upper jaw – left quadrant. Patient complains of discomfort/pain at right mandibular lateral area. Resistance to pharmacological therapy.
RADIOLOGICAL ANALYSIS
- Cortical thickness appears within physiological limits.
- Medullary trabecular architecture appears without pathological changes.
- Mild signs of periodontopathy.
- Erosion of 15 at the cervical level.
- No radiotransparent periapical lesions.
- Identified cyst-form radiotransparency with radiopaque halo in Periapical anatomical position 4.8 below the lower mandibular canal. (Stafne cyst / bone cavity?)
- Further investigation w/CBCT recommended.
IN-DEPTH…
Stafne’s gap (or bone cavity) is a rounded area that appears well circumscribed on a radiography. It characteristically presents without symptoms.
It was first described in 1942 as a cavity of the mandibular surface from the lingual side. Previously, it was referred to by the names “static bone cyst”, “idiopathic bone cavity of Stafne,” and “inclusion of salivary gland tissue.” The latter name describes very well the origin due to the inclusion, at the embryonic stage of growth of the mandible, of salivary gland tissue within the body of the bone.
This pathology is a rare, benign, asymptomatic lesion that is difficult to detect on objective clinical examination. The pathogenesis is not yet completely clear; on radiographic examination it presents as a unilocular, radiolucent, well-defined lesion located in the region between the first molar and the angle of the mandible below the inferior alveolar canal.
PATHOLOGY AND DIAGNOSTICS
The lesions that can be found radiographically are divided into four groups:
- well-circumscribed radiotransparent lesions;
- radiotransparent lesions that are not well defined;
- mixed radiopaque and radiotransparent lesions;
- radiopaque lesions.
The most recent classification by the WHO (World Health Organization) distinguishes lesions on the basis of histo-etiopathogenetic criteria and is the most widely accepted and used classification to date.
Stafne’s Cyst is classified as a radiolucent lesion on X-ray examination.
A radiotransparent lesion can be defined as a lesion that, on radiographic examination, has a lower bone density than the surrounding healthy bone.
The pathological processes that can establish such clinical picture are various (infectious, inflammatory, neoplastic, traumatic). In all cases, these are osteolytic lesions, in which the activity of osteoclastic processes has overwhelmed that of osteogenetic processes, resulting in the pathological process.
Diagnosis looks relatively simple when the gap occurs in its most frequent and characteristic form, while in doubtful cases it is important to perform further diagnostic investigation to confirm the presumptive diagnosis, and the examination that is performed to further identify and discriminate the lesion is CBCT.
Stafne’s Defect does not require any treatment; periodic radiographic follow-up is indicated to rule out modifications, changes in the appearance of the lesion, or degeneration of various kinds.
