Imaging of the Jaw Cysts with a Dental CT Software Program: Distinction of Odontogenic Keratocysts from Other Cysts

ABSTRACT

PURPOSE: To evaluate the usefulness of a dental CT software program in the assessment of jaw cysts and in the differentiation of odontogenic keratocysts and other cysts. MATERIALS AND METHODS: Seventeen patients with proven jaw cysts (8 maxillae & 9 mandibles) were evaluated with a dental CT software program for location, locularity, the presence or absence of marginal scalloping, and height to length ratio. For the delineation of involvement or displacement of neurovascular bundles, cortical erosion, perforation or expansion, and tooth root resorption by the jaw cysts, images from this program were compared to conventional images. RESULTS: Seventeen lesions icomprised 15 odontogenic cysts (five odontogenic keratocysts, five radicular, three residual and two dentigerous cysts) and two non-odontogenic cysts (one nasopalatine duct cyst and one postoperative maxillary cyst). Images of jaw cysts obtained with the dental CT software program delineated much more clearly than conventional images the status of neurovascular bundle and cortical bone, but there was no clear difference between the two modalities in delineating tooth root erosion. Dental CT findings of five mandibular odontogenic keratocysts were scalloped margin in all, mandibular ramus involvement in four, height to length ratio below 60% in four, and multilocularity in two. The findings of the other 12 cysts (eight maxillae and four mandibles) were unilocularity in all, smooth inner margin in ten, height to length ratio below 60% in only two, and ramus involvement in none. CONCLUSION: Adental CT software program is an improved imaging modality for assessing jaw cysts ; and findings which tend to indicate odontogenic keratocysts are marginal scalloping, mandibular ramus involvement, prominent spread along the marrow space and multilocularity.