Bilateral Stafne Bone Cavity in the Body of the Mandible: An Unusual Case Report and Literature Review.

Stafne defect also known as Stafne bone cavity is a lingual surface depression generally found in the posterior mandible. This entity is usually unilateral and asymptomatic, found during routine dental radiographic evaluation. Stafne defect appears as a well-defined, oval, corticated entity located below the inferior alveolar canal. These entities are the inclusion of the salivary gland tissues. In this case report, we present the case of a bilateral Stafne defect that was asymmetrically located in the mandible and was incidentally detected on the cone-beam computed tomography scan taken for implant treatment planning. This case report highlights the significance of three-dimensional imaging and correctly diagnosing the incidental findings within the scan.

The prevalence of Stafne bone cavity: A meta-analysis of 355,890 individuals.

Background/purpose: A Stafne bone cavity (SBC) is an incidental depression in the lingual surface of the mandible. The aim of this study is to provide pooled estimates of the frequency of Stafne bone cavity and to correlate its presence with such variables as sex, laterality, diagnostic methods and population. Materials and methods: Potential studies were searched through four electronic databases: Google Scholar, PubMed, Scopus, and Journal Storage. Titles, abstracts, and full texts of the articles were screened. Results: A total of 54 studies relating to 355,890 subjects met the inclusion criteria for meta-analysis. A meta-analysis using the DerSimonian-Laird model revealed an overall prevalence of 0.17% (CI:0.14%-0.21%, I 2 = 80.7%). SBC was four times more common in males than females (z = 6.94, P < 0.01), and was unilateral in almost all cases (z = 12.90, P < 0.01). Radiographic studies yielded a lower SBC prevalence at 0.12% (CI:0.09%-0.15%, I 2 = 71.7%) than computed tomography studies, skeletal studies and excavation studies. Ancient populations had three times higher SBC prevalences (0.47%, CI:0.21%-0.73%, I 2 = 89.5%) than the average populations today (z = 3.21, P < 0.01). Conclusion: The prevalence of Stafne bone cavity is approximately 0.17%, and was four times more prevalent in males than females. This variant bone cavity was also present unilaterally in the majority of cases. Awareness of SBC is important for dentists, maxillofacial surgeons and other practitioners performing routine dental practices and interpreting panoramic radiographs.

Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

A Connective Tissue Neoplasm of the Mandibular Angle Mimicking Stafne's Bone Cavity on Panoramic View.

BACKGROUND: When assessing sharply delineated bone lesions of the mandibular angle on X-rays, numerous diagnoses must be considered. The static bone cavity (Stafne's bone cavity, SBC) is a harmless lingual bone depression of the mandibular angle that usually does not require any treatment. It is essential to differentiate this bone deformity from other lesions that may require treatment. CASE REPORT: The 22-year-old patient was referred for further diagnosis and therapy after osteolysis of the mandible was noticed on a panoramic view (PV). The location and size of the lesion was typical of SBC. Only the three-dimensional representation of the lesion on cone beam computed tomographs revealed an intraosseous lesion. Histological examination of the lesion provided evidence of a fibrous neoplasm. CONCLUSION: The typical image of SBC is ambiguous on plain radiographs such as PV. The radiological diagnosis of the lesion should be based on the representation of the region of interest in different planes.

[Stafne's idiopathic bone cavity: characteristics and imagenological considerations. A review]. / Cavidad idiopática de Stafne: características y consideraciones imagenológicas. Una revisión.

In 1942, Dr. Edward Stafne presented 35 cases of asymptomatic, clearly defined, round or ovoid radiolucencies occurring near the angle of the mandible, with a greater incidence below the lower dental canal, between the mandibular angle and the roots of the first lower molar, which he referred to as a bone defect. This bone defect later became known by other names.Clinically, Stafne's idiopathic bone cavity (SIBC) is asymptomatic, is usually not palpated intraorally and has no present extraoral signs. Thus, in most cases it is an accidental radiological finding, which appears as a delimited, elliptical or rounded radiolucent image, with a diameter ranging from 1 to 3 cm, and delimited by osteocondensation in the anteroinferior limits. According to the location of the findings, they are classified as; anterior, posterior and branch.This entity should be considered as a variant of normality requiring differential diagnosis to achieve an accurate diagnosis. The present review provides information on the history, and general and radiographic characteristics of SIBC to facilitate diagnosis when presented with this type of findings.

Lingual Mandibular Bone Depression.

BACKGROUND/AIM: In the area of the jaw angle, osteolytic lesions can occur, the differential diagnosis of which can be difficult and require very different therapeutic measures. One of these lesions is lingual mandibular bone depression (LMBD). The aim of this study was to present the characteristics of the lesion in a group of LMBD patients and to differentiate it from other lesions. PATIENTS AND METHODS: Radiological images of 21 patients with LMBD were examined. RESULTS: The majority of LMBDs were located in the jaw angle. On cross-sectional images, the lesion could be distinguished from salivary tissue (n=2). One case of LMBD had an impact on the course of the fracture line in the mandibular trauma. CONCLUSION: LMBD is a developmental disorder of the mandible and only rarely of pathological importance. Imaging the lesion with cross-sectional images is preferable to using plain X-ray projections. In some cases, surgical exploration is essential for diagnosis.

Assessment of prevalence and volumetric estimation of possible Stafne bone concavities on cone beam computed tomography images.

OBJECTIVES: Our study aimed to determine the prevalence and volumetric estimates of Stafne bone cavities (SBC) on cone beam computed tomography (CBCT) images. METHODS: This retrospective study, which involved the CBCT images of 1141 men and 1260 women with an age range of 10-90 years, aimed to determine the prevalence of SBCs and to calculate their volumes using the semi-automatic segmentation method. RESULTS: A total of 15 SBCs were diagnosed in 14 patients. Among the detected SBCs, 7.14% were found in a female patient and 92.86% were found in 13 male patients. Of the total number of SBCs, 6.67% were anteriorly located and 93.33% were posteriorly located. Bilateral SBCs had a prevalence of 0.04%; unilateral posterior SBCs 0.54% and anterior SBCs 0.04%. The mean SBC volume was calculated as 338.05 mm3. CONCLUSIONS: The results of our study showed that SBC is a rare anomaly. In contrast to two-dimensional imaging techniques, CBCT allows a precise determination of SBCs' pattern of impact on adjacent bony structures, relationship with the mandibular canal and dimensions.

Stafne's bone defect: a case report and review of literatures.

Stafne's bone defect (SBD) or Stafne's bone cavity (SBC) is an uncommon bony defect occurred especially only at the lingual cortex of mandible. Clinically, patients with SBD are usually asymptomatic. In most cases, the defect is observed accidentally via X-ray panorama during other dental treatments. Here we presented a female with SBD and we reviewed relevant literatures on SBD, summarized the clinical characteristic and radiographic features with our experiences.

Non-odontogenic Intraosseous Radiolucent Lesions of the Mandibular Body Are Rare Findings on Panoramic Views of Patients With Neurofibromatosis Type 1.

BACKGROUND/AIM: The purpose of the study was to investigate whether non-odontogenic intraosseous translucent lesions of mandibular body are depicted on radiographs of patients with neurofibromatosis type 1 (NF1). MATERIALS AND METHODS: The panoramic radiographs of 179 NF1 patients were analysed for translucent lesions of the mandibular body that were of intraosseous, non-odontogenic origin. The results were compared to findings obtained in panoramic radiographs of age- and sex-matched controls. RESULTS: Only three patients showed intraosseous translucent lesions. These were always unilocular findings. There were no statistically significant differences between the groups (p=0.248). CONCLUSION: Intraosseous neurofibroma of the jaw is a very rare finding in NF1 patients compared to oral neurofibromas. Accurate and exact diagnosis should be made in the case of such findings because malignant tumours in the jaw area can arise in rare cases in NF1 patients. Plain radiology findings cannot clearly indicate the type and biology of the lesion.

Diagnosis and management of Stafne bone cavity with emphasis on unusual contents and location.

Stafne bone cavity (SBC) is a rare mandibular defect, and the diagnosis and management may be confused with the unusual contents and location. This report for the first time presented a case of SBC with a lymph node content. Meanwhile, a rare case of anterior SBC with fatty tissue content is reported. Typical SBCs with salivary glands content are asymptomatic and showed a well-shaped, ovoid, radiolucent image in the posterior mandible below the inferior alveolar canal in panoramic radiograph. The case of SBC with a lymph node content underwent surgical operation, and definite diagnosis is confirmed by histopathological examination. The case of anterior SBC with fatty tissue content is clarified by MRI confirmed the presence of the fatty tissue and avoided surgical exploration. Surgical interventions would be an unnecessary option in the management of SBC except for the doubtful cases or concomitant other pathologies.

Stafne bone cavity / 口腔疾病防治

Objective@#To study the clinical manifestations and biological characteristics of Stafne bone cavity and to reduce misdiagnosis and excessive treatment. @*Methods@#Four cases of typical Stafne bone cavity, including clinical features and follow-up data, were retrospectively analyzed, and the results, combined with a review of the literature, were analyzed in terms of the etiology, clinical manifestations, diagnostic criteria and treatment of Stafne bone cavity.@*Results@#Stafne bone cavity is also known as static bone cavity, idiopathic bone cavity, latent bone cavity defects, aberrant salivary glands, heterotopic mandibular salivary glands, mandibular lingual bone cavity, mandibular lingual cortical bone defect, etc. The incidence of Stafne bone cavity is approximately 0.5%. This condition is easily misdiagnosed as a jaw or jaw cyst tumor and treated unnecessarily. Most scholars believe that the causes of Stafne bone cavity can be divided into two types: developmental and glandular. Stafne bone cavity is characterized by either no symptoms or occasional pain. This condition is observed mostly in 40-60-year-old male patients. The imaging diagnostic criteria for Stafne bone cavity are as follows: ① projecting round or ovoid mandible and uniform density with a distinct bone-cortical white line; ② clearly distinguishable from adjacent structures, such as teeth; ③ typical location in the mandibular angle and molar area, below the mandibular neural tube. Most Stafne bone cavities without advanced bone destruction do not require treatment, although individual cases may gradually progress.@*Conclusion@#Stafne bone cavity presents no symptoms or causes occasional pain and can be clearly diagnosed with CBCT. This condition does not require surgical treatment and should be followed up with observation.

Prevalence of Stafne's bone cavity--retrospective analysis of 14,005 panoramic views.

AIM: Stafne's bone cavity (SBC) is a very rare defect, affecting only selected parts of the mandibular bone. Its etiology is unknown. On two-dimensional images, it appears as a narrowed cavity and might be interpreted as a space-occupying process inside the bone. The aim of the present study was to investigate the prevalence of SBC on panoramic views, and compare these results to published reports. MATERIALS AND METHODS: A total of 14,005 panoramic views were examined retrospectively with regard to the presence of SBC. All images were analyzed regarding typical characteristics as originally described by Stafne. RESULTS: A total of 11 cases fulfilled diagnostic criteria of SBC (0.08%). All patients were men (100%), at a mean age of 58.1 years (range=38-75 years). Eight patients (72.7%) had SBC on the left side, three patients on the right side (27.3%). In eight cases, SBC was found in the mandibular corpus (72.7%), and in three cases in the mandibular angle (27.3%). Correlating with published results, SBC was found at a relative frequency of 0.13%. CONCLUSION: SBC on panoramic views or other imaging modalities should alert the clinician to exclude other potential pathologies. In doubtful cases, surgical procedures might be necessary to verify the diagnosis.

Stafne bone cavities: systematic algorithm for diagnosis derived from retrospective data over a 5-year period.

Stafne bone cavities are usually found in men 50-70 years old. Typically they appear as lingual, open, ovoid lesions of the molar region of the lower jaw, and most contain parts of the submandibular gland. We have retrospectively examined panoramic radiographs acquired over a 5-year period. All lesions suspected of being Stafne bone cavities were included and analysed further to retrieve statistical information and derive a systematic diagnostic algorithm. We identified 21 Stafne bone cavities among 2928 patients (0.7%). Four of these were confirmed on cone-beam computed tomography (CT). One patient had magnetic resonance imaging (MRI) to confirm the diagnosis. The M:F ratio was 14:7 and the mean age 53 years (range 22-82). All cavities were located in the posterior mandible, 9 on the right and 12 on the left. The mean length was 10.9 (range 4.5-23) mm and height 5.7 (range 3.3-17.3) mm. All cavities were located in the posterior mandible. Sixteen panoramic radiographs (0.6%) were classified as possibly having a Stafne bone cavity but did not fulfil enough criteria to confirm the diagnosis. These 16 were not further analysed. It is rare to diagnose a Stafne bone cavity on a panoramic radiograph. Thorough investigation is essential to exclude differential diagnoses such as keratocystic odontogenic tumour, ameloblastoma, or a metastasis. In atypical presentations 3-dimensional cone-beam CT is helpful to verify the lingual opening. If the diagnosis is still not clear, it can be confirmed by MRI.

Differential diagnosis of a salivary gland bone defect by means of computerized tomography: a case report / Diagnóstico diferencial de defeito ósseo mandibular por meio de tomografia computadorizada: relato de caso

Purpose: Salivary gland bone defects are rare entities, generally asymptomatic and found in routine imaging exams. This paper reports the use of computed tomography (CT) with tridimensional rendering to investigate the differential diagnosis of a unilateral radiolucent area located near the angle of the left mandible, below the mandibular dental nerve canal. Case Description: A 71-year-old Caucasian male subject attended the University Dental Clinics of the Portuguese Catholic University, in Viseu, Portugal, seeking routine dental treatment for oral rehabilitation. Radiographic examination showed a radiolucent unilocular image, well circumscribed, located in the horizontal ramus of the left side of the mandible, near its angle, below the mandibular dental nerve canal. No teeth contact to the radiolucent image was detected. In the panoramic digital radiograph the image had 12 mm mesio-distal width. A CT scan with tridimensional rendering was performed to refine the measurements of the lesion dimension and its relation with other anatomical structures. Conclusion: According to the clinical and radiographic findings and based on the dental literature, it was concluded that the observed bone cavity was a Stafne bone defect, located in the angle of the mandible below the mandibular dental nerve canal.

Objetivo: Os defeitos ósseos das glândulas salivares são entidades raras, geralmente assintomáticas e normalmente encontradas em imagiologia de rotina. Neste caso clínico foi utilizada tomografia computadorizada com reconstrução tridimensional para estabelecer o diagnóstico diferencial de uma área radiolucente unilateral, localizada perto do ângulo mandibular esquerdo, abaixo do canal dentário inferior. Descrição do Caso: Indivíduo do sexo masculino, 71 anos de idade, raça caucasiana, recorreu à Clínica Odontológica da Universidade Católica Portuguesa, para tratamento dentário. Na radiografia panorâmica foi detectada uma imagem radiolucente, localizada na região posterior da mandíbula perto do seu ângulo, de limites bem definidos, unilocular, sem contacto com as raízes dentárias, abaixo do canal dentário. Na ortopantomografia digital a imagem media 12 mm mésio-distalmente. Utilizou-se uma tomografia computadorizada da mandíbula com reconstrução tridimensional para esclarecer dúvidas relacionadas com as dimensões da imagem e sua relação com estruturas anatômicas vizinhas. Conclusão: Os exames físico e imagiológicos realizados, juntamente com a revisão de literatura, permitiram concluir que havia um defeito ósseo no ramo horizontal no lado esquerdo da mandíbula, abaixo do canal dentário inferior.

Cone beam tomography evaluation of lingual cortical mandibular defect diagnosed as Stafne bone cavity / Cone beam tomography evaluation of lingual cortical mandibular defect diagnosed as Stafne bone cavity

Mandibular lingual bone depressions are considered to be developmental anomalies known as Stafne bone cavity. The purpose of the present report is to describe the characteristics of classic Stafne bone cavity in molar region evaluated by cone beam computed tomography (CBCT). A male patient, 27 years old, was submitted to CBCT to evaluation the relation between the right lower third molar roots and mandibular canal and the unilateral cystic image found in the panoramic radiographic below the mandibular canal in the right molar area. It was used a gray scale of 12 bits and voxel of 0.2 mm. The CBCT showed fine images of the Stafne bone cavity. In the present case, periodic clinical and radiological controls were the therapeutic option. In atypical cases or in doubtful diagnosis, surgical intervention and anatomopathological examination may be indicated. Although the diagnosis of a Stafne bone cavity can often be established with plain radiographs, confirmatory tests are sometimes required. In these situations, the diagnosis can be confirmed with CBCT.