Stafne Bone Research Articles

CBCT as a tool for differential diagnosis between bone lesions and anatomic variations: a clinical case series

The clinical examination associated with complementary tests are the basis for establishing the diagnosis. In the context of complementary imaging exams, cone beam computed tomography (CBCT) represents a relevant tool as it allows more precise and detailed assessments of the oral and maxillofacial region. The objective of this study was to identify and describe anatomical variations of the oral and maxillofacial complex that mimic bone lesions. The presence of these structures may increase the possibility of errors in diagnosis and consequently in the treatment plan, and the role of CBCT as an essential tool for differential diagnosis. This case series reported 9 patients with anatomical variations that mimicked bone lesions, of which the differential diagnosis was obtained through CBCT, as pneumatization of the sphenoid sinus, extensions of the maxillary sinus, Stafne's bone defects, reduced thickness of the mandibular symphyses and morphological variation of mandible head. Thus, CBCT seems to be a relevant tool that optimizes the differential diagnosis between variations in normality and bone lesions, favoring both the diagnosis and the design of the treatment plan.

Effect of deep transfer learning with a different kind of lesion on classification performance of pre-trained model: Verification with radiolucent lesions on panoramic radiographs.

The aim of this study was to clarify the influence of training with a different kind of lesion on the performance of a target model. A total of 310 patients (211 men, 99 women; average age, 47.9±16.1 years) were selected and their panoramic images were used in this study. We created a source model using panoramic radiographs including mandibular radiolucent cyst-like lesions (radicular cyst, dentigerous cyst, odontogenic keratocyst, and ameloblastoma). The model was simulatively transferred and trained on images of Stafne's bone cavity. A learning model was created using a customized DetectNet built in the Digits version 5.0 (NVIDIA, Santa Clara, CA). Two machines (Machines A and B) with identical specifications were used to simulate transfer learning. A source model was created from the data consisting of ameloblastoma, odontogenic keratocyst, dentigerous cyst, and radicular cyst in Machine A. Thereafter, it was transferred to Machine B and trained on additional data of Stafne's bone cavity to create target models. To investigate the effect of the number of cases, we created several target models with different numbers of Stafne's bone cavity cases. When the Stafne's bone cavity data were added to the training, both the detection and classification performances for this pathology improved. Even for lesions other than Stafne's bone cavity, the detection sensitivities tended to increase with the increase in the number of Stafne's bone cavities. This study showed that using different lesions for transfer learning improves the performance of the model.

Detection of Radiolucid Lesions in Digital Panoramic Radiographs

This study evaluated the presence of radiolucid lesions in digital panoramic radiographs from the archives of the State University of Paraiba (UEPB) Diagnostic Imaging Clinic, performed in 2017. After surveying the radiographs performed by the service in that year, those with radiolucent lesions were selected, being excluded those with poor quality and with patient positioning errors. By means of a structured form, the characteristics observed in the radiographs were recorded by a single trained and calibrated observer. The analysis took place through descriptive statistics and all ethical aspects were respected. There was a low prevalence (14.2%) of radiographs with radiolucent lesions, which mainly affected young female patients. These lesions were small in size, located predominantly in the posterior periapical region of the mandible, with a unilocular aspect, being associated with a posterior tooth, mainly premolar. Inflammatory lesions were the most prevalent, with a presumptive diagnosis highlighting the predominance of abscesses followed by cysts/granulomas. The dentigerous cyst was the third most prevalent odontogenic lesion, occurring in its entirety in females. Odontogenic keratocysts and Stafne's bone cavity were also detected.

Prevalence of Stafne's Cyst – A retrospective analysis of 18,040 Orthopantomographs in Western India

Introduction: Stafne's cyst (SC) is a bone depression found on the lingual side of the mandible. It is a sharply demarcated osteolytic lesion of the mandible, caudal to the inferior alveolar nerve and restricted to the regions of the molars and mandibular angle. Purpose: Stafne's bone cyst is usually asymptomatic being diagnosed on the routine radiographs as an incidental finding hence, its actual prevalence is unknown. Moreover, the lesion simulates many odonogenic pathologies thereby, and the entity remains a diagnostic challenge. So, the present study was conducted to investigate the prevalence of SC in Jodhpur population of Western India. Materials and Methods: A retrospective analysis of 18040 OPGs was done on the basis of diagnostic criteria described by Stafne. Results: A total of 6 cases fulfilled diagnostic criteria of SC (0.03%), 4 cases were reported in men (66.6%), at a mean age of 50.75 years, and 2 cases in women (33.3%), at a mean age of 31.5 years. Involvement of SC on left and right side of the mandible was given as 4:2 in ratio. All 6 cases of SC was found in the body of mandible (100%). Rare case of double unilateral form of SC was reported in 1 patient. Conclusion: Orthopantomographs (OPGs) may ensure initial opinion regarding the diagnosis of SC and alert the clinicians to exclude other potential pathologies to avoid invasive procedures.

Stafne's bone cavity – unusual presentation in the anterior mandible

Abstract: Stafne's Bone Cavity (SBC) is a well described but uncommon asymptomatic pseudocyst of the mandible. Most commonly occurring in the posterior mandible, presentations anterior to the mental foramen are extremely rare and warrant thorough investigation. This case describes the presentation of a 55-year-old male with an anteriorly-positioned SBC that resembled asymptomatic dental pathology. Clinicians should be aware of SBCs as a differential diagnosis for radiolucent lesions of the mandible. CPD/Clinical Relevance: To raise awareness of radiolucent lesions to dental professionals in both general and specialist settings.

Stafne bone cavity: An unusual case with involvement of the buccal and lingual mandibular plates

Lingual mandibular bone defects, also known as Stafne bone cavity (SC), are unilateral asymptomatic radiolucencies, generally seen in the mandibular angle, below the inferior alveolar canal. Although panoramic radiographies normally offer enough information to make a correct diagnosis, additional studies are often required, especially in atypical cases. The present report describes an atypical presentation of a Stafne’s bone cavity in a 78 years-old male patient. In this particular case, an asymptomatic and radiolucid lesion was observed during a routine dental examination. The computed tomography (CT) showed an involvement of both lingual and buccal mandibular plates producing a tunnel-like lesion. No history of mandibular trauma or surgery was refered. An additional magnetic resonance imaging (MRI) was made to discard submandibular gland pathology and to confirm the diagnosis. Since SC is asymptomatic and nonprogressive, a conservative approach based in clinical and radiological follow-ups was considered to be the most suitable treatment option. Key words:Stafne bone cavity, lingual mandibular bone defect, case report.

The importance of a careful radiographic analysis in the diagnosis of Stafne's bone defect: report of three cases

The importance of a careful radiographic analysis in the diagnosis of Stafne's bone defect: report of three cases

Aberrant location of salivary gland inclusion: Report of a case with review of the literature

Stafne's bone defects (SBDs) are asymptomatic radiolucent lingual/buccal bone lesions of the lower jaw and are frequently caused by soft tissue inclusion. SBDs located on the buccal ramus of the mandible are the rarest variant. To date, only one case involving the buccal ramus has been reported in the PubMed Database (National Library of Medicine) including both clinical cases and archaeological specimens. Advanced imaging techniques are useful in diagnosing these types of lesions in order to avoid unnecessary surgery. In the case described, the radiolucency in the condylar neck appeared to be developmental in origin and was later shown by computed tomography to be related to salivary gland tissue of the parotid gland.

Stafne's defects in two mandibles from archaeological sites in Croatia

Salivary gland inclusions in the mandible are relatively uncommon in recent as well as archaeological populations. This condition is well known to oral surgeons, but less so to anthropologists, osteologists and skeletal biologists. At present a limited number of reports pertaining to this condition in ancient populations are available in anthropological and palaeopathological literature, although scattered reports of cases in recent populations are found in dental journals. This paper analyses the prevalence of Stafne's bone defect in a large composite Croatian archaeological series (n = 4250 mandibles), and reports on two cases in which computerised tomography was performed, in order to draw the attention of anthropologists, osteologists and skeletal biologists to this condition when faced with differential diagnosis of odontogenic lesions, cysts and neoplasms in the area of the angle of the mandible. Copyright © 2009 John Wiley & Sons, Ltd.

Study of stafne's defects in Late Neolithic, Late Roman, Medieval and Modern skeletal samples from Portugal

ABSTRACTLingual mandibular cortical defects (Stafne's defects) are relatively uncommon in recent as well as past populations, but while this condition is often discussed in clinical reports, they are rarely the subject of anthropological research. In this paper, the prevalence of Stafne's bone defects in skeletal samples from Late Neolithic, Late Roman, Medieval and Modern Portugal is investigated (N = 704 complete mandibles and 111 incomplete mandibles). The aims of this paper are threefold: (1) to present and analyse for the first time in Portuguese osteological record prevalence data on Stafne's bone defect, (2) to analyse variations in defect prevalence between skeletal samples from a wide temporal array and (3) to verify if more tenuous lesions in which resorption of the lingual cortex was not yet extensive had the classic radiographic appearance described by Stafne in order to validate the hypothesis that lesions are present clinically in many more cases than published figures indicate. In all cases, differential diagnosis against other conditions that mimic Stafne's defects, namely odontogenic lesions, cysts and neoplasms, was done. In all samples, the evidence of Stafne's defect occurred in 12 individuals (1.7%), and males (2.84%) were more frequently affected than females (0.61%). When incomplete mandibles were considered, only one left fragment (0.90%) exhibited Stafne's defect. Accurate identification of all examples of Stafne's bone defects in antiquity is thought to represent an important contribution to elucidate which factors may be responsible for this trait's cultural, ecological, temporal and geographical patterning. Copyright © 2010 John Wiley & Sons, Ltd.

P68 Stafne's Bone cavity: Do we need further imaging?

P68 Stafne's Bone cavity: Do we need further imaging?

Stafne's Defect with Buccal Cortical Expansion: A Case Report

A rare case of Stafne's bone cavity, type III-G, is reported in a 49-year-old male patient who had been referred to a private clinic for a routine evaluation. The final diagnosis was based on computed tomography. Scintigraphy played a fundamental role in determining the most likely etiology.

Anterior Stafne's Bone Cavity Mimicking a Periapical Lesion of Endodontic Origin: Report of Two Cases

Introduction This report of 2 cases describes the diagnostic procedures used to identify 2 Stafne's bone cavities (SBC) found in unusually anterior locations in the mandible, both mimicking periapical lesions of endodontic origin. Methods In the first patient, a 47-year-old man, an SBC was diagnosed in the area of teeth #27, 28, and 29. In the second patient, a 62-year-old man, the SBC was a fortuitous finding, because this patient was referred for dental implant therapy. Results In both cases, the final diagnosis was achieved by using limited cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). In both patients, the lingual bone cavity was found to be occupied by accessory salivary gland tissue. Conclusions The combination of CBCT and MRI as noninvasive diagnostic techniques seems ideal to avoid surgical explorations, incisional biopsies, or enucleations of the lesion for diagnostic purposes.

CT analysis of the Stafne's bone defects of the mandible

To investigate the aetiology of Stafne's bone defects by analysing the CT findings of two types of defects, which appeared differently on panoramic radiographs. 32 lesions with suspicion of the Stafne's bone defect on a panoramic radiograph were categorised into two groups: typical "Stafne type", which showed the connection to the base of the mandible, and non-typical "Cyst type", which showed no connection. Age, sex, the existence of hypertension and the following CT findings: location, size and inner content of the defect, existence of expansion of the buccal cortical bone, and location of submandibular glands, were analysed. There were 14 "Stafne type" and 17 "Cyst type" on the panoramic radiographs. One lesion in the "Cyst type" was a true cystic lesion and was excluded from further review. The "Stafne type" was seen primarily in the posterior and inferior locations, while the "Cyst type" was seen in the anterior and superior locations on the CT. The size of the defect was significantly larger in the "Stafne type". Buccal cortical expansion was observed only in three lesions in the "Stafne type". While the "Cyst type" contained mainly fatty tissue, the "Stafne type" contained other soft tissues. Though the submandibular glands on the defect side were located anteriorly in both types compared with those on the contralateral side and on the control patients, they spread mainly outwards in the "Stafne type". The Stafne's bone defects are thought to be caused by the dislocated submandibular gland. The differences between the two types might occur as a result of a different location of the submandibular gland.

Stafne's bone cavity and its utilization in complete denture retention

This clinical report describes the fabrication of a mandibular denture for an elderly woman who presented with bilateral Stafne's bone cavities. A review of this anatomical entity is presented together with the prosthodontic management of the patient. (J Prosthet Dent 2002;87:245-7.)

Stafne’s Bone Cavity in the Anterior Mandible: A Possible Diagnostic Challenge

Stafne was the first to report the presence of "bone cavities" in the angle of 35 mandibles. Such cavities generally appear in the area between the mandibular first molar and the mandibular angle, and are not considered rare. One of their primary radiological diagnostic features is the characteristic location below the mandibular canal. Stafne's bone cavity is relatively rare in the anterior mandible. The mandibular canal is not present in the anterior mandible. As a result, diagnosis in the anterior mandible may be missed. Needless treatment modalities such as endodontic treatment, bone trephining, and bone exploration may be conducted. The purpose of the present report is to describe a new case of Stafne's bone cavity in the anterior mandible and discuss the differential diagnosis process. The dental computerized tomography scan is suggested as the most suitable noninvasive diagnostic and follow-up modality for this bony configuration in the anterior mandible.

Lingual mandibular bone defect. Case report and review of the literature

An unusual case of lingual mandibular bone defect (Stafne's bone cavity) is presented in which the lesion extended to above the inferior dental canal and caused expansion of the buccal cortical plate. The literature is reviewed with regard to the incidence, plausible aetiologic factors and methods of investigation of such lesions.

Lingual cortical defect of the mandible: an unusual presentation and tomographic diagnosis.

A well-defined, bilocular radiolucency was found in the angle of the lower left mandibular ramus. The patient was asymptomatic. Serial cross-sectional tomography of the lesion revealed a lingual concavity in the mandibular cortical bone. A diagnosis of atypical Stafne's bone cavity was made.

A radiographical classification of Stafne's bone cavity

So-called Stafne's bone cavity of the mandible were detected by panoramic radiography in 24 patients seen at the Second Department of Oral and Maxillofacial Surgery, Meikai University Hospital, and five associated hospitals. Unilateral and asymptomatic, all lesions were situated near the angle of the mandible, except for the one case that involved the anterior portion of the mandible. The mean age of the patients was 53 years with a range of 31 to 78 years, and included 22 men and 2 women. In this report, radiographic interpretation of the lesion was done, and a radiographic classification was made as follows: Type I (Indentation type): The inferior border of the mandible is involved. Type II (Medium type): The lesion is situated above the inferior border of the mandible but below the mandibular canal. Type III (Deviation type): Deviation of the mandibular canal is suspected. Type IV (Anterior type): The radiolucency is located in the anterior portion of the mandible.

Stafne's bone cavity: Classification based on outline and content determined by computed tomography

Fifteen cases (16 concavities) of the so-called “Stafne's bone cavity” were investigated with the use of computed tomography. The sizes, bony outlines, and contents were analyzed on axial images. In all cases, computed tomography clearly demonstrated the concavities on the lingual surface of the mandible. There were no empty concavities. The bony outlines and contents were divided into three types. The concavities with a portion of submandibular gland as a content were larger than those with other contents. Four of six concavities not extending to the buccal cortical plate were filled solely with fat tissue, whereas all concavities with expansion of the buccal cortical plate contained submandibular gland.