Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Comparison of Curettage and Active Surveillance in the Treatment of Idiopathic Bone Cavities of the Jaw.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Huang Yu-Ju, Liu Shi-Tong, Liu Mu-Qing, Liu Yang, Safa Masih, Su Jia-Zeng
Аннотация
BACKGROUND: Idiopathic bone cavities (IBCs) of the jaw may resolve spontaneously, creating controversy over optimal management (curettage vs active surveillance).
PURPOSE: The purpose of this study was to compare lesion control and radiographic bone fill outcomes between curettage and active surveillance for IBCs of the jaw.
STUDY DESIGN, SETTING, SAMPLE: Ambispective cohort study of IBC subjects treated at Peking University School of Stomatology (2008 to 2024).
EXCLUSION CRITERIA: involvement of carious or root canal-treated teeth, use of bone grafts (operative group), or incomplete clinical or imaging data.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The predictor variable was therapeutic approach, grouped into curettage and active surveillance.
MAIN OUTCOME VARIABLE: The main outcome variable was lesion control rate (6 months and overall), calculated as (complete radiographic bone fill + partial radiographic bone fill + no change)/sample size.
COVARIATES: The covariates were demographic characteristics, clinical characteristics and radiographic characteristics.
ANALYSES: Intergroup comparisons were analyzed with χ2 or Fisher's exact test. Lesion control rate was analyzed with Kaplan-Meier curves, and Cox regression assessed the effect of treatment on time to complete radiographic bone fill. P < .05 indicated statistical significance.
RESULTS: The sample was composed of 88 subjects with a mean age of 17.9 (±10.5) years; 34 (38.6%) were male, and the median follow-up was 1 [interquartile range: 0.58 to 2.87] years. There were 47 (53.4%) and 41 (46.6%) subjects treated operatively and nonoperatively, respectively. Six months lesion control rate was 82.1% for the operative group and 89.2% for the nonoperative group (P = .4). Overall lesion control rate was 97.9% for the operative group and 97.6% for the nonoperative group (P = 1). Six months complete radiographic bone fill rate was significantly higher in the operative group than in the nonoperative group (46.2 vs 10.8%, P < .05). No statistically significant difference in the 6 months partial radiographic bone fill rate between the 2 groups (33.3 vs 27.0%, P = .6). Operative costs were higher, with complications observed only in the operative group (4 vs 0).
CONCLUSIONS AND RELEVANCE: Curettage provides significantly faster and higher initial radiographic bone fill rates but incurs greater costs and complication risks. If a nonoperative approach is undertaken, long-term clinical follow-up is required to ensure lesion stability.
PURPOSE: The purpose of this study was to compare lesion control and radiographic bone fill outcomes between curettage and active surveillance for IBCs of the jaw.
STUDY DESIGN, SETTING, SAMPLE: Ambispective cohort study of IBC subjects treated at Peking University School of Stomatology (2008 to 2024).
EXCLUSION CRITERIA: involvement of carious or root canal-treated teeth, use of bone grafts (operative group), or incomplete clinical or imaging data.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The predictor variable was therapeutic approach, grouped into curettage and active surveillance.
MAIN OUTCOME VARIABLE: The main outcome variable was lesion control rate (6 months and overall), calculated as (complete radiographic bone fill + partial radiographic bone fill + no change)/sample size.
COVARIATES: The covariates were demographic characteristics, clinical characteristics and radiographic characteristics.
ANALYSES: Intergroup comparisons were analyzed with χ2 or Fisher's exact test. Lesion control rate was analyzed with Kaplan-Meier curves, and Cox regression assessed the effect of treatment on time to complete radiographic bone fill. P < .05 indicated statistical significance.
RESULTS: The sample was composed of 88 subjects with a mean age of 17.9 (±10.5) years; 34 (38.6%) were male, and the median follow-up was 1 [interquartile range: 0.58 to 2.87] years. There were 47 (53.4%) and 41 (46.6%) subjects treated operatively and nonoperatively, respectively. Six months lesion control rate was 82.1% for the operative group and 89.2% for the nonoperative group (P = .4). Overall lesion control rate was 97.9% for the operative group and 97.6% for the nonoperative group (P = 1). Six months complete radiographic bone fill rate was significantly higher in the operative group than in the nonoperative group (46.2 vs 10.8%, P < .05). No statistically significant difference in the 6 months partial radiographic bone fill rate between the 2 groups (33.3 vs 27.0%, P = .6). Operative costs were higher, with complications observed only in the operative group (4 vs 0).
CONCLUSIONS AND RELEVANCE: Curettage provides significantly faster and higher initial radiographic bone fill rates but incurs greater costs and complication risks. If a nonoperative approach is undertaken, long-term clinical follow-up is required to ensure lesion stability.