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Stafne's Bone Defect - Causes, Signs, Symptoms, Diagnosis and Treatment

Published on May 20, 2022   -  5 min read

Abstract

Stafne’s bone defect is a rare mandibular defect that causes no dysfunction and requires no treatment. Read the following article for more information.

Contents

What Is Stafne’s Bone Defect (SBD)?

Stafne’s bone defects are rare bony defects that occur primarily in the posterior portion of the mandible (lower jaw). These cavities contain ectopic salivary tissue within them. Edward C. Stafne described SBD in 1942, who reported at least 35 cases of Stafne’s defect. The lesion also has a rare anterior variation that Richard and Ziskind described in 1957.

What Are Some Other Terms for Stafne’s Bone Defect?

The following terms have also been used to refer to Stafne’s bone defect:

Where Does Stafne’s Bone Defect Usually Occur?

Who Is Commonly Affected by Stafne’s Bone Defect?

What Causes Stafne’s Bone Defect?

What Are the Signs and Symptoms of Stafne’s Bone Defect?

Stafne’s bone defect is usually asymptomatic. A clinical examination does not typically yield any definitive medical signs either. SBD usually presents as a unilateral defect and hardly ever appears bilaterally. A few cases may present with lingual mucosal depression on the mandible.

Other rare symptoms include:

How Is Stafne’s Defect Diagnosed?

Stafne’s defect is usually accidentally diagnosed radiographically during the course of other, unrelated dental treatments.

The following are the diagnostic techniques that may be used for SBD:

1. Panoramic Radiograph:

They appear as well-circumscribed, monolocular, round, or ovoid radiolucent lesions near the angle of the mandible when observed on a panoramic radiograph. They are located between the inferior alveolar nerve and the lower mandibular margin or the inferior border of the posterior mandible (between the molar teeth and the angle of the jaw). The size of these defects ranges from 1 cm to 3 cm. The border appears well-corticated, so the defect does not affect adjacent or surrounding structures.

2. Computed Tomography (CT) Scan:

The lesion appears as a shallow defect when viewed through the medial cortex of the mandible. It possesses an easily distinguishable corticated rim. While a part of the submandibular gland may be affected, soft tissue abnormalities do not typically arise due to the lesion and are therefore not visible on the CT scan. Three-dimensional CT reconstruction can help define and understand the spatial relationship between the bone defect and the inferior alveolar nerve.

3. Sialography:

Sialography may also aid in the diagnostic process as it can demonstrate the presence of salivary gland tissue within the bone.

4. Tissue Biopsy:

Tissue biopsy does not help with the diagnosis since the histopathologic features on a biopsy indicate normal salivary gland tissue. An empty cavity may be noticed in some cases if the gland has been displaced. Some biopsies may also show the presence of blood vessels, connective tissue, lymphoid tissue, and fat. There is a better likelihood of proper diagnosis through a biopsy when the lesions are in the anterior region of the mandible. They appear as radiolucent defects that may superimpose the lower anterior teeth or disrupt the contour of the lower mandibular border.

5. Magnetic Resonance Imaging (MRI) Scan:

MRI scans are better options than conventional CTs for the following two reasons:

However, MRI scans also have some associated concerns, including the following:

MRI helps describe the submandibular gland prolongation into the Stafne’s defect in the mandible. Therefore, it is used as an alternative in cases where CT is not recommended.

6. Other Diagnostic Particulars:

The defect does not increase in size or change in radiographic appearance, which means that it stays static. This can help when attempting to diagnose the lesion, as this characteristic static feature may set it apart from other lesions that are similar in appearance but not necessarily unchanging.

The anterior variant of SBD generally appears as a radiolucent, ovoid, or ellipsoid concave lesion. It is located in the canine-premolar mandibular area and is similar to the posterior variant's clinical and radiographic appearance.

How Is Stafne’s Defect Treated?

The treatment of Stafne’s defect is unnecessary since it is not considered a pathological condition. It causes no ill effects, abnormalities, or pathological changes. However, there is a possibility of the occasional abnormality arising due to the lesion.

In addition, the presence of salivary gland tissue means that salivary gland tumors may be seen within the defect. This is a rare occurrence but not impossible.

What Factors Should Be Considered in the Differential Diagnosis of Stafne’s Bone Cyst?

Clinical examination and imaging techniques may help recognize and rule out neoplasms such as lymph node malignancy and salivary gland tumors.

Anterior SBDs may be misdiagnosed as residual cysts. Differential diagnosis relies on the fact that SBD has no association with teeth, whereas residual cysts typically occur during the extraction of a tooth with severe apical infection.

Differential diagnosis of odontogenic and non-odontogenic cysts is also required. The best way to differentially diagnose SBD from cysts such as ameloblastomas, dentigerous cysts, and radicular cysts is to establish the presence or absence of an association with a relevant tooth. SBD does not have any such association, while most cysts are associated with teeth (inflamed, infected, or unerupted).

Conclusion:

Individuals affected with SBD hardly ever find out that they have the condition unless it has been diagnosed during a routine dental examination. Therefore, there is no cause for concern, and the defect does not hamper life or affect the quality of one’s oral health. Patients do not need to worry or seek treatment for a case of SBD, as it is not required. Associated side effects are rare and mostly absent.

Frequently Asked Questions


1.

What Is the Cause of Stafne’s Bone Cyst?

- While the actual cause of Stafne’s bone cyst is not fully understood, it is suggested that the defect primarily arises from lingual cortical plate remodeling, which occurs due to the proliferation of adjacent salivary glands or soft tissues.

- It may also occur as a result of entrapment of salivary gland tissue in the bone (typically the posterior portion of the mandible).

2.

What Is Meant by the Term Traumatic Bone Cyst?

- A traumatic bone cyst (TBC) is a rare non-epithelial lined, non-neoplastic cavity found in the jaws.

- It is considered a pseudocyst due to the lack of epithelial lining.

- It is usually located in the mandible, between the canine and third molar.

- TBC occurs mostly in younger patients in their second decade of life, usually due to trauma.

- Surgery for bone wall curettage is the treatment of choice for TBC.

3.

Is Stafne’s Bone Cyst Considered a Pseudocyst or a True Cyst?

Stafne’s bone cyst is considered a pseudocyst since it has no epithelial lining.

The cyst also has no fluid content within it, but may usually contain normal salivary gland tissue.

4.

What Is the Differential Diagnosis for Stafne’s Bone Defect?

The differential diagnosis of SBD should typically cover the following lesions and disorders:

- Salivary gland tumors.

- Lymph node malignancies.

- Residual cysts.

- Ameloblastomas.

- Radicular cysts.

- Dentigerous cysts.

- Other similar odontogenic and non-odontogenic cysts.

5.

Are Bone Cysts Considered Tumors?

- Bone cysts are fluid-filled cavities found inside the bones.

- They may be referred to as benign bone tumors.

- However, they are harmless and rarely ever transform into malignant tumors.

- They do not spread and are unaccompanied by symptoms in most cases, although pain or swelling may occur rarely.

- Aneurysmal bone cysts, however, are non-malignant bone tumors that tend to grow aggressively and have a rare potential for malignant transformation in those cases where radiation has been given. They are locally destructive and need prompt treatment.

6.

How to Treat an Aneurysmal Bone Cyst?

Surgical intervention is the preferred treatment for aneurysmal bone cysts. The surgical options may include:

- Intralesional Curettage: Evacuating the contents of the cavity and filling the space created with materials that strengthen the bone (bone graft materials, cement).

- Intralesional Excision: A broad opening is made in the bony wall of the lesion, the contents are evacuated, and bone grafts or other materials are placed to strengthen the bone. Adjuvant therapy may also be used for a better prognosis.

- En Bloc (Complete Excision): Complete removal of the lesion from the bone. This option is only used for patients with recurring lesions that have not been controlled by other means.

- Radiotherapy and selective arterial embolization may be considered as adjuvant therapeutic options.

- Monoclonal antibody use has also been suggested in patients who do not require surgical intervention.

Article Resources

Last reviewed at:
20 May 2022  -  5 min read

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