The radiographic study of cortical changes of bone caused by jaw lesions

악골 병소에 의한 피질골 변화에 관한 방사선학적 연구

Purpose : To investigate the diagnostic significance of cortical changes in the bone of diseased jaws utilizing computed tomography (CT). Materials and Methods: Computed tomographic images of 91 patients, consisting of 7 osteomyelitis, 46 cysts, 18 benign tumors, and 20 malignant tumors, were analyzed. The pattern of cortical expansion was classified into three types: no expansion (N), buccal or lingual expansion (B/L), and buccolingual expansion (B & L). The pattern of cortical destruction was classified into four types: no destruction (N), point destruction (PO), gross destruction (GR), and permeative destruction (PE). The pattern of periosteal reaction was classified into four types: parallel, irregular, spicule, and Codmans triangle. The relationship between the pattern of cortical bone changes and diseases of the jaws was assessed. Results: When the pattern of cortical expansion was compared to diseases of the jaw, N-type was most prevalent in cases of osteomyelitis and malignant tumors, B/L-type with cysts, and B&L-types with benign tumors. Comparison between the pattern of cortical bone destruction with diseases of the jaw showed strong correlations between PO and PE-types to osteomyelitis, N-type with cysts, N and GR-types with benign tumors, and GR-type with malignant tumors. Finally, the relationship between the pattern of periosteal reaction to diseases of the jaw showed a strong correlation between parallel-type to osteomyelitis and spicule-type to malignant tumors. Conclusion : The pattern of cortical expansion and cortical destruction is useful in differentiating diseases of the jaws.