The Digital Diagnostic Approach to Stafne’s Bone Cavity (SBC): From a Review of the Literature to the Description of a Clinical Case

Introduction:

Stafne’s Bone Cavity [SBC] is a rare, well-defined, mandibular bone lesion, which was first discovered by Edward C. Stafne in 1942.

Objective:

The purpose of this article is to evaluate a digital diagnostic approach to Stafne’s Bone Cavity (SBC) through a review and description of some clinical cases.

Methods:

The review was conducted through an analysis of the literature of all articles published on Stafne’s Bone Cavity.

We report the case of a 55-year-old male patient who needed tooth implant rehabilitation, and therefore, a panoramic radiograph was taken as part of the routine evaluation and plan of care. After the diagnosis, the focus was on more precise imaging and the merits of choosing Computerized Tomography or Magnetic Resonance Imaging were compared.

Results:

According to our review of the literature, the prevalence of these cavities was found to be 0.14%, while 8% of them were found in male patients and 72% of them were found in male patients older than 44 years of age.

The patient’s panoramic radiograph revealed the presence of an SBC in his left posterior side of the mandible. In order to confirm and improve the diagnosis, the patient underwent a Computer Tomography exam, chosen for its benefits outweighing those of an MRI.

Conclusion:

Stafne’s bone cavity (SBC) is indeed an uncommon finding as it is asymptomatic and is identified only through panoramic imaging, CT scans or MRIs. However, it can pose some logistical problems in the application of dental implants. The typology of this case study confirmed the findings of the systematic review; the patient, being a middle aged male, presented a mandibular SBC, which was discovered only during a routine panoramic x-ray to plan the fitting of dental implants. The use of tomography confirmed the diagnosis of SBC and detailed the anatomical structure, thus guiding the restoration process.

Neutral zone recording in computer-guided implant prosthesis: A new digital neuromuscular approach

Background

Neutral zone (NZ) is a specific area in the oral cavity where muscular opposite forces are null. NZ represents the ideal zone for prosthesis placement. In this study, we compared digital implant planning using conventional technique and using NZ registration through piezography.

Methods

Sixty-tree implants were digitally planned. Angular deviation differences between traditional planned and NZ-planned implants were calculated. In addition, interferences with soft tissues (i.e., tongue and cheeks) were evaluated.

Results

We observed a significant difference between traditional technique and piezographic approach in terms of implants angulation (p = .003), independent of site. A 4.7% of the planned abutments with traditional technique were placed outside the NZ, causing conflict with soft tissues in the digital model.

Conclusions

Compared with traditional technique, piezography allows a significantly different exploitation of the nonconflict area, which potentially translates into better management of soft tissues and improved functionality of the implants.

"All on short" prosthetic-implant supported rehabilitations

Objectives

Short implants are increasing their popularity among clinicians who want to fulfill the constant demanding of fixed prosthetic solutions in edentulous jaws. The aim of this report was to propose a new possibility to project and realize an occlusal guided implant cross-arch prosthesis supported by ultra-short implants, describing it presented an edentulous mandible case report.

Methods

A 61-year-old, Caucasian, female patient who attended the dental clinic of the University of L'Aquila presented with edentulous posterior inferior jaw and periodontitis and periimplantitis processes in the anterior mandible. The remaining tooth and the affected implant were removed. Six 4-mm-long implants were placed to support a cross-arch metal-resin prosthesis.

Results

At 1-year follow-up clinical and radiological assessment showed a good osseointegration of the fixtures and the patient was satisfied with the prosthesis solution.

Conclusion

The method, even if it requires further validation, seems to be a valid aid in solving lower edentulous clinical cases, and appears less complex and with more indications of other proposals presented in the current clinical literature. Our case report differs from the current technique All-on-Four, which uses four implants in the mandible to support over-denture prosthesis, assuring a very promising clinical result.