Size distribution and clinico-radiological signs of aggressiveness in odontogenic myxoma - three-dimensional analysis and systematic review.

Size distribution and clinico-radiological signs of aggressiveness in odontogenic myxoma - three-dimensional analysis and systematic review.

Dentomaxillofac Radiol. 2017 Oct 30;:20170262

Authors: Kauke M, Safi AF, Kreppel M, Grandoch A, Nickenig HJ, Zöller JE, Dreiseidler T

Abstract
OBJECTIVES: Therapeutic assessment of odontogenic myxoma (OM) is poorly standardized. Unidimensional size criteria have shown to be unreliable in therapeutic decision-making. We evaluate the size distribution of OM and scan for associated clinico-radiological signs of aggressiveness. Additionally, we evaluate three-dimensional size delineation of OM, aiming to improve future therapeutic assessment of this destructive neoplasm.
METHODS: Primarily, we reviewed the database "PubMed" for data concerning the size of OMs as radiologically determined. Afterwards, the impact of age, sex, locularity, and location on the size was investigated by χ²-test, Student's t-test, and regression analysis. Furthermore, we statistically evaluated the impact of size on the occurrence of clinico-radiological signs of aggressiveness. Secondly, we approximated the volume of five unpublished cases of OM by semiautomatic image segmentation of cone-beam computed tomography (CBCT) images.
RESULTS: Multilocular OMs were significantly larger than unilocular ones (p < 0.002). Age (0.042) and multilocularity (<0.002) significantly impacted size. Size was significantly associated with cortical perforation (<0.032) and multilocularity (<0.002), further regression analysis revealed tooth resorption (0.025), cortical perforation (0.005) and multilocularity (<0.002) as significant predictors of size. Employing the volume as a mean of comparison, we found that the biggest OM (38,42 ml; multilocular) was 128 times larger than the smallest (0.31 ml; unilocular). However, using the maximum diameter (cm) as a surrogate for size, the biggest lesion (6.3) was only 5.25 times larger than the smallest (1.2).
CONCLUSIONS: Locularity and volumetric size characterisation might help in therapeutic decision-making and could help to improve our understanding of OM.

PMID: 29082773 [PubMed - as supplied by publisher]

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