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. 2024 Jul 5;14(1):15492.
doi: 10.1038/s41598-024-66411-4.

A three-dimensional quantitative assessment on bony growth and symmetrical recovery of mandible after decompression for unicystic ameloblastoma

Tingwei Bao #  1 , Di Yu #  2 , Jiaqi Zheng  1 , Wenyuan Zhu  1 , Dong Wei  1 , Huiming Wang  3   4
Affiliations

A three-dimensional quantitative assessment on bony growth and symmetrical recovery of mandible after decompression for unicystic ameloblastoma

Tingwei Bao et al. Sci Rep. .

Abstract

Unicystic ameloblastoma (UAM) of the jaw can be effectively reduced in volume through decompression, which promotes bone regeneration and restores jaw symmetry. This study quantitatively evaluated changes in mandible volume and symmetry following decompression of mandibular UAM. This study included 17 patients who underwent surgical decompression followed by second-stage curettage for mandibular UAM. Preoperative and postoperative three-dimensional computed tomography (CT) images were collected. Bone volume and the area of cortical perforation were measured to assess bone growth during decompression. Mandibular volumetric symmetry was analyzed by calculating the volumetric ratio of the two sides of the mandible. Twelve pairs of landmarks were identified on the surface of the lesion regions, and their coordinates were used to calculate the mean asymmetry index (AI) of the mandible. Paired t-tests and the Mann-Whitney U test were used for statistical analysis, with p < 0.05 considered indicative of statistical significance. The mean duration of decompression was 9.41 ± 3.28 months. The mean bone volume increased by 8.07 ± 2.41%, and cortical perforation recovery was 71.97 ± 14.99%. The volumetric symmetry of the mandible improved significantly (p < 0.05), and a statistically significant decrease in AI was observed (p < 0.05). In conclusion, UAM decompression enhances bone growth and symmetry recovery of the mandible. The present evaluation technique is clinically useful for quantitatively assessing mandibular asymmetry.

Keywords: Ameloblastoma; Bone amount; Cortical perforation; Decompression; Symmetry; Volume reduction.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Decompression was maintained using a silicone tube. (A) Intraoral view. The decompression tube was fixed to the bracket on an adjacent tooth using a stainless steel ligature wire. (B) CT view. The decompression tube was inserted into the deep side of the lesion cavity through the opening.
Figure 2
Figure 2
Reconstruction of a 3D model of the mandible, impacted tooth, and lesion. (A) Coronal CT images of the mandible (purple), lesion (yellow), and impacted tooth (green) were selected. (B) A 3D image of the mandible showed severe swelling and resorption of the mandibular ramus and body, with a large defect in the cortical layer.
Figure 3
Figure 3
Measurements of the area of cortical perforation in a representative case. (A) Alignment of the mandible and lesion. (B) Markings of the cortical layer, including the perforation. (C) The cortical perforation was projected to the lesion surface for measurement.
Figure 4
Figure 4
Identification of landmarks for AI analysis. (A) Fabrication of the 3D coordinate system. (B) Alignment of the pre- and post-decompression mandible and the standard symmetrical mandible. (C) The preoperative mandible was remeshed. (D) The measurement landmarks were marked using nodes on the remeshed model. (E) Lines passing through the landmarks perpendicular to the YZ plane were marked. (F) Corresponding positions of landmarks on real mandibles.
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