A clinicopathological study of developmental cysts in the jawbones with radiographic analysis of cyst size

Developmental cysts of the jaws exhibit diverse clinical behaviors, yet few studies have incorporated radiographic cyst size into clinicopathological analysis.This study aimed to evaluate the clinicopathological characteristics of developmental cysts and determine whether cyst size measured on panoramic radiographs is associated with clinical outcomes.A total of 540 cases-including dentigerous cysts (DCs), odontogenic keratocysts (OKCs), and the non-odontogenic nasopalatine duct cysts-were retrospectively reviewed.Cyst area was calculated by multiplying the longest dimension by its perpendicular height on panoramic radiographs, and patients were categorized into three size groups using percentile-based thresholds.Statistical analyses were performed to investigate associations between cyst size and multiple clinical factors, including recurrence, inferior alveolar nerve injury, and postoperative bone healing.OKCs were most commonly observed in the largest size group, whereas DCs were observed predominantly in the smallest group.Cyst size showed no significant correlation with recurrence, symptoms, or nerve injury.However, postoperative bone healing 1 year after surgery was significantly lower in the largest cyst group compared with the smallest cyst group (p<0.05).These findings suggest that panoramic radiograph-based area measurements provide clinically meaningful information; as larger cysts demonstrate reduced postoperative bone healing.Radiographic cyst size may serve as a useful prognostic indicator and may help identify cases that could benefit from adjunctive regenerative procedures.