Assessment of odontogenic cysts by volume and topographic-anatomical location based on cone-beam computed tomography

Objective. To evaluate the diagnostic value of cone-beam computed tomography (CBCT) for stratifying odontogenic cysts by volume and topographic-anatomical location relative to critical structures, based on real-world clinical data. Materials and methods. A retrospective analysis of CBCT scans was conducted in 48 patients treated at Department of Oncology No. 8 (Maxillofacial Surgery) of the First Pavlov State Medical University of St. Petersburg, Ministry of Health of Russia, between 2020 and 2026. The cohort included 27 women (56%) and 21 men (44%) aged 20 to 74 years (mean age, 48 years). The following parameters were measured: linear cyst dimensions, cyst volume calculated using the ellipsoid formula, and the distance from the cyst margin to the floor of the maxillary sinus or the mandibular canal. Statistical analysis was performed using JASP 0.18.3 software. Results. Quartile analysis was used to establish objective threshold values for cyst classification. Based on volume, three categories were identified: small (<0.16 cm3), medium (0.16—2.7 cm3), and large (>2.7 cm3). For the maxilla, categories of topographic-anatomical proximity to the maxillary sinus floor were defined as high (≤0.57 mm), moderate (0.58—1.32 mm), and low (≥1.33 mm). For the mandible, categories of topographic-anatomical proximity to the mandibular canal were established as high (≤0.51 mm), moderate (0.52—2.61 mm), and low (≥2.62 mm). Conclusions. Applying quartile analysis to stratify CBCT data enables the development of an odontogenic cyst classification system based on volume and topographic-anatomical location, derived from a real-world clinical sample rather than arbitrary thresholds. Implementing these classification criteria in clinical practice may facilitate the standardized reporting of jaw cysts and improve surgical planning.