Systematic Reviews
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World J Clin Cases. Mar 26, 2022; 10(9): 2801-2810
Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2801
Efficacy of bone grafts in jaw cystic lesions: A systematic review
Jin Wang, Qiu-Yun Yao, Hui-Yong Zhu
Jin Wang, Qiu-Yun Yao, Hui-Yong Zhu, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Wang J and Zhu HY designed the research; Wang J and Yao QY performed the literature research and data analysis; Wang J performed the drafting of paper; Zhu HY made the final approval; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Yong Zhu, MD, PhD, Professor, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zhuhuiyong@zju.edu.cn
Received: September 22, 2021
Peer-review started: September 22, 2021
First decision: December 10, 2021
Revised: December 23, 2021
Accepted: February 15, 2022
Article in press: February 15, 2022
Published online: March 26, 2022
Processing time: 180 Days and 23.8 Hours
Abstract
BACKGROUND

Bone grafts have been applied for many years in orthopedic surgery to assist with bone repair for defects or bone discontinuity caused by trauma and tumors as well as periodontal defects. Jaw cysts are another common benign disease of the maxillofacial region which may lead to pathological bone fracture, loss of teeth, and infection. However, whether bone grafts are beneficial for bone regeneration in jaw cystic lesions and when bone grafts should be used remains unclear.

AIM

To study the efficacy of bone grafts compared to spontaneous healing in the treatment of jaw cystic lesions.

METHODS

A literature search was performed in Medline, Cochrane Library and Embase to identify related articles published in English in the last ten years. The following key words and MeSH terms were used: “jaw cyst”, “cystic lesion”, “odontogenic cyst”, “periapical cyst”, “dentigerous cyst”, “follicular cyst”, “keratocyst”, “treatment”, “surgery”, “bone graft”, “enucleation”, “cystectomy”, and “bone regeneration”. Case reports, clinical trials, clinical studies, observational studies and randomized controlled trials were included. Study quality was evaluated.

RESULTS

Ten studies (n = 10) met the inclusion criteria. Five studies reported spontaneous bone healing after enucleation, three studies investigated the efficacy of various bone grafts, and two randomized comparative studies focused on the comparison between spontaneous healing and bone grafting. Over 90% of bone regeneration occurred within 6 mo after bone grafting. The bone regeneration rate after cystectomy showed great variation, ranging from 50% to 100% after 6 mo, but reaching over 90% after 12 mo.

CONCLUSION

While the long-term superiority of bone grafting compared with spontaneous healing after cystectomy is unclear, bone grafts accelerate the process of healing and significantly increase bone quality.

Keywords: Jaw cysts; Odontogenic cysts; Enucleation; Bone grafting; Bone regeneration; Bone substitute.

Core Tip: Bone grafts have been widely applied to assist in bone repair in defects. However, whether and when to apply bone grafts in jaw cystic lesions is controversial. In this review, systematic research on the efficacy of bone grafts confirmed the role of bone grafts in accelerating bone regeneration and helping bone formation, but data on long-term outcomes were lacking. Further studies with better variable control and experimental design are needed.