Stafne bone cavities: systematic algorithm for diagnosis derived from retrospective data over a 5-year period

Stafne bone cavities are usually found in men 50-70 years old. Typically they appear as lingual, open, ovoid lesions of the molar region of the lower jaw, and most contain parts of the submandibular gland. We have retrospectively examined panoramic radiographs acquired over a 5-year period. All lesions suspected of being Stafne bone cavities were included and analysed further to retrieve statistical information and derive a systematic diagnostic algorithm. We identified 21 Stafne bone cavities among 2928 patients (0.7%). Four of these were confirmed on cone-beam computed tomography (CT). One patient had magnetic resonance imaging (MRI) to confirm the diagnosis. The M:F ratio was 14:7 and the mean age 53 years (range 22-82). All cavities were located in the posterior mandible, 9 on the right and 12 on the left. The mean length was 10.9 (range 4.5-23) mm and height 5.7 (range 3.3-17.3) mm. All cavities were located in the posterior mandible. Sixteen panoramic radiographs (0.6%) were classified as possibly having a Stafne bone cavity but did not fulfil enough criteria to confirm the diagnosis. These 16 were not further analysed. It is rare to diagnose a Stafne bone cavity on a panoramic radiograph. Thorough investigation is essential to exclude differential diagnoses such as keratocystic odontogenic tumour, ameloblastoma, or a metastasis. In atypical presentations 3-dimensional cone-beam CT is helpful to verify the lingual opening. If the diagnosis is still not clear, it can be confirmed by MRI.