Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Available online at www.ordoneardentistrylibrary.org
ISSN 2249-488X
Case – report
INTERNATIONAL JOURNAL OF RESEARCH IN DENTISTRY
STAFNE’S BONE CAVITY - ENHANCEMENT IN COMPLETE DENTURE RETENTION
Dr. Hasti Anurag1, Dr. Hasti Kalpana2, Dr. Mantur Sachin3, Dr. Sharma Rahul1, Dr.H.G Jagadeesh1,
Dr. Devanarayan Ashwin1
1. Dept. of Prosthodontics, School of dental sciences, Sharda university, Greater noida – 201307
2. Dept. of Prosthodontics, Jaipur Dental College
3. Dept. of Prosthodontics, Dental college Azamgarh
Received: 16 Oct. 2015; Revised: 11 Nov. 2015; Accepted: 16 Dec. 2015; Available online: 5 Jan. 2016
ABSTRACT
Stafne’s Bone Cavity (SBC) is a lesion located between mandibular angle and third molar below the inferior dental canal and
above the mandibular base. Many different terms have been introduced like Static bone cyst, Lingual mandibular bone defect,
idiopathic bone cavity and Lingual mandibular bone depression in order to define the lesion.
The two clinical cases describe the engagement of mandibular denture in bilateral and unilateral Stafne’s bone cavities.
Fabrication of denture by utilising either a unilateral or bilateral cavities improves the retention and stability of the mandibular
denture.
Keywords:- Stafne’s Bone Cavity, mandibular denture
INTRODUCTION
Stafne’s Bone Cavity (SBC) was first described by Stafne in 1942.Lesions were located between mandibular
angle and third molar below the inferior dental canal and above the mandibular base. Many different terms have
been introduced like Static bone cyst, Lingual mandibular bone defect, Iidiopathic bone cavity and Lingual
mandibular bone depression in order to define the lesion. SBC is generally encountered incidentally on routine
plain radiographs [1]. Radiographically the cortical outline of the bone defect is denser than the odontogenic
cyst [2]. Stafne’s bone cavities range from 1-3cm in diameter. Stafne’s defects are relatively rare with an
incidence of 0.3 %. More cases have been reported in men than in women with a striking incidence of 80% to
90% of all cases. The cavities are often filled with normal salivary gland tissue but occasional cases show cavity
contents that included skeletal muscles, fibrous connective tissue and adipose tissue [3].
Stafne’s bone cavity classification:
I.
The concavities were divided into three according to their outline and relationship to the buccal
cortical plate:
Type I: The bottom of concavity did not reach the buccal cortical plate.
Type II: the bottom of the cavity reached the buccal cortical plate, but there was no expansion or
distortion of the plate.
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Type III: There was buccal expansion of the cortical plate.
The concavities were also divided into three types according to their contents as determined by axial CT
analysis.
i.
Type F: Concavity was filled with only fat density.
ii.
Type S: Concavities were filled with a density of soft tissue structure suggesting a lymph node,
vessel, connective tissue or others.
iii.
Type G: The sub-mandibular gland was entrapped in or was located close to the cavity.
Case Report-1:
A 73 years old female (Figure-1) reported to the Department of Prosthodontics with a chief complaint of
replacement of missing teeth. Patient was edentulous since 1 year.
On intra-oral examination, upper and lower arches were found to be edentulous, ovoid in shape and with firm
mucosa.
Palpation of lingual surfaces revealed bilateral concavities in the premolar – molar region.
Patient gave no history of Jaw surgery, Trauma or pain in this region.
A Panoramic radiograph was done and it showed an asymptomatic defect in the pre-molar molar region in the
mandible corresponding to the concavities.
Correlating history of patient, intra oral examination and Panaromic radiograph, it was concluded that it is a
Stafne’s cavity.
It was thought that these concavities could be utilised for the retention and the stability of mandibular denture.
Upper and Lower complete denture was planned for the patient.
Procedure:
Preliminary impressions of maxillary and mandibular arches were made with impression compound.
Impressions were poured in dental plaster and special trays were fabricated taking care that auto-polymerising
resin material did not engage into the concavities in the mandibular arch.
During Border molding at the site of these concavities the green stick was slightly pushed taking care not to fill
the Stafne’s bone cavity. The final impressions were made with addition silicon impression material.
The master cast record base and occlusal rims were fabricated.
Jaw relation records were taken and transferred onto the articulator.
After teeth arrangement and try in, compression moulding technique was used for fabrication of complete
denture followed by finishing and polishing (Figure-2 and Figure-3).
Upper and lower complete denture were inserted after correction of occlusal discrepancies (Figure-4).
Post insertion check-up was done after 24 hours and slight inflammation was observed in one of the cavity and
in pre mylohyoid region. These areas were relieved and patient was subsequently called after 1 month, 6 months
and 1 year follow-up.
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Case Report-2:
A 61 years old male patient reported to the Department of Prosthodontics with chief complaint of replacement
of missing teeth. Patient was edentulous with a history of extraction 3 months back (Figure- 5)
On intra oral examination maxillary and mandibular arches were found to be edentulous with high well rounded
ridges.
A routine Panaromic radiograph showed a small 1 cm asymptomatic defect in the molar region on the left side.
After correlating the history intra-oral examination and panoramic radiograph it was concluded that it is a
unilateral Stafne’s cavity. It was thought to utilise it for the retention and stability of the mandibular denture.
A complete upper and lower denture was planned for the patient.
Procedure:
Preliminary impressions of upper and lower arches were made with impression compound.
Impressions were poured in dental plaster and special trays were fabricated taking care that auto-polymerising
resin material did not engage into the concavity of the mandibular arch.
During Border molding at the site of this concavity the green stick was slightly pushed taking care not to fill the
Stafne’s bone cavity on the left side. The final impressions were made with addition silicon impression material
(Figure - 6).
On master cast record base and occlusal rims were fabricated (Figure- 7).
A Jaw relation records were made and transferred onto the articulator.
After teeth arrangement and try in, flasking and curing was done followed by finishing and polishing. Upper
and lower complete denture were inserted after correction of occlusal discrepancies (Figure-8 and Figure -9).
Post insertion check-up was done after 24 hours and slight inflammation was observed in retromylohyoid on
right side. The area was relieved and patient was subsequently called after 1 month, 6 months and 1 year
follow-up (Figure - 10).
Discussion:
Stafne’s bone cavities may not be diagnosed visually during intra-oral examination because salivary gland or
tissues fill these cavities. It is obvious that a routine manual examination of all denture border areas must be
performed at the initial examination appointment. This Stafne’s cavity occur more commonly in posterior
region of the mandible (posterior variant). Stafne’s may also appear in the anterior region (anterior variant) and
the ascending ramus of the mandible (mandibular ramus variant) [5]. The utilization of Stafne’s defects for
improving the retention of the mandibular denture has been well documented. Heat cure acrylic engaging into
these cavities is preferable as done in the clinical reports because theses cavities are typically lined with
unattached mucosa. Ulceration with prosthesis in use is rare. If at all the patient complains of sore spots during
wearing and removal of the prosthesis, permanent or temporary soft liner can be used. In addition it is advisable
that the soft liner should be thicker in the region of theses cavities [6].
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Conclusion:
These clinical reports describe the engagement of mandibular denture in bilateral and unilateral Stafne’s bone
cavities. Fabrication of denture by utilising either a unilateral or bilateral cavities improves the retention and
stability of the mandibular denture.
References:
1. Dogan Dolanmaz, Osman A. Etoz, A. Alper Pampu, Erdem Kilic, Yilderay Sisman Diagnosis of stafne’s
bone cavity with dental computerised tomography. Eur J Gen Med 2009; 6(1): 42 – 45.
2. Idil Dikbas, Tenel Koksal. Utilization of stafne’s bone cavity for improving complete denture
retention.OHDMBSC – Vol. VI No.1 Martie 2007.
3. Hyunchul Kim, Jae Yeon Seok, Sangho Lee, Jungsuk An, Ne Rae Kim, Dong Hae Chung, Hyun Yee
Chi, Seung Yeon Ha.Bilateral stafne’s bone cavity in the anterior mandible with heterotropic salivary
gland tissue – A case report.The Korean journal of pathology 2014; 48: 248 – 249.
4. Manesh Lahori, Roshika Sudan. Stafne’s bone cavity and its utilization in complete denture retention. A
review. Guident december 2011; 22 - 24.
5. A.P. Munevveroglu and K. C. Aydn. Open acess article distributed under the creative attribution licence.
6. Florin, Whitney, Mandil, Louis.New York state dental journal, April 2010 Volume 76 issue -3, 36-38.
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Legends:
Figure -1: Preoperative photograph of the patient
Figure -2: Finished and Polished Upper and lower complete denture
Figure -3: Finshed Lower complete denture showing bilateral bulbous areas corresponding to Stafne’s cavities
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Figure -4: Postoperative photograph of the patient with upper and lower complete denture
Figure 5: Preoperative photograph of the patient
Figure 6: Secondary impression of the mandibular arch
Figure -7: Photograph of Master Cast
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Dr. Hasti Anurag et al . / IJRID Volume 5 Issue 6 Nov.-Dec. 2015
Figure -8 : Showing Unilateral Bulbous area showing region corresponding to Stafne’s cavity
Figure-9 : Showing enlarged view of bulbous area of Stafne’s cavity
Figure – 10 : Post operative picture of the patient
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Dr. Hasti Anurag et al / IJRID Volume 5 Issue 6 Nov.-Dec. 2015