Diagnosis and Treatment of Pediatric Primary Jaw Lesions at Massachusetts General Hospital

Purpose: To review the demographic data, presenting symptoms, location, radiographic findings, treatment, and prognosis of pediatric jaw lesions in children treated at a single academic institution. Patients and Methods: A retrospective medical record review was undertaken of patients younger than 18 years who presented to the Massachusetts General Hospital for Children between 2006 and 2018 with a primary jaw lesion . Results: About 164 patients were identified. The most common lesions were giant cell tumors (n = 25), odontogenic keratocysts (n = 24), simple bone cysts (n = 19), odontomas (n = 17), fibrous dysplasia (n = 11), and dentigerous cysts (n = 11). Fifty-one patients (30.7%) were asymptomatic. About 94% were referred by their dentist, outside oral and maxillofacial surgeon or orthodontist. Most common presenting symptoms were swelling (66.9%), pain (32.5%), tooth mobility (17.5%), and neurosensory change (6.6%). Mandibular location was most common (72.3%). Radiographically, most were well-circumscribed radiolucencies with mean size of 2.9 cm (range, 0.7 to 15.6). Treatment varied from excisional biopsy to wide composite resection. Mean follow-up time was 38 months (range, 1 to 204). Recurrence was found in 21%. Conclusions: Pediatric jaw lesions are often asymptomatic and discovered incidentally by dental practitioners on routine examination. Clinical features (age, gender, location, and radiographic appearance) can help narrow the differential and expedite treatment. It is important that clinicians involved in the care of children be familiar with the wide differential diagnosis and management considerations of primary jaw lesions. Published by Elsevier Inc. on behalf of the American Association of Oral and Maxillofacial Surgeons

Automated summary

This study reviewed the demographic data, presenting symptoms, location, radiographic findings, treatment, and prognosis of pediatric jaw lesions in children treated at a single academic institution between 2006 and 2018. It found that common lesions included giant cell tumors, odontogenic keratocysts, and simple bone cysts. Most patients were asymptomatic and common presenting symptoms included swelling, pain, and tooth mobility.