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LETTER TO THE EDITOR Diagnosis: a simple bone cyst I would agree with the recent letter to The literature on subchondral cysts access to scientific publications that not the editor from Dr Jeffery B. Price in attributes them to excessive pressure only contribute to the updating of clinical the March/April 2018 issue of General in the TMJ. This is typically due to the practice but also improve the capacity to Dentistry (“Horse or zebra”) regarding maladaptive growth of the maxilla and conduct clinical research, aiming at better simple bone cysts vs subchondral mandible as a result of airway problems patient care. bone cysts. I agree, and the literature early in growth. Dental equilibration In our response to the previous letter, also suggests, that subchondral of teeth also decreases joint support if we clarified in detail the reasons why temporomandibular joint (TMJ) bone vertical change is made to the molars. the subchondral cyst was not listed as a cysts are not uncommon. They are the A classic “centric relation” jaw position differential diagnosis of the simple bone result of excessive pressure in the TMJ and will excessively load the TMJ and, in the cyst in the clinical case discussed in the breakdown of the vascular components presence of parafunction, will rapidly article. We agree that, as a general rule, underlying the articular bone. Yes, they exceed physiologic pressures. Maxillary these 2 entities are listed as a differential may need to have a diagnostic biopsy. In retrusive “nightguards” are also one of the diagnosis for each other. In an attentive my practice, they are identified in many most common “final straws” in TMJ disc/ reading of the clinical case in the January/ TMJ patients by radiographic appearance condylar displacement. February issue, colleagues may note that alone, especially teenage girls. I also see I have working relationships with many we mentioned that simple bone cysts are aggressive degenerative joint disease in oral surgeons, and our need for surgical more prevalent in the second decade of 1-4 younger girls on a routine basis. intervention within the first 6 months life. However, in the present case, the I have a practice limited to TMJ and of orthopedic-based treatment of TMJ patient was 40 years old. After the age of sleep disorders and see an average of 30-35 disorders is around 1%-2%. I do have 25 years, the occurrence of simple bone new patients referred for orofacial pain/ consultations on cases prior to treatment cysts is rarer, indicating the significance 2,5 TMJ disorders each month. The majority start just to establish a relationship with of the clinical case that was reported. present with orthopedic pain and jaw the surgeon and have another set of “eyes” The article also pointed out that simple dysfunction and mouth opening well in prepubescent cases. bone cysts correspond to 1% of all cysts below the normal range of 48-50 mm. I that can affect the mandible, occurring would estimate 50% of our new patients Mark J. Barnes, DDS, FAGD with more prevalence in the symphyseal are below age 25 and have significant Boulder, Colorado and mandibular body regions and more 1-3,6 damage to the joints. I see many cases each rarely in the condylar region. month with subchondral cyst–like lesions Response from the authors Although simple bone cysts can be and/or aggressive avascular necrosis–like We appreciate the interest of Dr Barnes identified in radiographic examinations, destruction. Causes are rarely trauma; in the March/April letter to the editor several studies have performed additional altered maxillomandibular growth and an (“Horse or zebra”) as well as our original imaging tests, such as computed underlying orthopedic malalignment are article (“Simple bone cyst: rare incidental tomography (CT) and cone beam cone the underlying culprit in virtually all TMJ finding in the mandibular condyle by beam CT (CBCT), for a more precise 1-3,6-8 disorders. cone beam computed tomography,” evaluation of the lesion. In the present The potential effects of selective General Dentistry, January/February case, the CBCT was not requested for serotonin reuptake inhibitors (which 2018). Dr Barnes has questioned some the initial diagnosis of the cyst. The are prescribed in abundance to high aspects of our article based on his CBCT was requested for orthodontic school– and college-aged people) on bone personal opinion from the cases that purposes, and the cyst was an incidental signaling, I believe, play some role in the routinely present at his practice. Although finding. The diagnosis was favored by the increasingly aggressive damage we are professional experience is important, it radiologist’s experience in evaluating the seeing at younger ages. is fundamental that professionals have entire volume of the imaging examination 6 GENERAL DENTISTRY September/October 2018 as well as his knowledge in identifying References 6. Saia G, Fusetti S, Emanuelli E, Ferronato G, Procopio O. 9 1. Hatakeyama D, Tamaoki N, Iida K, et al. Simple bone cyst Intraoral endoscopic enucleation of a solitary bone cyst of anatomical and pathologic alterations. of the mandibular condyle in a child: report of a case. J the mandibular condyle. Int J Oral Maxillofac Surg. 2012; This finding demonstrates the importance Oral Maxillofac Surg. 2012;70(9):2118-2123. 41(3):317-320. of case reports, which provide clinical 2. Sabino-Bezerra JR, Santos-Silva AR, Jorge J Jr, Gouvêa 7. Kim KA, Koh KJ. Recurrent simple bone cyst of the updates to the dental professional for the AF, Lopes MA. Atypical presentations of simple bone cysts mandibular condyle: a case report. Imaging Sci Dent. of the mandible: a case series and review of literature. J 2013;43(1):49-53. benefit of patients. Craniomaxillofac Surg. 2013;41(5):391-396. 8. Mathew R, Omami G, Gianoli D, Lurie A. Unusual cone- 3. Kim HK, Lim JH, Jeon KJ, Huh JK. Bony window approach beam computerized tomography presentation of Eliana Dantas da Costa for a traumatic bone cyst on the mandibular condyle: a traumatic (simple) bone cyst: case report and radiographic Gina Delia Roque-Torres case report with long-term follow-up. J Korean Assoc Oral analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. Maxillofac Surg. 2016;42(4):209-214. 2012;113(3):410-413. Priscila Dias Peyneau 4. Madiraju G, Yallamraju S, Rajendran V, SrinivasaRao K. 9. da Costa ED, Verner FS, Peyneau PD, Freitas DQ, Almeida Luís Roberto Godolfim Solitary bone cyst of the mandible: a case report and brief SM. Diagnosis of ethmoid sinolith by cone-beam Francisco Haiter Neto review of literature. BMJ Case Rep. 2014;2014: computed tomography: case report and literature review. Solange Maria de Almeida bcr2013200945. Oral Radiol. December 29, 2017 [epub ahead of print]. 5. Tong AC, Ng IO, Yan BS. Variations in clinical presentations of the simple bone cyst: report of cases. J Oral Maxillofac Surg. 2003;61(12):1487-1491. RETRACTION Duplicate publication It has recently come to our attention that an article published General Dentistry in February 2013 by Hitesh Gupta, MDS, in General Dentistry in 2014 substantially duplicates an article Abhinay Puri, MDS, and Saru Kumar, MDS. General Dentistry published in the Indian Journal of Dental Sciences in 2012: is committed to providing readers with original content, and • Gupta H, Puri A, Kumar S. Diagnosis and management of Drs Gupta, Puri, and Kumar signed a copyright release declar- cemental tear: a case report. Gen Dent. 2014;62(3):e12-e13. ing that the article was original, their own work, and not • Kaur S, Kumar S, Mishra R, Gera A, Gupta H. Cemental published previously or submitted for publication in any other tear: an un-usual [sic] case report. Indian J Dent Sci. journal. General Dentistry published the article in good faith 2012;4(Suppl):84-86. that the authors’ assertions were true. Due to this misrepre- We regret that this duplication of the original article was not sentation, the Editor retracts the article. discovered prior to publication. The article was submitted to 8 GENERAL DENTISTRY September/October 2018.
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