Mucoperiosteal Flap versus Simple Curettage for Jaw Cysts: A Retrospective CBCT Study of 3D Bone Regeneration and Tooth Stability

Background: Odontogenic jaw cysts often result in bone defects that typically heal spontaneously after enucleation. This study compared two enucleation techniques in terms of postoperative bone regeneration and adjacent tooth stability using cone-beam computed tomography (CBCT). Methods: In this retrospective single-center cohort study, 60 patients with jaw cysts were allocated to two groups (n = 30 each): group A (mucoperiosteal flap with ostectomy) and group B (limited curettage). CBCT scans were obtained preoperatively and at 3, 6, and 9 months postoperatively. Defect volume, surface area, and grayscale values were quantified using three-dimensional reconstruction. Tooth mobility was assessed at each follow-up.Longitudinal changes were analyzed using repeated-measures analysis of variance (ANOVA), and tooth stability was evaluated using generalized mixed models. Results: Both groups showed significant bone regeneration over time (p < 0.001). At 9 months, the flap group demonstrated a significantly smaller residual defect volume (0.25 ± 0.10 vs. 0.44 ± 0.15 cc; p < 0.001) and surface area (158 ± 50 vs. 208 ± 60 mm²; p = 0.002). Grayscale values increased in both groups, with higher early values observed in the flap group at 3 months (p = 0.01), although intergroup differences diminished by 9 months. Tooth mobility improved in both groups, with higher stability rates in the flap group at 9 months (90% vs. 67%; odds ratio = 4.5, p = 0.03). Conclusions: Both surgical approaches achieved substantial bone regeneration. However, the mucoperiosteal flap technique was associated with faster early bone regeneration and improved tooth stability. This approach may facilitate earlier functional recovery following jaw cyst treatment