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201:Stafne Defect of the Premolar Area: Report of a Rare Presentation[AAOM2020}
Poster Title: 201:Stafne Defect of the Premolar Area: Report of a Rare Presentation[AAOM2020}
Submitted on 29 Mar 2021
Author(s): Richard J. Vargo, DMD 1,2
Affiliations: 1 Missouri School of Dentistry & Oral Health, St. Louis, MO and 2 Saint Louis University School of Medicine, St. Louis, MO
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 257
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Poster Information
Abstract: Background: Stafne defects are rare lesions which represent a focal concavity of the lingual cortical bone of the mandible. They classically present as an asymptomatic radiolucency below the mandibular canal in the posterior mandible, between the mandibular angle and molars. The radiolucency is usually well circumscribed and corticated. Similar lingual cortical defects have been noted more anteriorly in the incisor, canine, or premolar areas of the mandible. The clinical and radiographic features of anterior Stafne defects are similar to the classic posterior variant. While posterior Stafne defects can usually be diagnosed radiographically due to their unique radiographic presentation, anterior Stafne defects may be misdiagnosed radiographically as other pathological entities because of their unusual locations and rarity.

Case Summary: A 46-year-old male presented to A.T. Still University - Missouri School of Dentistry & Oral Health for routine dental care. His medical history was noncontributory. A screening panoramic radiograph revealed a well-circumscribed, noncorticated, unilocular radiolucent lesion in the left mandibular premolar area directly anterior to the mandibular canal. The lesion was not associated with the roots of the mandibular left premolars. Initial radiographic examination suggested an enlarged mandibular foramen and possible intraosseous mesenchymal neoplasm, but close radiographic scrutiny revealed that the left mental foramen was uninvolved. The clinical examination was unremarkable. Given the location of the lesion at the level of mandibular canal, an odontogenic origin was considered unlikely and a possible Stafne defect was suspected. A cone beam computed tomography (CBCT) scan was taken, which revealed a well-defined concavity on the lingual aspect of the mandible and thin, intact bone between the concavity and the mandibular canal in the mental foramen area. Because the CBCT confirmed the diagnosis of Stafne defect, no further treatment was rendered.

Conclusions: Stafne defects of the premolar area may be misdiagnosed radiographically as other more common pathological entities due to their unusual location and rarity. Clinicians should consider this entity in the differential diagnosis of mandibular, apical, well-circumscribed, unilocular radiolucent lesions—especially when the radiolucency is more apical in location—and utilize three-dimensional radiographic imaging as a diagnostic tool in order to avoid more invasive procedures.
Summary: Stafne defects are asymptomatic bone lesions that were first described by Edward C. Stafne in 1942. They represent a focal concavity of the lingual mandibular cortical bone. Most cases occur in middle aged or older adults, and they are much more common in males.

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References: 1)Stafne, ED. Bone cavities situated near the angle of the mandible. J Am Dent Assoc. 1942;29:1969 72.
2)Richard EL, Ziskind J. Aberrant salivary gland tissue in mandible. Oral Surg Oral Med Oral Pathol. 1957 Oct;10(10):1086 90.
3)Hisatomi M, Munhoz L, Asaumi J, Arita ES. Stafne bone defects radiographic features in panoramic radiographs: Assessment of 91 cases. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e12 e19.
4)Taysi M, Ozden C, Cankaya B, Olgac V, Yıldırım S. Stafne bone defect in the anterior mandible. Dentomaxillofac Radiol. 2014;43(7):20140075.
5)Krafft T, Eggert J, Karl M. A Stafne bone defect in the anterior mandible a diagnostic dilemma. Quintessence Int. 2010 May;41(5):391 3.
6)de Courten A, Küffer R, Samson J, Lombardi T. Anterior lingual mandibular salivary gland defect (Stafne defect) presenting as a residual cyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Oct;94(4):460 4.
7)Pires FR, Bruzigueses Espíndola CB, Ferreira Espíndola
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