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Buccal-lingual localization of the mandibular canal in relationship with the third molar using the lateral oblique technique
Gainer Raul Jasa, Mariana Boessio Vizzotto, Priscila Fernanda da Silveira, Heloisa Emilia Dias da Silveira, Heraldo Luis Dias da Silveira, Leticia Ruhland Correa, Tabare Raveca
January-April 2014, 2(1):15-20
Aim: The aim of this study was to evaluate the use of lateral oblique radiography (LOR) at two different incidence angles for the bucco-lingual topographic localization of the mandibular canal with respect to the lower third molars. Materials And Method: A total of 24 dry jaws bearing at least one third molar were subject to LOR at vertical incidence angles of 0° and -30°. A trained and calibrated examiner measured the distance between the top of the mandibular canal to the most apical point of the third molar, using a digital calliper and individual light box for the radiographs. Based on the analysis of the two measurements (incidence angles of 0° and -30°) and considering the buccal object rule, the observer estimated the location of the mandibular canal, which was classified as lingual, central or buccal to the corresponding third molar. Results were compared with the computerized tomography images (gold standard). Results: The statistical analysis included sensitivity, specificity and accuracy tests. These results showed that LOR (0° e -30°) could be used to determine the bucco-lingual location of the mandibular canal with respect to the third molar. Conclusion: In spite of the magnification, LOR images demonstrated that the technique could be used for this study proposal.
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A comparison of fractal dimension values of peri-implant bone and healthy contralateral side using panoramic radiographs
Betül Ilhan, Pelin Güneri, Ahmet Saraçoglu, Hüseyin Koca, Hayal Boyacioglu
January-April 2015, 3(1):1-6
Context: Trabecular bone around dental implants has been rarely evaluated by means of fractal analysis. Aims: The aim was to assess fractal dimension (FD) values of peri-implant bone 12 months after implant installation and to compare these FD values with those of healthy control sites on the contralateral side of the implant area. Materials and Methods: Panoramic radiographs from 29 patients with 29 mandibular implants functioning for 12 months were analyzed. Radiographs were digitized at 300 dpi with 256 grey levels. Healthy trabecular bone from the corresponding contralateral implant-free area was referred as "control site." Three region of interests (ROIs) from mesial, distal and apical areas were selected for each implant and each control site. The FD from peri-implant and control ROIs were calculated by means of box-counting method. Statistical analysis was performed using two-way ANOVA with repeated measure on one factor. The independent variable included a between-subjects variable, the site and within-subject variable, repeated measures of ROI. An alpha level of 0.05 was utilized. Results: Mean FD for apical, mesial and distal peri-implant areas were 1.220, 1.222 and 1.226 respectively while the corresponding results were 1.198, 1.183 and 1.202 for control sites. There was not a significant main effect between the FD values of implant and control sides (P = 0.332). Similarly, result of the main effect of ROI (apical, mesial, distal) on FD values was not statistically significant (P = 0.632). Conclusions: Fractal dimension values from trabecular bone around implants as calculated from panoramic radiographs at 12 months revealed comparable results with implant-free healthy alveolar bone.
  2 1,951 318
Latest advancements in imaging of oral and maxillofacial neoplasm: A comprehensive review
Devvrat Singh, Sukant Sahoo, Vineet Gupta, Deepti Srivastava
May-August 2013, 1(2):37-42
Radiographic imaging is one of the greatest investigative tools that are used in medical sciences since ages. There is an important role of imaging in staging, during treatment planning, and post-treatment follow up of patients with head and neck cancer. To design an effective treatment strategy, two tasks are very important which are accurate staging and timely assessment of the cancer. There lies the importance of pre-treatment imaging in diagnosis. Awareness of the presence of cervical node metastasis is important in treatment planning and in prognostic prediction for patients with head and neck cancer. Currently, MRI and CT are commonly used to evaluate the primary tumor and the neck status. They characterize the cervical lymph nodes dependent on morphological criteria. Doppler ultrasound and Positron emission tomography are also used to overcome some of the limitations of MRI and CT.
  2 4,162 774
Quick response code in Oral and Maxillofacial Radiology
Moidin Shakil, Durbakula Karteek, Kulkarni Spoorti, Maji Jose
September-December 2014, 2(3):95-96
Quick response (QR) codes are two-dimensional barcodes that are used to encode and decode information. QR code is an innovative approach in which patient details and radiographic interpretation can be encoded. These QR codes can be shared efficiently worldwide with easy authentication. QR code is a boost to early diagnosis and retrospective studies. Implementing QR code in Oral and Maxillofacial Radiology will save time, eliminate paper work, and problems encountered in storage of patient details with radiographic interpretation and minimize manual efforts in retrieval of information.
  2 1,541 94
Craniofacial microsomia: A rare case report
Swapnali Yogesh Chaudhari
May-August 2013, 1(2):70-74
Craniofacial microsomia is a unique clinical presentation of "1 st and 2 nd arch syndrome" with asymmetrical craniofacial development along with conductive hearing loss. It involves the underdevelopment of the structures of the first and second pharyngeal arches: Maxilla, mandible, external and middle ear, facial and trigeminal nerves, muscles of mastication and overlying soft tissue. In this article, we report a case of craniofacial microsomia diagnosed based on clinical and cone beam computed tomography (CBCT) findings. CBCT scan revealed incompletely formed inner ear structures in association with craniofacial microsomia, rarely reported in the literature.
  1 3,085 197
Stafne bone cavity incidentally ''Twice'' diagnosed on panoramic radiographs
Ulkem Aydin, Yener Oguz
January-April 2014, 2(1):26-29
A 63-year-old male patient admitted to another hospital for prosthetic restoration. On the panoramic radiograph a lesion was detected on the right mandible and he was referred for a cone beam computed tomography (CBCT) examination. The patient then admitted to our clinic for the diagnosis of this lesion. Review of the dental records revealed that a panoramic radiograph and a maxillofacial computed tomography scan were made about 10 years ago, and a Stafne bone cavity (SBC) was diagnosed. Moreover, a follow-up panoramic radiograph was made about 5 years ago. Despite the explanation given, the patient requested the CBCT examination in a private imaging center. The imaging features of the lesion were the same. In order to protect the patients from unnecessary radiation, the clinicians should make every effort to prevent duplicate imaging, and X-ray based advanced imaging techniques should be reserved for selected cases.
  1 2,084 184
Peripheral osteoma of the mandible with radiologic and histopathologic findings
Asli Tanrivermis Sayit, Gokhan Kutlar, Ilkay Sedakat Idilman, Pinar Hediye Gunbey, Asuman Celik
January-April 2014, 2(1):35-37
Osteomas are benign, slow growing osteogenic tumors. They are often occurring in the craniofacial bones but rarely originates from the mandible. Osteomas have three varieties as central, peripheral and extraskeletal. Central and peripheral osteomas are often seen in the facial bones. Peripheral osteoma often located in the frontal, ethmoid and maxillary sinus, but rarely occurs in the jaws. Usually they are asymptomatic and discovered incidentally during radiological and clinical examinations. Osteomas are characterized with well-defined, rounded or oval radiopaque mass in the computed tomography. Herein, we report a rare case of peripheral osteoma of the lower part of the mandible in a 19-year-old female with radiologic and pathologic findings.
  1 3,579 270
Isolated masseter cysticercosis in a healthy woman
Ranjan Kumar Sahoo, Santosh Kumar Subudhi, Adyakinkar Panda, Harshmohan Pathak, Swagatika Panda
January-April 2015, 3(1):11-14
We report a rare case of unilateral masseter muscle swelling in a 44-year-old female patient who was provisionally diagnosed as cysticercosis of master muscle on ultrasonography and magnetic resonance imaging. Intraoral excision of the cyst and histopathological examination confirm the mass as masseter cysticercosis.
  1 2,069 170
Aneurysmal bone cyst of the mandible: Report of a case with a review of the literature
Hasan Onur Simsek, Derya Yildirim, Ozlem Gormez, Esra Yuce, Fatma Nilgun Kapucuoglu
May-August 2014, 2(2):64-67
Aneurysmal bone cyst (ABC), is a rare benign osteolytic bone neoplasm of bone tissue characterized by several sponge-like blood or serum filled, generally non-endothelialized spaces of various diameters that can contain osteoid tissue and osteoclast-like giant cells. In this article, we describe a case of ABC in the mandibular corpus region with clinical, radiological and pathological findings and review the literature concerning the case. A 23-year-old male patient attended to our clinic with the complaint of a mild-pain on the left posterior lower jaw since two months. The superior margin of the lesion was extending between the apical third parts of the roots of the teeth 35-38. Cone beam computed tomography (CBCT) was performed. CBCT Slices revealed an expansile lesion with hydraulic-appearing outer margins above the mandibular canal. Excisional surgical treatment was performed after raising a mucoperiosteal flap and finalized with curette of lesion under local anesthesia. Diagnosis of aneurysmal bone cyst was confirmed by histopathological evaluation. The patient was pain free after six months follow-up, and panoramic radiography showed no evidence of recurrence. The ABC is most common in those regions of the skeleton where there is a relatively high venous pressure and high marrow content. Clinical presentation of the ABC varies from a small, indolent, asymptomatic lesion to rapidly growing, expansile, destructive lesion causing pain, swelling, deformity, neurologic symptoms, pathologic fracture, and perforation of the cortex. As the radiologic and clinical presentation of ABC is extremely variable, histopathologic examination is placed a great emphasis on for the diagnosis.
  1 4,305 376
Investigation and differential diagnosis of Stafne bone cavities with cone beam computed tomography and magnetic resonance imaging: Report of two cases
Elif Tarim Ertas, Meral Yircali Atici, Fahrettin Kalabalik, Ozlem Ince
September-December 2015, 3(3):92-96
Stafne bone cavity (SBC), commonly known as Stafne bone cyst or defect is mostly asymptomatic, appearing as a unilateral, round or ovoid, radiolucent defect with thick and corticated border. Defects that are referred as pseudocysts generally occur in mandibular molar region, below the mandibular canal at the lingual side of the mandible and may grow slowly in time. They have been also located lingually in the anterior mandible above the mylohyoid muscle, and on the ascending ramus just inferior to mandibular condyle or very rarely buccal region of the ascending ramus. The aim of this case report is to present two unusual cases of SBC detected incidentally during radiographic examination with cone beam computed tomography and magnetic resonance imaging findings. In the first case, significant enlargement caused vestibular resorption of the buccal cortex, which is a rare finding with SBCs and in the second case the large bone resorption reached up to the mental foramen.
  1 3,412 280
Facial nerve paralysis after dental procedure
Melda Misirlioglu, Mehmet Z Adisen, Alime Okkesim, Yagmur Y Akyil
September-December 2016, 4(3):80-82
Peripheral facial nerve palsy (FNP) is a common neuropathy of cranial nerves. However, it is a rare condition in dental treatment and may be associated with local anesthetic injections. Initial trauma to facial nerve cab is usually minor. In this instance, a complete and rapid recovery is expected and most cases resolve within 12 hours. If more extensive damage occurs, nerve palsy can be significant and long lasting. We report a 15-year-old female patient with FNP that developed within 8 hours after a dental procedure. The treatment was continued for 10 days with prednisone and acyclovir. At the end of the 4 th day, movement began to return to her face and the symptoms disappeared within 3 weeks period. In dental practice, it should be considered that iatrogenic factors may play a direct or indirect role in FNP, as presented in our case. Clarification of the etiology and treatment of FNP requires a multidisciplinary medical team. Therefore, dentists should be aware of clinical findings along with an essential treatment plan of FNP in dental office.
  1 7,868 182
Extensive cervicofacial and mediastinal subcutaneous emphysema after endodontic retreatment of a maxillary canine: A case report
M Buchbender, S Musazada, S Kreißel, CM Schmitt
January-April 2017, 5(1):14-18
The current case reports of an iatrogenic cervicofacial and mediastinal subcutaneous emphysema (SCE) after endodontic retreatment of a maxillary canine with the usage of a rubber dam. A 79-year-old woman was brought to the hospital with a swelling of the right side of her face and neck. A computed tomography (CT) was performed, and she was directly treated with intravenous antibiotic chemotherapy. Clinical examination and CT revealed a pronounced cervicofacial and mediastinal SCE. After treatment with intravenous antibiotic chemotherapy, the patient showed a decrease of the SCE and was discharged from the hospital. SCEs should be diagnosed at the earliest possible stage to manage an appropriate treatment. In case of misinterpretation of the signs and symptoms or a misdiagnosed SCE, it can become life threatening for patients. Therefore, every clinician should consider preventive measures to avoid such complications.
  1 1,402 102
Compliance of Indian dentists with oral radiology safety measures
Swarna Yerebairapura Math, Devarasa Giriyapura Murugeshappa, Rajeshwari Annigeri, Dheeraj Kalra
September-December 2013, 1(3):104-110
Objectives: The aim of this study was to determine the dentist's knowledge and practice about dose reduction techniques, radiographic equipment and quality of dental radiographic service among private dental practitioners in Davangere City, India. Materials and Methods: The survey was performed on 80 dental practitioners from Davangere City, India. Information on the demographic characteristics of the dentists, radiographic equipment, techniques and processing they used and radiation protection was obtained with a 40 point questionnaire. Results: The study yielded a response rate of 90%. The respondents' knowledge concerning the technical details of their equipment was limited, with 27.7% not knowing kVp settings of their equipment. Only 11% and 5% respondents reported having long and rectangular collimators respectively. Regarding the film speed 16.6% dental practitioners were unaware about it. The most preferred technique (81%) for periapical radiography was the bisecting angle technique. Lead aprons were worn more often by female dentists. None of the dental practitioners had thyroid collars. The distance of the dentist to the radiation tube during exposure was on average 2.2 m, although 13% of the dentists assisted in holding the image receptor inside the patient's mouth. Only 4% of the dental practitioners reported that they used automatic processor. About 40% of the dental practitioners used film badges. Conclusions: In the present study, the results indicate that for minimizing any unnecessary radiation, attempts should be made to improve dentists' knowledge about radiation dose reduction techniques. Some dose-reducing strategies are commonly used in Davangere Dental clinics, whereas others have not gained wide acceptance.
  1 3,236 490
Magnetic resonance imaging observation of bone marrow edema of the mandibular condyle in patients with temporomandibular joint osteoarthritis
Galal Omami
May-August 2014, 2(2):41-43
Purpose: The purpose of the study was to demonstrate the relationship between bone marrow edema of the mandibular condyle and osteoarthritic changes of the temporomandibular joint (TMJ) in a group of symptomatic patients using magnetic resonance imaging (MRI). Materials and Methods: MRI data of 96 TMJ dysfunction patients were investigated for association between bone marrow edema of the mandibular condyle and TMJ osteoarthritis. Chi-square test was used for statistical analysis and P values less than 0.05 were accepted as statistically significant. Results: There was statistically significant association between osteoarthritis and bone marrow edema of mandibular condyle. Conclusion: Bone marrow edema of the mandibular condyle appears to be a predictor of TMJ osteoarthritis. Further histology-based MRI data are needed to improve our understanding of the pathophysiology of TMJ osteoarthritis.
  1 2,746 276
Evaluation of diagnostically difficult impacted maxillary canines in orthodontic patients and its effect on the root of adjacent teeth using cone beam computed tomography
Zahra Dalili Kajan, Ali Khalighi Sigaroudi, Navid Karimi Nasab, Zhaleh Shafiee, Somayeh Nemati
January-April 2014, 2(1):2-7
Purpose: To evaluate the morphology of apical portion of impacted maxillary canines and their effects on root resorption of adjacent teeth as well as their locations and inclinations with cone beam computed tomography (CBCT) in an individual group of orthodontic patients. Materials and Methods: In this descriptive cross-sectional study, 71 diagnostically difficult impacted canines of 55 orthodontic patients were studied with CBCT images. In this group, the orthodontic treatment approaches for eruption of their impacted teeth were not successful. A radiologist opined about the angulation, the position of apical and coronal portion of maxillary canine tooth, resorption of adjacent teeth as well as existence of apical hook and root curvature in reconstructed images. The simultaneous existence of hook and root resorption with other data was subjected to statistical analysis by Chi-square and Fisher's Exact tests. Results: In this cross-sectional study, the position of crown in buccopalatal dimension were respectively 16.9, 73.2 and 9.9% in buccal, palatal and middle portion of the alveolar bone. Apical hook was seen in 28.2% of cases. Root resorption of the adjacent teeth was induced in 32.3% of the cases, 69.6% of which were slight. Overall, there were no significant statistical differences between the presence of hook, and the positions and angulations of impacted teeth. Conclusions: Apical and palatal positions of crowns of the impacted maxillary canines were the most common locations in the selected groups. The possibility of root resorption of adjacent teeth could be related to angulation of impacted tooth.
  1 3,089 450
Comparison of radiopacities of different flowable resin composites
Derya Yildirim, Rabia Banu Ermis, Ozlem Gormez, Gul Yildiz
January-April 2014, 2(1):21-25
Objectives: Radiopacity can facilitate diagnostic observations adjacent to flowable resin composites. The aim of this study was to evaluate the radiopacity of the current low viscosity flowable resin composites and to compare them with human dental tissues. Materials and Methods: Five specimens of seven flowable light cured composite materials with a thickness of 2 mm were prepared and radiographed alongside an aluminum stepwedge, human enamel and dentin. Three standart occlusal radiographs for each material were taken with exposure time of 0.32 seconds and focus-film distance of 40 cm. Films were processed in an automatic device, and digitized using a desktop scanner. Mean gray values of the materials, stepwedge, enamel and dentine were measured using Image J software. The data were analyzed using the Duncan multiple range test. Results: The mean gray values of flowable resin composites ranged from 26.61 ± 1.45 to 38.38 ± 1.47. The radiopacity values of the materials evaluated were in decreasing order: G-aenial Flo, Filtek Ultimate Flowable, Flowline, Estelite Flow Quick, Leaddent Flow, Supraflow, Bright Light Flow. All flowable resin composites, except Bright Light Flow, demonstrated significantly greater radiopacity values than 2 mm of the aluminum scale and dentin (P < 0.05). The radiopacity of only one flowable composite, G-aenial Flo, was found to be significantly higher from enamel (P < 0.05). Conclusions: All investigated materials presented radiopacity values above the minimum recommended by the international organization for standardization.
  1 2,546 250
A comparison of cone-beam computed tomography image quality obtained in phantoms with different fields of view, voxel size, and angular rotation for iCAT NG
Dorothy A Sonya, Jonathan Davies, Nancy Lee Ford
May-August 2016, 4(2):31-39
Objectives: To characterize cone-beam computed tomography (CBCT) image quality (IQ) and dose for different fields of view (FOVs), voxel size, and angular rotation. Materials and Methods: IQ parameters, including image noise, homogeneity, geometric distortion, artifacts, contrast resolution and spatial resolution, and radiation dose, were measured for different FOV, voxel size, and angular rotation for an iCAT NG CBCT machine. Results: Noise increased with smaller voxel sizes as measured in the homogeneity layers. The 360° gantry rotation leads to improvements in contrast-to-noise ratio and spatial resolution and a decrease in artifacts compare to 180° gantry rotation with the same voxel size and FOV. Dose reduction was not always observed with smaller FOVs if smaller voxel sizes and longer scan times are used. Some of the test objects included in the phantom are not useful for dental CBCT machines, such as the range of resolutions tested by the bar pattern insert and the suitability of the materials used for the contrast assessment layer. Conclusions: A reduction in the patient dose can be achieved by reducing the angular rotation to 180°, increasing the acquired voxel size or decreasing the FOV height. However, using the reduced rotation angle also leads to increased artifacts around metallic objects. Changing the voxel size did not necessarily lead to improved spatial resolution or reduced dose, as some of the voxel sizes on this machine have identical imaging parameters.
  1 1,951 233
Cephalometric evaluation of upper airway in healthy adult population: A preliminary study
Kruthika S Guttal, Krishna N Burde
May-August 2013, 1(2):55-60
Objective: To obtain normative cephalometric data of upper airway in normal adult population. Materials and Methods: Study included 60 healthy subjects, 30 males and 30 females with age range of 18-40 years with normal skeletal profile, no history of sleep-related disorders, obesity. The cephalometric parameters assessed included airway measurements like size of the tongue, soft palate, dimensions of naso, oro, hypopharynx, and relative positions of hyoid bone and vellaculae. Statistical Analysis: Paired t-test was used T-value <0.05 was considered to be significant. Results: Significant sex dimorphisms were observed in most of the parameters with the exception of upper airway width and length of soft palate. Conclusions: The data provides preliminary details of upper airway assessment in normal individuals. Further correlations can be drawn with the studies comparing airway dimensions in normal individuals and in subjects with sleep-related disorders.
  1 6,455 677
Current status of knowledge, attitude, and perspective of dental practitioners toward cone beam computed tomography: A survey
Amita Aditya, Shailesh Lele, Priyam Aditya
May-August 2015, 3(2):54-57
Context of the Study: In India, cone-beam computed tomography (CBCT) has lately gained popularity as preferred imaging modality by the dental practitioners in recent times. However, CBCT is included neither in the undergraduate nor the Postgraduate dental curriculum. There is also a lack of any standardized training modules on CBCT. Many CBCT imaging centers are being established in various cities of India lately; however optimal use of this technique cannot be assured without assessing the attitude and present status of knowledge of the dental practitioners in this field. This shall warranty some remedial steps; in case a gap in knowledge is identified. Hence, this study was designed to analyze the current status of the knowledge, attitude and perspective of the dental practitioners in Pune, Maharashtra toward the use of CBCT. Materials and Methods: A survey was conducted among dental specialists, using a structured questionnaire. This was complemented with the opinion of the experts in the field of Oral Radiology. Results: The study results indicate that there is a definite gap in knowledge of CBCT applications among the dental specialists. The dental specialists themselves feel that there is a lack of awareness as well as training in this field, and strongly perceive a need for the same. Even the experts in the field of oral radiology strongly agree educational strategies must be developed for training in CBCT. Introduction of training in CBCT at undergraduate as well as Postgraduate level, and developing well-structured training modules shall ensure that dental specialists use this technique in an efficient way to improve the accuracy and reliability of Oral and Maxillo-facial diagnosis, treatment planning and outcomes.
  1 2,008 325
Magnetic resonance imaging of temporomandibular joint disc abnormalities: A pictorial essay
Galal Omami
September-December 2013, 1(3):99-103
Internal derangement is the most common pathological condition affecting the temporomandibular joint (TMJ). Magnetic resonance imaging (MRI) of TMJ is principally directed toward assessment of the soft-tissue abnormalities in terms of internal derangement. This pedagogical article describes anatomy and biomechanics and provides a pictorial overview of the MRI findings of the disc abnormalities of TMJ.
  1 8,917 995
Role of computed tomography imaging in dental implantology: An overview
Hemchand Surapaneni, Pallavi Samatha Yalamanchili, Ravi Shankar Yalavarthy, Arunima Padmakumar Reshmarani
May-August 2013, 1(2):43-47
Dental implants have become an accepted form of permanent tooth replacement. Advanced imaging studies can be used to determine the suitability of implant placement. Dental computed tomography (CT) has been proved to be an excellent procedure for characterizing the anatomy and dental related abnormalities of the jaws. A number of modalities such as dentascan, cone beam computed tomography (CBCT), dental CBCT software, etc., are now available. This makes the diagnostic process more interactive and increases the diagnostic potential. This article reviews the various imaging modalities available for pre-operative implant site assessment, measurement of bone density, use of radio opaque surgical guide and stimulation of implant placement using computerized application of CT.
  1 5,048 799
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