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   2017| September-December  | Volume 5 | Issue 3  
    Online since December 18, 2017

 
 
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ORIGINAL ARTICLES
Pneumatization patterns of onodi cell on multidetector computed tomography
Vishwanath T Thimmaiah, C Anupama
September-December 2017, 5(3):63-66
DOI:10.4103/jomr.jomr_3_17  
Background: Onodi cell is the most common anatomical variant of posterior ethmoidal air cells. Pneumatization patterns of Onodi cell are important clinically due to its proximity to optic nerve and internal carotid artery canal. Multidetector computed tomography (MDCT) provides the best imaging modality for identification and pneumatization pattern of Onodi cell. Objectives: The present study is done to know the patterns of pneumatization of Onodi cell by 128 slice MDCT. Materials and Methods: This was a retrospective analysis of paranasal sinuses in 1080 cases by MDCT in adults. Axial images of paranasal sinuses were taken by 128 MDCT with further multiplanar reconstruction to identify Onodi cell and their pneumatization patterns. Statistical analysis was done using SPSS version 20, and 95% confidence interval (CI) values were calculated using a confidence Interval calculator for proportional values. Results: A total of 260 cases (24.07%, CI - 21.52%–26.62%) showed Onodi cell among the total 1080 cases included in this study. Males formed more cases than females with 62.69% and 37.31%, respectively, Type II was the most common pattern of pneumatization with 56.55% (CI - 50.12–62.18), followed by Type I with 41.53% (CI - 35.54–47.52) and Type III with 1.92% (CI - 0.25–3.59) of cases. Conclusion: Onodi cell is the most common anatomical variation of ethmoidal sinuses with higher prevalence among Asian populations. Their patterns of pneumatization are important clinically to avoid surgical damage to optic nerve and internal carotid artery canals. Onodi cell is better detected with MDCT and helpful for sinonasal surgeons for a better surgical outcome.
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CASE REPORTS
Bone scintigraphy as a diagnostic tool in condylar hyperplasia
Rajendran Appadurai, Deenadayalan Lingeshwar, Venugopal Shwetha, Rani Dhivya Christina
September-December 2017, 5(3):84-89
DOI:10.4103/jomr.jomr_26_17  
Unilateral condylar hyperplasia (UCH) is a pathological condition characterized by unrestrained growth of condyle unilaterally and is of idiopathic in nature. It is often diagnosed clinically but more frequently if not always is augmented by planar and single photon emission computed tomography bone scans to confirm the finding. Hence, bone scintigraphy using technetium-99 m methylene diphosphonate is the diagnostic tool to identify these active growth centers. Detection and excision of active growth center are the line of management for condylar hyperplasia. This article highlights the importance of using these radioactive scans to diagnose as well as to monitor the prognosis of UCH in two such cases.
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ORIGINAL ARTICLES
Role of multislice computed tomography and three-dimensional rendering in the evaluation of maxillofacial injuries
N Sreenivasa Raju, Prashanth Ishwar, Rumpa Banerjee
September-December 2017, 5(3):67-73
DOI:10.4103/jomr.jomr_25_17  
Aims and Objectives: The aim of this is to identify and classify maxillofacial fractures using multislice computed tomography (CT) and identify the advantages of three-dimensional (3D) rendered images over two-dimensional axial images in evaluating maxillofacial injuries. Materials and Methods: This was a descriptive study. Multislice CT evaluation was done on 60 patients with maxillofacial injuries using a 16-slice CT scanner. 3D rendered images, as well as coronal reformatted images, were reconstructed. Statistical Analysis: Descriptive study. Results: Individuals within the age group of 36–45 years were most commonly affected by maxillofacial injuries with males being more common. The most common cause of these injuries was road traffic accident in 40 (80%) cases. The mandible was the most involved region observed in 37 cases, maxillary and nasoorbitoethmoid region being the next common regions seen in 32 (53.3%) cases. 3D rendered images were similar or superior to axial images (in the assessment of fractures) in most patients and were inferior when the fractures involved the thin bones of the orbital region. Conclusion: This study demonstrates that Multislice CT with 3D images provides better perception of the pattern of the fracture lines, and the displacement of the bony fragments thus helping in the faster and improved communication of the information to the referring physician. However, the 3D images alone have a limited role in evaluating orbital region fractures and also when there is minimal displacement of the fractured fragment.
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Are dental and periapical status related to incidental findings of calcifications along the course of the internal carotid artery in cone-beam computed tomography?
Heraldo Luis Dias Da Silveira, Fernanda Hoffmann Busanello, Carolina Nedel, Mariana Boessio Vizzotto, Spyros Damaskos
September-December 2017, 5(3):74-80
DOI:10.4103/jomr.jomr_30_17  
Context: Given that tooth loss, periapical lesion, and manifestations of periodontal disease are generally related to previous inflammatory events and that a linear relationship exists between tooth loss and degree of arterial stiffness, reasonable ground exists to investigate whether there is an association with presence of calcifications along the course of the internal carotid artery (ICA). Aims: This study aims to determine whether an association exists between the extra- and intracranial calcifications of the internal carotid artery (ExCICA and InCICA, respectively) and missing teeth (MT) as well as the periapical index (PAI), in cone-beam computed tomography (CBCT) scans. Settings and Design: A retrospective study with CBCT examinations obtained from a database of a dental imaging center. Materials and Methods: A number of 174 adults' CBCT examinations of both genders were evaluated on the presence of calcifications along the course of the ICA and the number of MT as well as the PAI score. Statistical Analysis Used: The interobserver agreement was assessed by Cohen's kappa. The t-test for independent samples was used to compare the groups presented with or without calcifications. Furthermore, the Pearson's test was used to evaluate whether an association exists between variables that had a statistical difference. Results: The t-test showed a significant difference in the mean age (MA) and the number of MT between patients with and without presence of calcifications along the course of ICA, in both extra- and intracranial segments. The Pearson's correlation test showed a positive correlation between MA, MT, and both ExCICAs' presence and InCICAs' presence. Although the number of MT increases with age, this increment is high in the presence of ExCICA and even higher in the presence of InCICA. Conclusion: We support that not only patients' age but also the number of MT can be predictive for atherosclerosis “signs” presence.
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CASE REPORTS
Acute subcutaneous laterocervical emphysema and pneumomediastinum secondary to inferior third molar extraction
Roberta Catania, Alfredo La Fianza
September-December 2017, 5(3):81-83
DOI:10.4103/jomr.jomr_24_17  
Subcutaneous laterocervical emphysema and pneumomediastinum are often due to head and neck surgery, but these are uncommon complications of dental procedures. The use of high-speed air-turbine headpieces during dental extractions is sometimes associated with this complication, making simple the spread of air under sublingual, submandibular, retropharyngeal, and parapharyngeal spaces, routes of communication to the mediastinum. Due to its rarity, it is not simple to recognize, often confused with other complications after oral surgery, such as allergic reaction, hematoma, and infections. We present a case of subcutaneous laterocervical emphysema and pneumomediastinum after inferior impacted third molar tooth extraction, self-limiting with a conservative therapy. We need to focus on this case because it is often misdiagnosed by physicians in emergency department as an allergic reaction. We also underline the importance of an empiric antibiotic therapy to prevent spreading of oral microorganism causing severe mediastinitis and sepsis. To avoid these complications, high-speed air-turbine headpieces should be used only when it is essential.
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Hypercementosis: Diagnostic imaging by radiograph, cone-beam computed tomography, and magnetic resonance imaging
Antonione Santos Bezerra Pinto, Matheus Santos Carvalho, Alan Leandro Carvalho de Farias, Brunna da Silva Firmino, Luis Paulo da Silva Dias, João Marques Mendes Neto, Amanda Maria Lopes da Silva, Fernando Antônio Pontes Castro, André Luiz Ferreira Costa, Sérgio Lúcio Pereira De Castro Lopes
September-December 2017, 5(3):90-93
DOI:10.4103/jomr.jomr_27_17  
Cementum is an adaptable component of the periodontium which can respond to functional changes throughout its development, with its formation being characterized by apposition during the final stage of the tooth's life. In some cases, this formation occurs in excess, giving rise to hypercementosis, or other lesions (e.g., cementoblastoma) often presenting similar clinical and imaging features, but they are actually distinct entities requiring different approaches. The objective of the present study is to demonstrate the clinical and imaging characteristics of a case based on a differential diagnosis of these entities. Accurate diagnosis through detailed examination and adequate interpretation of imaging characteristics is essential for appropriate and successful therapy.
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