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   2016| September-December  | Volume 4 | Issue 3  
    Online since December 21, 2016

 
 
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CASE REPORTS
Facial nerve paralysis after dental procedure
Melda Misirlioglu, Mehmet Z Adisen, Alime Okkesim, Yagmur Y Akyil
September-December 2016, 4(3):80-82
DOI:10.4103/2321-3841.196356  
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.
  46,527 995 1
Idiopathic mucocele of maxillary sinus: A rare and frequently misdiagnosed entity
Abhilasha Sadhoo, Isha Preet Tuli, Nishi Sharma
September-December 2016, 4(3):87-89
DOI:10.4103/2321-3841.196360  
Maxillary sinus mucocele is an unusual uncommon benign lesion which develops due to retained secretions and presents as an expansile cystic lesion. Presenting symptoms are nonspecific and mostly due to pressure effects on the orbit or facial deformity. Etiology of such mucoceles is not well understood, and it is postulated that they ensue due to obstruction of the ostium by inflammation or previous procedures such as Caldwell-Luc surgery. De novo origins are rare causing unnecessary investigations and delayed diagnosis and treatment. Endoscopic marsupialization of the mucocele is the surgery of choice, even though complicated cases maybe approached by an external route. We present a case of right maxillary mucocele without an identifiable cause, which is reported due to its rarity and delayed management.
  16,331 647 2
ORIGINAL ARTICLES
Comparison between cone-beam computed tomography and direct digital intraoral imaging for the diagnosis of periapical pathology
Arpita Rai, Krishna Burde, Kruthika Guttal, Venkatesh G Naikmasur
September-December 2016, 4(3):50-56
DOI:10.4103/2321-3841.196346  
Purpose: Early precise evaluation of periapical inflammatory lesions is necessary not only for diagnosis but also for treatment and follow-up. This study was performed to compare direct digital intraoral periapical images with three-dimensional (3D) images acquired from cone-beam computed tomography (CBCT) for the diagnosis and treatment planning of periapical pathology. Materials and Methods: Sixty teeth with clinical and/or radiographic evidence of periapical pathology were examined with direct digital imaging (DDI) and CBCT technique. Both the image dataset were evaluated by three oral radiologists. Numbers of roots and root canals, presence and location of periapical lesions, size of the lesion, root resorption and root fracture, and relation of the lesion to cortical bone and neighboring structures were studied. Cone-beam computed tomography periapical Index (CBCTPAI) was used and the values were compared using Wilcoxon-matched pairs test. The scores obtained for the 5-point scale for presence/absence of periapical lesion were also compared using Wilcoxon-matched pairs test. Results: Among 60 teeth, both the techniques demonstrated periapical lesions in 52 teeth, and an additional 5 teeth were found to have periapical lesions in the CBCT images. In regards to individual roots, 67 lesions were found in both the techniques, and 33 more roots were found to have lesions in CBCT images. Statistical analysis showed significant difference in both the imaging modalities for ascertaining the presence or absence of lesion on the 5-point scale and significant difference between DDI and CBCT in relation to the CBPAI scores. Conclusions: A high-resolution 3D technique can be of value for diagnosis of periapical problems, especially for multirooted teeth. CBCT is a promising technology for the diagnosis and management of periapical pathology.
  4,222 1,644 1
Prevalence and characteristics of impacted permanent molars in a Turkish subpopulation
Elif Yildizer Keris, Süleyman Bozkaya, Mustafa Öztürk, Kahraman Güngör
September-December 2016, 4(3):45-49
DOI:10.4103/2321-3841.196345  
Background: The aim of the present study was to evaluate the prevalence and characteristics of impacted permanent molars in a Turkish subpopulation. Materials and Methods: A total of 45816 panoramic radiographs of patients aged more than 13 years were examined retrospectively to determine the presence, number, location, position, and related complications. The patients' age and sex were noted. During statistical analysis, descriptive statistics and cross-tabulations, Chi-square test, and Fisher's exact were used. The P value was set at 0.05. Results: The prevalence of impacted permanent molars was found to be 0.18% in this population. In total, 109 impacted first/second molars were observed in 83 patients, 18 cases had two or more impacted permanent molars. Impacted first/second molars were observed significantly more frequently in male patients than in female patients (P < 0.05). Mandible was a more common region of impaction (P < 0.05) whereas there was no significant difference between the left and right sides (P > 0.05). According to the position of the impacted permanent molars, 58 were detected as vertical direction, 28 were impacted as mesioangular, 12 were impacted as distoangular, 9 were impacted as horizontal, and 2 were impacted as buccolingual direction. In this study, cystic changes related to impacted teeth were observed in 14 (12.9%) cases and root resorption, carious lesion of the neighboring teeth were uncommon, our findings showed that majority of impacted first/second molars were found to be asymptomatic. Conclusions: Early diagnosis and treatment of eruption disturbances may avoid impaction in complicated orthodontic treatment.
  2,741 1,876 3
Cone beam computed tomography guided surgical stent: A preimplant planning procedure, a pilot study
Kritika Saxena, Bharat M Mody, Akshay Rathore
September-December 2016, 4(3):57-61
DOI:10.4103/2321-3841.196347  
Aim: The aim of the present study was to evaluate the efficacy of cone-beam computed tomography (CBCT)-based radiologic stent in guidance for preimplant placement procedures. Setting and Design: This study was a pilot study conducted among 5 patients who presented for dental implants and attending the department of Oral Medicine and Radiology, ITS Dental College, Muradnagar for CBCT volumetric scans. Materials and Methods: The dimensions of bone available for implants were measured from the scans. A radiologic stent was prepared on the study model using three radiopaque pins per implant site, which simulated the implant in the CBCT scan. The pin which was in the direction of the residual bone was identified and retained, and the remaining pins were removed. The retained pin was utilized and the final surgical stent was prepared. It was checked if the final implant placement could be accomplished surgically using the modified stent. Results: A total of 7 implants were inserted. The final implant placement was based on the CBCT data and was evaluated by postoperative radiographs. All the implant sites showed proper placement of the implants. Conclusion: The stent used in our study was cost effective and easy to fabricate. Apart from the anteroposterior direction, it was also possible to give buccolingual direction to the implant, reducing the chances of perforation.
  3,597 448 -
Symphysis menti: A strong indicator of osteoporosis
Dur-e-Shahwar Rehman, Naila Parveen, Imran Ishaq
September-December 2016, 4(3):62-66
DOI:10.4103/2321-3841.196349  
Context: Osteoporosis is a highly prevalent disease especially in elderly females. Orthopantomogram (OPG) X-ray is a commonly employed technique in dental clinics which shows bony details for both mandible and maxilla. It can be used as a window to the whole skeleton if the bone density changes on dual energy X-ray absorptiometry (DXA) scan correlates with the changes in the morphology of mandible. Aim: This study aims to establish a relation between changes in height of body of mandible at symphysis (HS) on OPG with DXA scan of the femoral neck and spine to see whether OPG can be employed for screening and early detection of osteoporosis. Settings and Design: Patients, attendants, volunteers visiting the Dow Radiology and Patel Hospital participated in this cross-sectional study. Materials and Methods: Female participants aged 25-85 years were selected randomly. DXA scan was performed to determine bone mineral density. OPG was performed to measure HS. Correlation between the two was studied in a sample of size of 174 females. Statistical Analysis: Statistical analysis was done by using the Statistical Package for the Social Sciences version 16. For intragroup comparisons, Kruskal-Wallis Test was applied in the groups where normality assumption was not fulfilled. One-way analysis of variance was applied to evaluate the significance between subgroups. For multiple comparisons in the subgroups of both groups, Tukey's B test was applied. Independent samples t-test was applied for intergroup comparison. Results: Highly significant decrease in height HS was observed in intergroup comparison of Group I (P < 0.001) and Group II (P < 0.001). In intergroup comparisons between subgroups of Groups I and II, significant decrease in HS was observed between osteopenic and osteoporotic subgroups (P = 0.038 and P = 0.001, respectively), and highly significant decrease between normal participants (P < 0.001). Conclusion: Because the decrease in HS is seen in younger and older groups of females at osteopenia stage, this variable can be conveniently used for early detection of osteoporosis for both age groups. The findings conclude that the OPG can be used as a screening tool for osteoporosis.
  3,408 365 -
CASE REPORTS
Characteristic MRI and cone beam CT findings in a case of paradental cysts arising in the bilateral retromolar regions of the mandible
Antonione S Pinto, Andre L Costa, Moara C Pinto, Paulo H Braz-Silva, Mari E Moraes, Sérgio L Lopes
September-December 2016, 4(3):83-86
DOI:10.4103/2321-3841.196358  
Paradental cyst is an inflammatory odontogenic cyst linked with mandibular molars. The occurrence rate of the lesion ranges from 0.9 to 4.7% suggesting its infrequency. The histopathologic findings in hematoxylin and eosin routine staining are not pathognomonic, and the correlation with clinical and imaging characteristics is essential to establish the final diagnosis. The periapical radiographs show a unilocular radiolucency on the distal or disto/buccal aspect of the involved tooth, however, the lesion can superimpose over the roots and mimic periapical pathology. We report the imaging features of a rare bilateral paradental cyst with an emphasis on magnetic resonance imaging and cone beam computed tomography to help a correct identification and characterization of the cyst and to reliably establish the diagnosis.
  2,518 375 1
ORIGINAL ARTICLES
Ultrasonographic evaluation of superficial space infections
Sarfaraz Padda, Yashmeet Padda, S Sathasivasubramanian, S Aarvind Warrier, Gaurav Goyal, Bhawandeep Kaur
September-December 2016, 4(3):67-75
DOI:10.4103/2321-3841.196351  
Aims and Objectives: To evaluate the use of ultrasonography as a diagnostic tool in determining the state of infection, i.e., cellulitis or abscess, in the superficial space infection of odontogenic origin. Materials and Methods: A total of 35 patients visiting the department and having an inflammatory swelling of odontogenic origin were chosen. Thorough history and clinical examination of patients was done to reach a clinical diagnosis of cellulitis or abscess. Ultrasonography was performed with the help of transducing gel using a linear probe to determine the state of infection, i.e., cellulitis or abscess. Results: Out of 35 patients, 19 patients were clinically diagnosed as abscess whereas the remaining 16 patients were clinically diagnosed as cellulitis. For the 19 patients who were clinically diagnosed as abscess, ultrasonography revealed focal accumulation of fluid suggestive of abscess cavity in all the 19 cases, and ultrasound-guided aspiration was positive in all the cases. For the 16 patients who were clinically diagnosed as cellulitis, ultrasonography revealed focal areas of fluid accumulation suggestive of abscess formation in 5 cases, and ultrasound-guided aspiration was positive all these 5 cases. Sensitivity (100%) and negative predictive value (100%) of ultrasound is much better than that of clinical diagnosis, which is 79% and 69%, respectively, in the detection of state of infection. Conclusion: Ultrasonography was found to be a valuable adjunct to clinical diagnosis in determining the state of infection, i.e., cellulitis or abscess.
  2,522 334 -
CASE REPORTS
A rare case of beaten copper skull pattern associated with Treacher Collins syndrome
Sunita Gupta, Anju Garg, Khusboo Singh, Sinny Goel
September-December 2016, 4(3):76-79
DOI:10.4103/2321-3841.196354  
Treacher Collins syndrome (TCS) is an autosomal dominant disorder with craniofacial abnormality. Typical features are downslanting palpebral fissures, lower eyelid colobomas, microtia, and malar and mandibular hypoplasia. Management requires a multidisciplinary team from birth through adulthood with proper planning, counselling, and surgical techniques. Here, we present a case of TCS with a very unusual and rare finding of beaten copper skull appearance on the radiograph.
  2,403 209 -
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