Dental implant treatment with different techniques for sinus floor elevation--a case report.

Bull Tokyo Dent Coll. 2007 May;48(2):87-91

Authors: Sekine H, Taguchi T, Seta S, Takano M, Takeda T, Kakizawa T

A 60-year-old man with missing maxillary molar teeth received dental implant therapy for reconstruction of occlusion. Sinus floor elevation with autogenous bone graft consisting of iliac bone block and particulate cancellous bone and marrow (PCBM) was performed in the bilateral maxillary sinuses for implant placement. On the right side, bone height in the molar region was less than 2mm. Therefore, a delayed protocol was applied, and 2 implants were placed 4 months after bone grafting. Bone graft resorption occurred during the healing period of 4 months. On the left side, 3 implants were placed simultaneously with sinus floor elevation, as bone height in the molar region was more than 4-5mm. The bone graft was carried out at the same time as implant placement. After implant placement, resorption of the bone graft stopped, and the superstructures were delivered on both sides. The tissues around the implants were clinically healthy at one year after examination. Sinus floor elevation with autogenous bone graft is an acceptable option for implant treatment in the maxillary molar region where there is adequate height of existing bone. In postoperative care, it is important to undertake adequate follow-up to ascertain occurrence of bone graft resorption.

PMID: 17978549 [PubMed - indexed for MEDLINE]

Listeria endocarditis with acute thoracoabdominal aortic dissection.

Intern Med. 2007;46(15):1209-12

Authors: Kida K, Osada N, Isahaya K, Mikami T, Yoneyama K, Kongoji K, Osada K, Tsuchiya K, Miyake F

The patient was 71-year-old male under treatment at a clinic for hypertension, aortic regurgitation, alcoholic hepatitis and dental treatment. He mainly complained fever and anorexia. Since blood culture examination revealed Listeria monocytogenes and echocardiography exhibited vegetation at the mitral leaflet, the patient was diagnosed as infective endocarditis. Fever and inflammatory reaction were improved after penicillin administration; however, he had fever on the 24th hospital day. CT revealed type IIIb acute thoracoabdominal aortic dissection which was not observed on admission. The blood pressure was controlled with antihypertensive agents. He could leave the hospital on the 61st day.

PMID: 17675771 [PubMed - indexed for MEDLINE]

Surgical management of accidentally displaced mandibular third molar into the pterygomandibular space: a case report.

Kaohsiung J Med Sci. 2007 Jul;23(7):370-4

Authors: Huang IY, Chen CM, Chang SW, Yang CF, Chen CH, Chen CM

Surgical removal of the mandibular third molar is a regular surgical procedure in dental clinics, and like all operations, it may have some complications, such as infection, bleeding, nerve injuries, trismus and so on. An accidentally displaced lower third molar is a relatively rare complication, but may cause severe tissue injury and medicolegal problems. As few papers and cases have been published on this topic, we report this case to remind dentists on ways to prevent and manage this complication. The patient, a 28-year-old male, had his right lower mandibular third molar extraction in January 2006. The dentist resected the crown and attempted to remove the root but found that it had suddenly disappeared from the socket. Assuming that the root had been suctioned out he closed the wound. The patient was not followed up regularly because he studied abroad. About 3 months later, the patient felt a foreign body sensation over his right throat, and visited a local hospital in Australia. He was told after a computed tomography (CT) scan that there was a root-like radio-opaque image in the pterygomandibular space. The patient came to our hospital for further examination and management in June 2006. We rechecked with both Panorex and CT and confirmed the location of the displaced root. Surgery for retrieving the displaced root was performed under general anesthesia by conventional method without difficulty, and the wound healed uneventfully except for a temporary numbness of the right tongue. This case reminds us that the best way to prevent a displaced mandibular third molar is to evaluate the condition of the tooth carefully preoperatively, select adequate instruments and technique, and take good care during extraction. If an accident does occur, dentists should decide whether to retrieve it immediately by themselves or refer the case to an oral and maxillofacial surgeon, and should not try to remove the displaced root without proper assurance. Localization with images and proper surgical methods are the keys to retrieving the displaced fragment successfully. When immediate retrieval is decided on, Panorex and occlusal view are useful in localizing the displaced fragment. When the fragment moves into a deeper space or the retrieval has been delayed for months, three-dimensional CT seems to be a better choice.

PMID: 17606433 [PubMed - indexed for MEDLINE]

Stress distribution in maxillary alveolar ridge according to finite element analysis using micro-CT.

Bull Tokyo Dent Coll. 2006 Nov;47(4):149-56

Authors: Nomoto S, Matsunaga S, Ide Y, Abe S, Takahashi T, Saito F, Sato T

The purpose of the present study was to evaluate stress distribution by finite element analysis in an accurate model simulating trabecular bone using micro-CT. Dentulous and edentulous maxillary jaws of Japanese adult cadavers were used (5 sides each; total, 10 sides). Imaging was performed using a micro-CT, followed by reconstruction with 3-D images. Finite element analysis models were developed using the maxilla with average bone morphometry. A load corresponding to occlusal force was applied in different loading conditions, followed by evaluation of stress distribution. In dentulous maxillas, a load was applied in the dental axis direction to the first molar crown (LD). In edentulous maxillas, a load was applied directly to a circular area 4mm in diameter (LER0) to a cylinder 4mm in diameter and 10mm in height (LER10) corresponding to the first molar area. Stress was concentrated in cortical bone around the first molar, trabecular bone and cortical bone at the maxillary sinus base in LD, cortical bone of the alveolar ridge in LER0, and trabecular bone around the cylinder and cortical bone at the maxillary sinus base in LER10. LER0 showed a stress distribution markedly different from that in LD. Compared with LER0, LER10 showed a stress distribution close to that in LD. A model simulating trabecular bone allows a more accurate evaluation of stress distribution.

PMID: 17510544 [PubMed - indexed for MEDLINE]

[influence and improvement of metal artifacts in dental structures by CT for radiation treatment planning: reconstruction of transverse images using oblique images by gantry tilt scanning]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2007 Mar 20;63(3):326-34

Authors: Nakae Y, Inoue H, Minamoto T, Yamamoto T, Johkou T

Intensity-modulated radiation therapy (IMRT) radiation treatment planning (RTP) requires accuracy. Metal artifacts are one of the factors that influence RTP. The metal artifacts from dental structures are problems at the level of the oropharynx, since these artifacts impair visualization of tumors or lymph nodes and change CT (computed tomography) values. We simulated RTP at the level of the oropharynx using CT images with and without artifacts from dental structures. Gantry tilt scanning was performed to avoid artifacts from dental structures and transverse images reconstructed from oblique images by gantry tilt scanning using a technique of multiplanar reconstruction (MPR) . The reconstructed transverse images were used for the RTP. The reconstructed transverse images were useful to obtain accurate target volumes and the RTP of two opposed equally weighted beams by correct CT values. As dose distribution was changed slightly by the metal artifacts, the use of CT images without artifact is recommended in RTP.

PMID: 17409624 [PubMed - indexed for MEDLINE]

Cone-beam CT (CB Throne) applied to dentomaxillofacial region.

Bull Tokyo Dent Coll. 2006 Aug;47(3):133-41

Authors: Yajima A, Otonari-Yamamoto M, Sano T, Hayakawa Y, Otonari T, Tanabe K, Wakoh M, Mizuta S, Yonezu H, Nakagawa K, Yajima Y

Cone-beam CT (CBCT) systems specifically designed for hard-tissue imaging of the maxillofacial region have recently become commercially available. The newly-developed CBCT system, CB Throne (Hitachi Medical Corp., Tokyo), is characterized by a number of features such as low dose, sub-millimeter spatial resolution, and a small footprint. This system has been clinically applied at Chiba Hospital, Tokyo Dental College, since April 2005. This article reports the characteristics of this system, and its diagnostic power for maxillofacial lesions and the pre-operative planning dental implants.

PMID: 17344621 [PubMed - indexed for MEDLINE]

Reliability of linear distance measurement for dental implant length with standardized periapical radiographs.

Bull Tokyo Dent Coll. 2006 Aug;47(3):105-15

Authors: Wakoh M, Harada T, Otonari T, Otonari-Yamamoto M, Ohkubo M, Kousuge Y, Kobayashi N, Mizuta S, Kitagawa H, Sano T

The purpose of this study was to investigate the accuracy of distance measurements of implant length based on periapical radiographs compared with that of other modalities. We carried out an experimental trial to compare precision in distance measurement. Dental implant fixtures were buried in the canine and first molar regions. These were then subjected to periapical (PE) radiography, panoramic (PA) radiography, conventional (CV) and medical computed (CT) tomography. The length of the implant fixture on each film was measured by nine observers and degree of precision was statistically analyzed. The precision of both PE radiographs and CT tomograms was closest at the highest level. Standardized PE radiography, in particular, was superior to CT tomography in the first molar region. This suggests that standardized PE radiographs should be utilized as a reliable modality for longitudinal and linear distance measurement, depending on implant length at local implantation site.

PMID: 17344618 [PubMed - indexed for MEDLINE]

Masseter muscle hypertrophy: case report.

Braz Dent J. 2006;17(4):347-50

Authors: Sannomya EK, Gonçalves M, Cavalcanti MP

Masseter muscle hypertrophy is characterized by unilateral or bilateral enlargement of the masseter muscles affecting both males and females after puberty. Its etiology remains unknown. Limitations on mouth opening and also tension in the region of the hypertrophied muscle are symptoms reported. This paper reports a case of masseter muscle hypertrophy diagnosed using imaging modalities such as conventional radiography, computed tomography and magnetic resonance imaging scans. The familiarity with this condition is important to settle the differential diagnosis with other pathologies such as parotid gland tumors and dental infection.

PMID: 17262151 [PubMed - indexed for MEDLINE]

Length determination of zygomatic implants using tridimensional computed tomography.

Braz Oral Res. 2006 Oct-Dec;20(4):331-6

Authors: Koser LR, Campos PS, Mendes CM

Considering the potential of tridimensional computed tomography (3D-CT) as a predictor of real bone dimensions, nine dried human skulls with maxillary edentulism were evaluated using images obtained by 3D-CT, prior to the installation of zygomatic implants, in order to obtain the measurements of the implants. In the analysis of correlation between the two 3D-CT examiners, a 75% agreement was found, and no correlation was found between them and the surgical measurement. The worst result was the surgical one, possibly because an inaccurate probe was used. Based on the obtained data, we concluded that the probe used is inaccurate, suggesting that the surgical probe be changed in its measurement scale. Agreement between surgeon and radiologist could possibly be obtained by using insertion guides, since what might have possibly caused the discrepancy in the results is the fact that the 3D-CT examiners and the surgeon used different implant insertion points. It is also possible that a larger sample might produce a more accurate evaluation, thus improving the results.

PMID: 17242794 [PubMed - indexed for MEDLINE]

Unilateral submandibular gland aplasia associated with ipsilateral sublingual gland hypertrophy.

AJNR Am J Neuroradiol. 2006 Nov-Dec;27(10):2214-6

Authors: Srinivasan A, Moyer JS, Mukherji SK

Congenital absence of the major salivary glands is an infrequent disorder. Clinically, patients may be asymptomatic or may present with dryness of the mouth, difficulty in chewing and swallowing, and dental caries. The absence of the submandibular gland may be associated with hypertrophy of the contralateral submandibular gland. We report a case of ipsilateral sublingual hypertrophy associated with unilateral submandibular aplasia.

PMID: 17110697 [PubMed - indexed for MEDLINE]

Dacryoadenitis associated with Acanthamoeba keratitis.

Arch Ophthalmol. 2006 Sep;124(9):1239-42

Authors: Tomita M, Shimmura S, Tsubota K, Shimazaki J

OBJECTIVE: To report the incidence of dacryoadenitis as a symptom associated with Acanthamoeba keratitis. METHODS: We investigated all cases of Acanthamoeba keratitis (20 patients and 21 eyes) diagnosed and treated at Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Japan, between May 1, 1994, and November 30, 2005. We recorded the incidence of dacryoadenitis diagnosed using clinical signs of lacrimal gland swelling and pain on pressure, computed tomography, magnetic resonance imaging, and histopathologic analysis. RESULTS: Eight eyes (38%) of 8 patients had dacryoadenitis simultaneously with Acanthamoeba keratitis. Dacryoadenitis was diagnosed using histopathologic analysis and computed tomography in 1 patient, histopathologic analysis and magnetic resonance imaging in 1, magnetic resonance imaging in 2, and clinical signs alone in 4. Histopathologic examination in 2 patients revealed moderate infiltration of lymphocytes and plasma cells in the lacrimal gland compatible with dacryoadenitis. No Acanthamoeba organisms were found in the lacrimal gland. The standard protocol for Acanthamoeba keratitis was performed without particular treatment of dacryoadenitis in all patients. Lacrimal gland swelling improved after a mean of 10 weeks (range, 4-17 weeks) in conjunction with symptoms of keratitis; however, 1 patient (patient 1) required levator muscle surgery and blepharoplasty for residual ptosis. CONCLUSION: Dacryoadenitis is a clinical finding associated with Acanthamoeba keratitis.

PMID: 16966617 [PubMed - indexed for MEDLINE]

Pygmoid Australomelanesian Homo sapiens skeletal remains from Liang Bua, Flores: population affinities and pathological abnormalities.

Proc Natl Acad Sci U S A. 2006 Sep 5;103(36):13421-6

Authors: Jacob T, Indriati E, Soejono RP, Hsü K, Frayer DW, Eckhardt RB, Kuperavage AJ, Thorne A, Henneberg M

Liang Bua 1 (LB1) exhibits marked craniofacial and postcranial asymmetries and other indicators of abnormal growth and development. Anomalies aside, 140 cranial features place LB1 within modern human ranges of variation, resembling Australomelanesian populations. Mandibular and dental features of LB1 and LB6/1 either show no substantial deviation from modern Homo sapiens or share features (receding chins and rotated premolars) with Rampasasa pygmies now living near Liang Bua Cave. We propose that LB1 is drawn from an earlier pygmy H. sapiens population but individually shows signs of a developmental abnormality, including microcephaly. Additional mandibular and postcranial remains from the site share small body size but not microcephaly.

PMID: 16938848 [PubMed - indexed for MEDLINE]

[Improvement of metal artifacts in dental structures by X-ray CT: reconstruction of transverse images using oblique images by gantry tilt scanning]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2006 Jun 20;62(6):863-6

Authors: Nakae Y, Sakamoto K, Minamoto T, Kotoura N, Ozaki T, Johkoh T

PMID: 16799415 [PubMed - indexed for MEDLINE]

Harder and stiffer bone osseointegrated to roughened titanium.

J Dent Res. 2006 Jun;85(6):560-5

Authors: Butz F, Aita H, Wang CJ, Ogawa T

Mechanisms underlying the beneficial anchorage of roughened titanium implants have not been identified. We hypothesized that the implant surface roughness alters intrinsic biomechanical properties of bone integrated to titanium. Nano-indentation performed on two- and four-week post-implantation bone specimens of rats revealed that bone integrated to acid-etched titanium was approximately 3 times harder than that integrated to the machined titanium, both at the osseointegration interface and at the inner area of the peri-implant bone. The hardness of the acid-etched surface-associated bone was equivalent to that of untreated cortical bone at week 4, while the bone hardness around the machined surface was equivalent to that of the untreated trabecular bone. The elastic modulus of the integrated bone was 1.5 to 2.5 times greater around the acid-etched surface than around the machined surface. Analysis of the data suggests that the implant surface roughness affects the biomechanical quality of osseo-integrated bone, and that the bone integrated to the acid-etched surface is harder and stiffer than the bone integrated to the machined surface.

PMID: 16723656 [PubMed - indexed for MEDLINE]

Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT.

J Oral Sci. 2006 Mar;48(1):27-34

Authors: Hashimoto K, Kawashima S, Araki M, Iwai K, Sawada K, Akiyama Y

The authors evaluated the imaging performance of cone-beam computed tomography (CBCT) for dental use using 3DX multi-image micro-CT (Morita Co., Kyoto, Japan) and four-row multi-detector helical computed tomography (MDCT) using an Asteion (Toshiba, Tokyo, Japan). A dried right maxillary bone was cut into eight slices 2 mm thick toward the zygomatico-palate and used as a phantom. Images of the phantom were then taken using 3DX and MDCT. The images of two bone slices were evaluated by five dentists for image quality and reproducibility of cancellous bone, as well as enamel, dentin, pulp cavity, periodontal ligament space, lamina dura and the overall image. Using the MDCT images as the standard, the 3DX images were evaluated with a subjective 5-level scale: 3 for an image equal to the MDCT image, 4 or greater for better, and 2 or lower for worse. The scores for all parameters exceeded 4 points. Maximum mean score was 4.8 for the lamina dura. Statistically significant differences were found for all items (P < 0.01). Our subjective evaluation of imaging performance clarified that 3DX was superior to MDCT. The results of this study suggest that 3DX is useful for imaging in the dental field.

PMID: 16617198 [PubMed - indexed for MEDLINE]

Odontogenic orbital inflammation: clinical and CT findings--initial observations.

Radiology. 2006 Apr;239(1):187-94

Authors: Caruso PA, Watkins LM, Suwansaard P, Yamamoto M, Durand ML, Romo LV, Rincon SP, Curtin HD

PURPOSE: To retrospectively review computed tomographic (CT) and clinical findings in patients with odontogenic orbital infection. MATERIALS AND METHODS: Approval from the institutional review board was obtained for chart and scan review, and informed consent was waived for this HIPAA-compliant study. Five patients, two male and three female (median age, 37 years; age range, 13-55 years), who had odontogenic orbital cellulitis underwent clinical evaluation, CT scanning, and treatment. CT findings, including periapical lucency suggesting abscess, sinus opacification, and the route of spread of infection, were analyzed in each patient. Imaging, clinical, and surgical findings, including the initial clinical diagnosis and the presence of a periapical abscess at surgery and at pathologic examination, were compared. RESULTS: Periapical lucency and sinus opacification were seen in all patients. The route of infection spread was through either the premalar soft tissues or the maxillary sinuses. The odontogenic origin of the orbital infection was not clinically suspected in any patients. Correct diagnosis was later made at CT in all patients. Four patients had periapical abscesses at pathologic analysis, and the fifth patient had apical periodontitis at clinical analysis and granuloma at pathologic analysis. Dental surgery was required in each of the five patients for resolution of infection; four patients underwent extraction of the infected tooth, and one patient underwent incision and drainage of a periapical abscess. CONCLUSION: Abnormal periapical lucency, widening of the periodontal ligament space, and the presence of a subperiosteal abscess suggested an odontogenic origin of orbital infection.

PMID: 16567486 [PubMed - indexed for MEDLINE]

Assessment of the accuracy of dental enamel thickness measurements using microfocal X-ray computed tomography.

Anat Rec A Discov Mol Cell Evol Biol. 2006 Mar;288(3):263-75

Authors: Olejniczak AJ, Grine FE

Tooth enamel thickness has long been an important character in studies of primate and especially hominin phylogeny, taxonomy, and adaptation. Current methods for accurately assessing enamel thickness involve the physical sectioning of teeth, because measurements of enamel thickness using some radiographic techniques are unreliable. However, because destructive methods limit sample sizes and access to important fossil specimens, it is desirable that they be replaced with nondestructive techniques. Although microfocal X-ray computed tomography (mCT) has been used recently in studies of enamel thickness, the accuracy of this technique has yet to be established. The present research compares physical sections to computer-generated mCT sections of teeth from a variety of primate and nonprimate, recent and fossil taxa to examine whether enamel thickness, tooth size, and diagenetic remineralization (fossilization) impact the ability of mCT to measure enamel thickness accurately. Results indicate that recent teeth of varying size and thickness are clearly and accurately depicted in mCT scans, with measurements from nearly identical planes in physical and mCT sections differing by 3-5%. A fossil papionin molar (ca. 2 Myr) was also accurately measured using mCT scans, although thinner enamel in much older therapsid (ca. 263-241 Myr) teeth could not be distinguished from dentine. mCT is thus an accurate technique for measuring enamel thickness in recent taxa, although heavily mineralized teeth pose an obstacle to the ability of mCT to distinguish dental tissues. Moreover, absolutely thin enamel (less than approximately 0.10 mm) is difficult to resolve adequately in raw mCT images based on pixel values alone. Therefore, caution must be exercised in the application of mCT to the study of fossilized teeth.

PMID: 16463379 [PubMed - indexed for MEDLINE]

Three-dimensional analysis of mandibular growth and tooth eruption.

J Anat. 2005 Nov;207(5):669-82

Authors: Krarup S, Darvann TA, Larsen P, Marsh JL, Kreiborg S

Normal and abnormal jaw growth and tooth eruption are topics of great importance for several dental and medical disciplines. Thus far, clinical studies on these topics have used two-dimensional (2D) radiographic techniques. The purpose of the present study was to analyse normal mandibular growth and tooth eruption in three dimensions based on computer tomography (CT) scans, extending the principles of mandibular growth analysis proposed by Bj&#xF6;rk in 1969 from two to three dimensions. As longitudinal CT data from normal children are not available (for ethical reasons), CT data from children with Apert syndrome were employed, because it has been shown that the mandible in Apert syndrome is unaffected by the malformation, and these children often have several craniofacial CT scans performed during childhood for planning of cranial and midface surgery and for follow-up after surgery. A total of 49 datasets from ten children with Apert syndrome were available for study. The number of datasets from each individual ranged from three to seven. The first CT scan in each of the ten series was carried out before 1 year of age, and the ages for the 49 scans ranged from 1 week to 14.5 years. The mandible and the teeth were segmented and iso-surfaces generated. Landmarks were placed on the surface of the mandible, along the mandibular canals, the inner contour of the cortical plate at the lower border of the symphysis menti, and on the teeth. Superimposition of the mandibles in the longitudinal series was performed using the symphysis menti and the mandibular canals as suggested by Björk. The study supported the findings of stability of the symphysis menti and the mandibular canals as seen in profile view previously reported by Bj&#xF6;rk & Skieller in 1983. However, the mandibular canals were, actually, relocated laterally during growth. Furthermore, the position of tooth buds remained relatively stable inside the jaw until root formation started. Eruption paths of canines and premolars were vertical, whereas molars erupted in a lingual direction. The 3D method would seem to offer new insight into jaw growth and tooth eruption, but further studies are needed.

PMID: 16313399 [PubMed - indexed for MEDLINE]

Soft tissue cervicofacial emphysema after dental treatment: report of 2 cases with emphasis on the differential diagnosis of angioedema.

Arch Dermatol. 2005 Nov;141(11):1437-40

Authors: Frühauf J, Weinke R, Pilger U, Kerl H, Müllegger RR

BACKGROUND: The development of soft tissue cervicofacial emphysema after dental treatment is a rare complication, with few descriptions in the dermatologic literature. It is usually restricted to only moderate local swelling. However, spread of larger amounts of air into deeper spaces may sometimes cause serious complications, including airway compromise due to accumulation of air in the retropharyngeal space, pneumomediastinum, and pneumopericardium. Fatal air embolism and soft tissue infections through dissemination of oral flora microorganisms along the emphysematous tracts have also been described. Therefore, early recognition is important, but the unfamiliarity of dermatologists with this condition often causes diagnostic problems. Important differential diagnoses include angioedema, soft tissue infections, and hematoma. OBSERVATIONS: We describe 2 patients with different severity of the emphysema and airway compromise, representing the wide spectrum of its clinical expression. Our first case was remarkable, because the emphysema was massive and extended far into deep spaces, including the orbita, mediastinum, and pleural cavity. The present case is only the third report of pneumothorax associated with dental treatment published to date. The patient's condition was initially misdiagnosed and treated as angioedema. CONCLUSIONS: Dermatologists should be aware that soft tissue emphysema can cause acute swelling of the cervicofacial region after dental procedures. Angioedema is an important differential diagnosis, because it may be caused by the use of nonsteroidal anti-inflammatory drugs or local anesthetics, which are often administered during dental treatments.

PMID: 16301391 [PubMed - indexed for MEDLINE]

Florid cemento-osseous dysplasia and chronic diffuse osteomyelitis Report of a simultaneous presentation and review of the literature.

J Am Dent Assoc. 2005 Jul;136(7):927-31

Authors: Singer SR, Mupparapu M, Rinaggio J

BACKGROUND: Infection, neoplasia and bone dysplasias cause alteration in bone architecture. Florid cemento-osseous dysplasia (FCOD) and chronic diffuse osteomyelitis (CDO) are two independent disease processes that may have overlapping clinical and radiographic characteristics. Differential diagnosis can be crucial, as the course of each process and its clinical management varies. CASE DESCRIPTION: A patient reported to the oral and maxillofacial radiology clinic at the University of Medicine and Dentistry of New Jersey's New Jersey Dental School with a complaint of chronic pain in the mandible. One of the authors (S.R.S.) obtained a panoramic radiograph. Later, the patient underwent computerized tomographic examination and biopsy. On the basis of the clinical, radiographic and histopathologic examinations, the authors made diagnoses of CDO and FCOD. The bilateral presentation of CDO along with the simultaneous presence of FCOD and these conditions' vivid radiographic appearances make this case highly unusual. CLINICAL IMPLICATIONS: Multiple, simultaneous processes can yield an atypical radiographic appearance seen on routine radiographic examinations. Characteristics unique to each process are used to make the differential diagnoses. FCOD can make the mandible more susceptible to osteomyelitis.

PMID: 16060474 [PubMed - indexed for MEDLINE]

Cerebral infarctions and brain abscess due to Lemierre syndrome.

Intern Med. 2005 Jun;44(6):653-6

Authors: Shibasaki Warabi Y, Yoshikawa H, Idezuka J, Yamazaki M, Onishi Y

Lemierre syndrome is characterized by anaerobic bacterial infection in the head and neck, causing thrombophlebitis of the jugular vein and septic metastasis to various distant organs, most often the lungs. Here we describe previously unreported clinical features of cerebral infarctions and brain abscess due to metastatic septic embolism of this uncommon but lethal syndrome, and the successful course of treatment with ampicillin, cefotaxime and metronidazole.

PMID: 16020900 [PubMed - indexed for MEDLINE]

Functional activity of superior head of human lateral pterygoid muscle during isometric force.

J Dent Res. 2005 Jun;84(6):548-53

Authors: Ruangsri S, Whittle T, Wanigaratne K, Murray GM

There is controversy as to the jaw tasks for which the superior head of the human lateral pterygoid muscle (SHLP) becomes active. The aim was to describe the functional activities of SHLP single motor units (SMUs) during horizontal isometric force tasks. In 11 subjects, 48 SMUs were recorded from computer-tomography-verified SHLP sites during generation of horizontal isometric force in the contralateral (CL), protrusive (P), and ipsilateral (IL) directions and intermediate directions (CL-P, IL-P). In eight subjects, SHLP SMUs were active in CL, CL-P, and P. Qualitatively, SHLP EMG activity increased with increased isometric force. Forty-two SMUs were active in directions other than IL; 6 exhibited activity at IL and other directions. The similarity of these data to previous human lateral pterygoid (IHLP) data supports the notion that SHLP and IHLP should be regarded as a single muscle, with activities shaded according to the biomechanical demands of the task.

PMID: 15914593 [PubMed - indexed for MEDLINE]

Evaluation of the implantation position of mini-screws for orthodontic treatment in the maxillary molar area by a micro CT.

Bull Tokyo Dent Coll. 2004 Aug;45(3):165-72

Authors: Ishii T, Nojima K, Nishii Y, Takaki T, Yamaguchi H

The interalveolar septum between the upper first molar and the second premolar of the separated human maxillary bone was three-dimensionally observed by micro CT to evaluate the appropriate mini-screw type implant placement position by considering the relationship between the tooth roots and the maxillary sinus. After taking micro CTs of 5 human maxillary bones, horizontally sectioned images of the interalveolar septum area 2, 4, 6, 8, 10, and 12 mm deep from the crest of the alveolar ridge were reconstructed by three-dimensional reconstruction software. The bucco-lingual and mesio-distal lengths and area in each sectioned interalveolar septum were measured using digital image measurement software. Using the results, the interalveolar septum area between the upper first molar and the second premolar approximately 6-8 mm deep from the alveolar crest in the tooth root apical direction was determined to be the safest position for mini-screw implantation. Furthermore, lateral implantation from the palatal side was deduced to be the safest approach.

PMID: 15779459 [PubMed - indexed for MEDLINE]

Role of Spiral and Multislice Computed Tomography in the evaluation of traumatic and spontaneous oesophageal perforation. Our experience.

Radiol Med (Torino). 2005 Mar;109(3):252-9

Authors: De Lutio di Castelguidone E, Pinto A, Merola S, Stavolo C, Romano L

PURPOSE: To assess the role CT in the evaluation of traumatic and spontaneous oesophageal perforation. MATERIALS AND METHODS: From March 2001 to May 2003, we studied 12 patients (7 males and 5 females; age range: 25-66 years, mean age: 43.5 years) with suspected oesophageal perforation due to motor-vehicle accidents (4 cases), stab wound (one case), post-intubation (2 cases), foreign body ingestion (2 cases) and spontaneous (3 cases). Five patients underwent standard chest and cervical radiography; two patients with suspected foreign body ingestion also underwent a gastrografin swallow study; all of the 12 patients underwent CT of the neck, chest and abdomen before and after intravenous, and in four cases oral, administration of contrast material. RESULTS: In 5 patients with cervical, thoracic and abdominal trauma, the CT examination showed the presence of pleuroparenchymal injury (pneumothorax, pleural effusion and subcutaneous emphysema) as well as findings suggestive of oesophageal perforation: peri-oesophageal air (5 cases), peri-oesophageal fluid (4 cases), oesophageal wall thickening (3 cases), oesophageal wall laceration (2 cases) with abnormal course of the nasogastric tube in one of them and extraluminal extravasation of oral contrast material (2 cases). In 2 patients with post-intubation complications, CT showed the presence of a small peri-oesophageal fluid collection containing small gas bubbles in one case, and a gross perioesophageal abscess-like collection in the second case. In the 2 patients with foreign body ingestion, the plain radiography associated with CT showed the presence of a thin metal object in the cervical region (fragment of a dental plate) and a small extraluminal extravasation of gastrografin in one case, whereas in the other case CT showed the presence of a foreign body (chicken bone) in the hypopharynx with oesophageal wall thickening and peri-oesophageal oedema. In the remaining three patients with suspected spontaneous oesophageal perforation, CT showed the presence of a intramural haematoma in one case, oesophageal fluid distension with gas and a small peri-oesophageal fluid effusion (Mallory-Weiss syndrome) in another, and oesophageal rupture (Boerhaave syndrome) in the last case. CONCLUSIONS: Our experience shows that in patients with suspected traumatic and spontaneous oesophageal perforation, standard cervical and chest radiography may suggest a suspected oesophageal perforation in only a small proportion of cases, whereas oral contrast oesophagography has a higher sensitivity. Through the careful analysis of suggestive and specific signs of oesophageal perforation, a correct CT examination enables an accurate and timely diagnosis which significantly affects prognosis and provides valuable indications for treatment.

PMID: 15775894 [PubMed - indexed for MEDLINE]

Reference values for diagnostic radiology: application and impact.

Radiology. 2005 May;235(2):354-8

Authors: Gray JE, Archer BR, Butler PF, Hobbs BB, Mettler FA, Pizzutiello RJ, Schueler BA, Strauss KJ, Suleiman OH, Yaffe MJ

Reference values (RVs) are recommended by the American Association of Physicists in Medicine for four radiographic projections, computed tomography, fluoroscopy, and dental radiography. RVs are used to compare radiation doses from individual pieces of radiographic equipment with doses from similar equipment assessed in national surveys. RVs recommended by the American Association of Physicists in Medicine have been developed from the Nationwide Evaluation of X-ray Trends survey performed by the state radiation protection agencies with the cooperation and support of the U.S. Food and Drug Administration, the Conference of Radiation Control Program Directors, and the American College of Radiology. The RVs selected by the American Association of Physicists in Medicine represent, approximately, the 80th percentile of the survey distributions. Consequently, equipment exceeding the RVs is using higher radiation doses than is 80% of the equipment in the surveys. Radiation doses for specific projections, with standard phantoms, should be measured annually, as recommended by the American College of Radiology. When the RVs are exceeded, the medical physicist should investigate the cause and determine, in cooperation with the responsible radiologist, whether these doses are justified or the imaging system should be optimized to reduce patient radiation doses. RVs are a useful tool for comparing patient radiation doses at institutions throughout the United States and for providing information about radiographic equipment performance.

PMID: 15758190 [PubMed - indexed for MEDLINE]

Heterozygosity for Lmna deficiency eliminates the progeria-like phenotypes in Zmpste24-deficient mice.

Proc Natl Acad Sci U S A. 2004 Dec 28;101(52):18111-6

Authors: Fong LG, Ng JK, Meta M, Cot&#xE9; N, Yang SH, Stewart CL, Sullivan T, Burghardt A, Majumdar S, Reue K, Bergo MO, Young SG

Zmpste24 is a metalloproteinase required for the processing of prelamin A to lamin A, a structural component of the nuclear lamina. Zmpste24 deficiency results in the accumulation of prelamin A within cells, a complete loss of mature lamin A, and misshapen nuclear envelopes. Zmpste24-deficient (Zmpste24(-/-)) mice exhibit retarded growth, alopecia, micrognathia, dental abnormalities, osteolytic lesions in bones, and osteoporosis, which are phenotypes shared with Hutchinson-Gilford progeria syndrome, a human disease caused by the synthesis of a mutant prelamin A that cannot undergo processing to lamin A. Zmpste24(-/-) mice also develop muscle weakness. We hypothesized that prelamin A might be toxic and that its accumulation in Zmpste24(-/-) mice is responsible for all of the disease phenotypes. We further hypothesized that Zmpste24(-/-) mice with half-normal levels of prelamin A (Zmpste24(-/-) mice with one Lmna knockout allele) would be subjected to less toxicity and be protected from disease. Thus, we bred and analyzed Zmpste24(-/-)Lmna(+/-) mice. As expected, prelamin A levels in Zmpste24(-/-)Lmna(+/-) cells were significantly reduced. Zmpste24(-/-)Lmna(+/-) mice were entirely normal, lacking all disease phenotypes, and misshapen nuclei were less frequent in Zmpste24(-/-)Lmna(+/-) cells than in Zmpste24(-/-) cells. These data suggest that prelamin A is toxic and that reducing its levels by as little as 50% provides striking protection from disease.

PMID: 15608054 [PubMed - indexed for MEDLINE]

Lipiodol UF retention in dental sialography.

Br J Radiol. 2004 Dec;77(924):1040-1

Authors: Ozdemir D, Polat NT, Polat S

Lipiodol is a lipid based contrast medium and is very useful in sialography. It gives very fine images and clearly shows the details of the gland. It is viscous and has a relatively high iodine content. However, lipiodol UF drops sometimes remain in the salivary gland and in the adjacent tissues for a long time and may cause irritation. We report a case where lipiodol UF leaked from Stensen's duct and was not resorbed after a period of 70 months.

PMID: 15569647 [PubMed - indexed for MEDLINE]

Head and neck hemangiopericytoma in a child: case report.

Sao Paulo Med J. 2004 Sep 2;122(5):223-6

Authors: Carvalho JR, Haddad L, Leonhardt FD, Marques Filho MF, Santos Rde O, Cervantes O, Abrah&#xE3;o M

CONTEXT: Hemangiopericytoma is a relatively rare tumor, first described in 1942, with approximately 300 cases described in the literature to date. In most cases, it affects the trunk and lower extremities. The head and neck incidence is less than 20%, mostly in adults. We describe a case of malignant head and neck hemangiopericytoma in a child. TYPE OF STUDY: Case report. CASE REPORT: A twelve-year-old male patient noted the presence of a firm painless right-side retroauricular lymph node of 1 cm in diameter, which at first remained unchanged for six months, but subsequently enlarged progressively. He denied having had previous trauma at that site. In November 2000, he presented nasal obstruction and voluminous epistaxis that required hospitalization and blood transfusion. During dental treatment one month later, a cranial x-ray revealed bone alterations. A subsequent computed tomography scan showed an extensive lesion of soft tissue density that had invaded the maxillary fossa, eroding the skull base and middle and nasal fossa. The child was then referred to our service, where biopsy was performed, giving a diagnosis of hemangiopericytoma. Shortly afterwards, magnetic resonance imaging revealed that this lesion had undergone significant growth, while maintaining the same invasion pattern. The patient was submitted to conservative surgery in April 2001, with only partial resection of the tumor because of its extent. Histopathological examination of the specimen confirmed the presence of malignant hemangiopericytoma. Following the surgery, the patient presented fast regrowth of the lesion, with partial response to chemotherapy and radiotherapy.

PMID: 15558145 [PubMed - indexed for MEDLINE]

Virtual endoscopy in odontogenic sinus disease. Study technique and main pathological findings.

Radiol Med (Torino). 2004 Sep;108(3):225-37

Authors: Fanucci E, Leporace M, Di Costanzo G, Mannino M, Simonetti G

The use of CT scans in dental pathology is an established technique. The potential applications of Dentascan are further enhanced by the use of virtual navigation software, resulting in endoscopy-like imaging of the maxillary sinus, thus optimising both the diagnostic and therapeutic approach to sinus pathology of dental origin. The aim of this paper is to illustrate the technical-methodological aspects of maxillary sinus virtual endoscopy with Dentascan software and to document the most important and frequent diseases.

PMID: 15343137 [PubMed - indexed for MEDLINE]

Life-threatening necrotizing fasciitis of the neck: an unusual consequence of a sore throat.

Ann R Coll Surg Engl. 2004 Jul;86(4):253-7

Authors: Persaud R, Krah&#xE9; D, Georgalas C, Kaniyur S, Das S, Alusi G

BACKGROUND: Necrotizing fasciitis is life-threatening bacterial infection which spreads with frightening speed along the fascial planes resulting in extensive tissue necrosis and often death. The infection is caused by either Group A streptococci or a combination of aerobic and anaerobic bacteria. Necrotizing fasciitis of the neck is rare and commonly has a dental origin. CASE REPORT: Here we present a unique case of the condition that was preceded by a sore throat in a young immunocompetent woman. We also describe, for the first time, a successful outcome involving primary skin closure and daily irrigation of the wound with hydrogen peroxide.

PMID: 15239865 [PubMed - indexed for MEDLINE]

Applications of 3D imaging in orthodontics: part II.

J Orthod. 2004 Jun;31(2):154-62

Authors: Hajeer MY, Millett DT, Ayoub AF, Siebert JP

PMID: 15210932 [PubMed - indexed for MEDLINE]

Quantitation of transverse maxillary dimensions using computed tomography: a methodological and reproducibility study.

Eur J Orthod. 2004 Apr;26(2):209-15

Authors: Podesser B, Williams S, Bantleon HP, Imhof H

The present investigation was a methodological study of a new method of quantification of a series of factors in the transverse dimension of the maxilla including the nose, maxillary bones and dental arches, based on computer tomographic (CT) scanning. The aim was to investigate a series of parameters thought to be relevant in the differential diagnosis of discrepancies in the morphology of this area and probably affected by orthodontic appliances. Based on a standardized CT scanning registration of 10 subjects, a series of points on the scans were identified and then measured in a special cephalometric computer system (linear and angular values). The quantitation was repeated by each observer and inter- and intra-observer differences were calculated. The results demonstrated that virtually all the parameters showed a high degree of reproducibility at both levels and confirmed the statistical suitability of the method described. The method will be used in a series of ongoing studies regarding the morphology and treatment of discrepancies of the midface and therefore supplement the relatively sparse information based on quantitative reports concerning this important anatomical area.

PMID: 15130045 [PubMed - indexed for MEDLINE]

Applications of 3D imaging in orthodontics: part I.

J Orthod. 2004 Mar;31(1):62-70

Authors: Hajeer MY, Millett DT, Ayoub AF, Siebert JP

Part I of this paper describes the background, general concepts, available techniques and the clinical applications of recording external craniofacial morphology in three dimensions. Part II explores the different 3D techniques of imaging the dental arches, and their possible uses in orthodontic diagnosis and treatment.

PMID: 15071154 [PubMed - indexed for MEDLINE]

Clinical validity of the interactive and low-dose three-dimensional dento-alveolar imaging system, tuned-aperture computed tomography.

Bull Tokyo Dent Coll. 2003 Aug;44(3):159-67

Authors: Hayakawa Y, Yamamoto K, Kousuge Y, Kobayashi N, Wakoh M, Sekiguchi H, Yakushiji M, Farman AG

Based on technical studies and clinical examinations, the clinical value of a new three-dimensional dento-alveolar imaging system, Tuned-Aperture Computed Tomography (TACT), were examined for dental applications. TACT is a conventional and low-cost tomosynthesis method in which the benefit of digitization is fully utilized. The clinical information yield of TACT has been examined for the detection of dental caries, periodontal defects and radicular fractures, and also for the pre-surgical assessment of implant placement and impacted teeth. In this article, we introduce basic TACT technology, review the literature pertaining to in vitro and in vivo studies, and describe the outline of our study of TACT to determine its clinical value in the assessment of impacted maxillary teeth.

PMID: 14694831 [PubMed - indexed for MEDLINE]

[Assessment of mandibular vascular canals by dental CT]

Tani Girisim Radyol. 2003 Jun;9(2):188-91

Authors: G&#xFC;ltekin S, Araç M, Celik H, Karaosmaoğlu AD, Işik S

PURPOSE: Sublingual artery and its branches run in the floor of the mouth and prone to substantial bleeding when injured during an implantation procedure. These branches enter the mandible from the lingual side and run through bony canals in the mandible. The purpose of this investigation is to evaluate the frequency, diameter, direction and position of lingual canals by dental CT. MATERIALS AND METHODS: 26 patients who underwent dental CT of the mandible before implantation were included in this study. Tomographic examination was performed in a transverse plane parallel to the mandibular base by bone algorithm. Multiplanar reconstructions were obtained in the sagittal and coronal oblique planes. RESULTS: All patients demonstrated at least one canal, and 8 patients had two or more canals. Two of the patients presented with four canals. The typical lingual canal locations were the middle of the mandible and the premolar regions. The mean diameter of the lingual canals was 0.8 mm +/- 0.2 mm in the middle, 0.6 mm +/- 0.1 mm in the premolar regions. The direction of median canal was anterior and slightly caudal. Lateral canals were directed in a medial manner. CONCLUSION: Before the dental implantation procedure, beside the relationships of implant with the important anatomic structures, lingual vascular canals should also be evaluated. Dental CT examination easily demonstrates the presence, position, direction and size of the lingual canals. By ensuring that radiologists and dentists are aware of these canals and their importance, bleeding complications during the placement of implants could be avoided.

PMID: 14661487 [PubMed - indexed for MEDLINE]

[Clinical usefulness of limited cone beam X-ray CT for dental use in the cranio-facial region]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2003 Oct;59(10):1222-8

Authors: Maruhashi K

PMID: 14646989 [PubMed - indexed for MEDLINE]

The importance of intrafibrillar mineralization of collagen on the mechanical properties of dentin.

J Dent Res. 2003 Dec;82(12):957-61

Authors: Kinney JH, Habelitz S, Marshall SJ, Marshall GW

It is widely held that the hardness and modulus of dentin increase in proportion to the mineral concentration. To test this belief, we measured hardness and modulus of normal dentin and an altered form of dentin without gap-zone mineralization in wet and dry conditions by AFM nanoindentation to determine if the modulus and hardness scale linearly with mineral concentration. Mineral concentrations in the mid-coronal location of the normal and altered dentins were 44.4 vol% and 30.9 vol%, respectively. Surrounding the pulp of the altered dentin was a region of higher mineralization, 40.5 vol%. The indentation modulus of normal dentin was 23.9 (SD = 1.1) GPa dry and 20.0 (SD = 1.0) GPa wet. In mid-coronal regions of the altered dentin, the indentation modulus was 13.8 (SD = 2.0) GPa dry and 5.7 (SD = 1.4) GPa wet. In the more mineralized regions of the altered dentin, the modulus was 20.4 (SD = 1.8) GPa dry and 5.3 (SD = 0.8) GPa wet; the properties of the altered wet dentin did not correlate with mineral concentration. The results of this study raise doubt as to whether mineral concentration alone is a sufficient endpoint for assessing the success or failure of remineralization approaches in restorative dentistry.

PMID: 14630894 [PubMed - indexed for MEDLINE]

Radiologic evaluation of the Llullaillaco mummies.

AJR Am J Roentgenol. 2003 Dec;181(6):1473-9

Authors: Previgliano CH, Ceruti C, Reinhard J, Araoz FA, Diez JG

OBJECTIVE: Our purpose was to determine the imaging findings in three 500-year-old frozen mummies of sacrificial Inca children. MATERIALS AND METHODS: CT, conventional radiography, and dental radiography of Inca mummies were reviewed. Different techniques, which were adjusted to the anatomic position of the bodies, were used for radiologic analyses. Working sessions were limited to 20 min because of the fragility of these mummies and to prevent thawing of the specimens. RESULTS: Internal organs in good condition with a natural shrinkage caused by dehydration were shown on CT scans. Both white and gray matter were clearly observed in the brain and cerebellum. The white matter and the fatty tissue of the bodies were visibly white. This condition was possibly caused by the transformation of the fatty tissue into a waxlike substance and the deposition of calcium salts. The lungs were expanded in all three mummies. The ages of the three children at the time of their deaths were estimated by means of radiographs of the teeth and long bones. Bone mineralization, the muscular volume, and the thickness of the adipose panniculus indicated the good nutritional state of the three Inca children. The spleen was not visualized in any case. CONCLUSION: Radiology helped us determine the state of the internal organs, the nutritional conditions, and the physical abnormalities of the naturally mummified children. These mummies can be considered among the best preserved mummies currently known.

PMID: 14627558 [PubMed - indexed for MEDLINE]

Dynamic maneuvers in local staging of head and neck malignancies with current imaging techniques: principles and clinical applications.

Radiographics. 2003 Sep-Oct;23(5):1201-13

Authors: Henrot P, Blum A, Toussaint B, Troufleau P, Stines J, Roland J

Imaging has been widely demonstrated to be important in local staging of head and neck malignancies as a complement to clinical examination, including endoscopy. Recent developments in multidetector row computed tomography (CT) provide better anatomic resolution within a shorter acquisition time and wider anatomic coverage. However, in many cases lesions still remain undefined. In such cases, performance of dynamic maneuvers could provide useful information about the local extent of a tumor. The usefulness of dynamic maneuvers has increased with the improvement in temporal and spatial resolution that resulted from the most recent techniques of multidetector row CT. The puffed cheek technique and the modified Valsalva maneuver allow evaluation of a lesion that was poorly demonstrated owing to apposition of mucosal surfaces. In some cases, phonation improves demonstration of small lesions of the vocal cords and allows more precise anatomic localization. The open mouth technique allows demonstration of a lesion that was previously overlooked due to dental amalgam artifacts.

PMID: 12975510 [PubMed - indexed for MEDLINE]

Radiation dose to the lens of eye and thyroid gland in paranasal sinus multislice CT.

Br J Radiol. 2003 Jun;76(906):418-20

Authors: Zammit-Maempel I, Chadwick CL, Willis SP

CT has become an established examination in the evaluation of the paranasal sinuses. Until recently this was achieved by the direct coronal technique on conventional and single slice helical scanners. With the advent of multislice technology, thin slice axial CT with excellent coronal and sagittal reconstructions is now the norm. We describe a study designed to evaluate the radiation dose to the lens of the eye and thyroid gland in the axial and coronal planes on a Siemens Volume Zoom quad slice scanner at 140 kV and effective mAs of 100 using 1 mm collimation. Thermoluminescent dosimeters were placed on the eyelid and thyroid gland of 29 patients scanned axially in the supine position and a further 28 patients scanned coronally in the prone position with gantry tilt. The results show mean doses of 35.1 mGy (lens) and 2.9 mGy (thyroid gland) in the coronal plane compared with 24.5 mGy (lens) and 1.4 mGy (thyroid gland) in the axial plane. Results obtained from a head phantom and from using the ImPACT CT dose calculator were comparable. The kV and mAs were then reduced to 120 and 40, respectively, and the axial study repeated using the head phantom and predicted doses using the ImPACT CT dose calculator. The low dose scanning technique revealed a lens dose of 9.2 mGy and thyroid dose of 0.4 mGy. The eye dose on a multislice scanner is still substantially less than the threshold dose of 0.5-2 Gy for detectable lens opacities. These results indicate that, in addition to the established perceived advantages of multislice axial sinus CT, i.e. patient comfort, no artefact from dental amalgam and reproducible true coronal images, should be included a decreased radiation dose to both the eye lens and thyroid gland compared with direct coronal scanning.

PMID: 12814929 [PubMed - indexed for MEDLINE]

Chronic submasseteric abscess: anatomic, radiologic, and pathologic features.

AJNR Am J Neuroradiol. 2003 Jun-Jul;24(6):1159-63

Authors: Jones KC, Silver J, Millar WS, Mandel L

Herein we present five cases of submasseteric abscess that most commonly occurred in patients with a history dental disease. CT has been the main imaging method for diagnosing lesions in the masticator space and adjacent to the mandible; however, we found that, in some of our cases, CT defined the lesion poorly or not at all. In some cases, MR imaging defined the lesion better. Radiologic manifestations of this condition and pathologic correlations are discussed.

PMID: 12812946 [PubMed - indexed for MEDLINE]

[Useful knowledge for diagnostic imaging of oral region]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2003 Mar;59(3):343-9

Authors: Sakamoto M

PMID: 12740555 [PubMed - indexed for MEDLINE]

Type 2 diabetes complicated by multiple pyomyositis.

Intern Med. 2003 Feb;42(2):174-7

Authors: Yoneda M, Oda K

A 40-year-old man was hospitalized due to fever, muscular swelling and pain. He had poorly controlled diabetes with many dental caries and repeated periodontitis. CT revealed multiple intramuscular abscesses; administration of antibiotics and pus drainage were performed. Intraoral infection was suspected as the route of infection of pyomyositis, and a total of six teeth was extracted. In the clinical treatment of diabetic patients, it is important to instruct patients to routinely check for the presence of traumatic injuries of the lower extremities, and to have routine check-ups and dental care to check for dental caries or periodontitis.

PMID: 12636237 [PubMed - indexed for MEDLINE]

Dental technician's pneumoconiosis: mineralogical analysis of two cases.

Yonsei Med J. 2003 Feb;44(1):169-73

Authors: Kartaloglu Z, Ilvan A, Aydilek R, Cerrahoglu K, Tahaoglu K, Baloglu H, Misirli Z

Pneumoconiosis was diagnosed by open lung biopsy in two dental technicians who had interstitial lung disease. Mineralogical analysis was performed to investigate the origin of the dust that had been inhaled. A marked accumulation of silicon and phosphorus was found in both cases. The hard metals chromium and cobalt were also found. Dental technician's pneumoconiosis is a complex pneumoconiosis in which such dust and hard metals may play a role.

PMID: 12619195 [PubMed - indexed for MEDLINE]

DentaScan as an accurate method of predicting mandibular invasion in patients with squamous cell carcinoma of the oral cavity.

Arch Otolaryngol Head Neck Surg. 2003 Jan;129(1):113-7

Authors: Brockenbrough JM, Petruzzelli GJ, Lomasney L

OBJECTIVE: To determine the diagnostic accuracy of a dental computed tomographic software program, DentaScan, in assessing mandibular bone invasion in patients with squamous cell carcinoma (SCC) of the oral cavity clinically fixed to the mandible. DESIGN: Retrospective chart review. SETTING: Academic tertiary care medical center. PATIENTS: Thirty-six consecutive patients underwent DentaScan imaging of the mandible prior to composite resection for tumor ablation. All patients included in this review had SCC of the oral cavity clinically fixed to the mandible. A final histopathology report specifically addressing the presence or absence of bone invasion was available for each patient. RESULTS: The diagnostic accuracy for DentaScan in this study was as follows: sensitivity, 95%; specificity, 79%; positive predictive value, 87%; and negative predictive value, 92%. CONCLUSION: DentaScan is an accurate method of preoperative evaluation for mandibular invasion in patients with SCC of the oral cavity.

PMID: 12525205 [PubMed - indexed for MEDLINE]

[Digital sampling limitation on the dental radiograph]

Nippon Hoshasen Gijutsu Gakkai Zasshi. 2002 Nov;58(11):1469-75

Authors: Sumida H

PMID: 12469025 [PubMed - indexed for MEDLINE]

AAOMP case challenge: "The case of a subtle expansion of the mandible".

J Contemp Dent Pract. 2002 Nov 15;3(4):66-72

Authors: Hellstein JW, Roholt RL, Ferguson HW

A healthy 25-year old Caucasian man presented for a routine dental examination. He was unaware of a subtle expansion involving the right posterior mandible, which was bony hard and nontender. Radiographic findings prompted an immediate referral of the patient to an oral and maxillofacial surgeon for diagnosis and management of the jaw lesion. What is your diagnosis?

PMID: 12444403 [PubMed - indexed for MEDLINE]

Management of patients with trigeminal nerve injuries after mandibular implant placement.

J Am Dent Assoc. 2002 Oct;133(10):1351-4

Authors: Kraut RA, Chahal O

BACKGROUND: Placement of mandibular endosseous implants can result in damage to the lingual nerve, the inferior alveolar nerve or both nerves. All dentists who place mandibular implants should be aware of the appropriate early management of these injuries, as well as the appropriate time to refer patients with these injuries to a microneurosurgeon. OVERVIEW: The lingual nerve is less likely to undergo spontaneous regeneration than is the inferior alveolar nerve, which is protected within the inferior alveolar canal. Since the inferior alveolar canal can be seen on most panoramic radiographs and on all high-quality computed tomographic scans, it is easier to avoid damage to the inferior nerve than to the lingual nerve, which is not visualized on radiographs and whose relationship to the posterior portion of the mandible varies from person to person. RESULTS: The authors reviewed one study that showed that lingual nerve repair helped 90 percent of patients. A second study found that patients who underwent lingual nerve repair reported a mean score of 7 on a scale from 0 to 10 in regard to the postoperative return of nerve function. Several other studies reported favorable patient responses to inferior alveolar nerve repair. CONCLUSIONS AND CLINICAL IMPLICATIONS: These results reinforce the need for early referral and intervention when inferior alveolar nerve injuries occur. Failure to refer patients with trigeminal nerve injury before distal nerve degeneration develops prevents minimization of the injury through microneurosurgical repair.

PMID: 12403537 [PubMed - indexed for MEDLINE]

Desmoplastic variant of ameloblastoma: report of two cases and review of the literature.

J Am Dent Assoc. 2002 Aug;133(8):1072-5

Authors: Mintz S, Velez I

BACKGROUND: The desmoplastic ameloblastoma exhibits important differences in anatomical distribution, histologic appearance and radiographic findings compared with the classic type of ameloblastoma. The purpose of this article is to assist the dental community in better understanding this variation in odontogenic tumor. CASE DESCRIPTIONS: The authors present two cases of desmoplastic variant of ameloblastoma localized in the anterior portion of the jaw. The tumors were expansile, destructive and painless. The radiographic findings showed diffuse, mixed (radiopaque/radiolucent) lesions with cortical bone destruction. Block excision was performed in both cases. Follow-up examination one and two years later disclosed no recurrence of tumor. CLINICAL IMPLICATIONS: The desmoplastic variant of ameloblastoma tends to infiltrate between bone trabeculae. Curettage leaves islands of tumor within bone, which later manifest as recurrences. Therefore, block excision is the most widely used treatment to avoid recurrence.

PMID: 12198986 [PubMed - indexed for MEDLINE]

Nonsurgical treatment for odontogenic maxillary sinusitis using irrigation through the root canal: preliminary case report.

Tohoku J Exp Med. 2002 May;197(1):47-53

Authors: Iikubo M, Sasano T, Shoji N, Sakamoto M

As a new nonsurgical treatment for odontogenic maxillary sinusitis (OMS), irrigation of the maxillary sinus through the root canal of the causal tooth was carried out to the patient with OMS that had proved refractory to conservative treatments (i.e., root-canal treatment of the causal tooth and antibiotic therapy). Clinical signs, symptoms, and radiographs before and after the new treatment revealed evidence of good healing. The clinical signs and symptoms, such as oppressive pain in the cheek and retrorhinorrhoea, entirely disappeared immediately after the irrigation (which was done only once) without pain, and the obstructed ostiomeatal unit was aerated on the follow-up CT images. There was no side effect associated with saline irrigation, nor any recurrence of symptoms since the irrigation. We therefore propose the irrigation through the root canal of the causal tooth as a new treatment for periapical disease-induced maxillary sinusitis, a technique that should ensure proper ventilation and drainage by relieving obstruction of the ostiomeatal unit.

PMID: 12180793 [PubMed - indexed for MEDLINE]