Routine Radiographic Examination Research Articles

An incidental radiographic finding of an inverted mesiodens — A case report with a comprehensive review

Supernumerary teeth (ST) are uncommon developmental disorders that can be seen in either of the dental arches. Mesiodens is the most common type of ST. The experience of observing one such case is reported along with a literature review. This article describes a clinical case of a 46-year-old female patient with an impacted inverted mesiodens that was diagnosed accidentally during the routine radiographic examination. The mesiodens was very close to the nasal floor. Advanced radiographic investigations (CBCT) was advised for locating the exact position of mesiodens. The patient was counselled regarding the potential complications of ST and was advised for the surgical removal of the mesiodens, but the patient denied the treatment as ST was not causing any immediate problem. Therefore, the patient is under the continuous follow-up to avoid any complications with the mesiodens. The present case focuses on the importance of careful clinical and radiographic assessment in the diagnosis of ST, especially when they are asymptomatic. Patients should be educated regarding the same with proper explanations of all the treatment options.

Odontomes involving both the jaws: A case report

Introduction: Odontomes are most common type of odontogenic tumors. They are generally asymptomatic and discovered on routine radiographic examinations. Morphological classification of odontomes can be doneas complex and compound odontomes. Here we document a case of a 15 year old boy who attended our dental department with apparent malocclusions. A panoramic radiograph revealed presence of multiple radio opaque masses in maxillary as well as mandibular arches. These structures were seen associated with impacted permanent teeth. The histopathological examination confirmed the diagnosis of them as being complex odontomes. Keywords: Odontogenic tumor, Odontome, Complex, Compound.

Ameloblastoma of the mandible: A case series

Ameloblastoma is a benign odontogenic neoplasm which exhibits a locally aggressive behaviour. It commonly affects the mandible and seen in third to fifth decades of life. In most cases, an ameloblastoma is usually asymptomatic and may be detected during the course of routine radiographic examination. Radiographically, it may have a unilocular or multilocular appearance, which is usually well defined and have corticated margin in the mandible whereas ill-defined in case of maxilla. In this case series, we report 3 cases of ameloblastoma of the mandible. Keywords: Ameloblastoma, mandible, Multilocular radiolucency, Bicortical expansion.

NAZOPALATİN KANAL KİSTLERİ - 3 OLGU SUNUMU VE LİTERATÜR DERLEMESİ

Nazopalatin kanal kisti ya da diğer adıyla insiziv kanal kisti, nazopalatin kanalın embriyolojik kalıntılarından meydana gelir. Gelişimsel, epitelyal ve non-odontojenik bir kisttir. Palatinal ön bölgede orta hatta lokalize olup genellikle rutin radyografik muayene sırasında tespit edilir. Bu yazıda kliniğimizde opere edilen üç adet nazopalatin kanal kisti olgusu bildirilmiş ve bu kist tipinin tanı, tedavi ve özellikleriyle ilgili literatür derlemesine yer verilmiştir.

18F-FDG PET findings of a case of polyostotic fibrous dysplasia

Fibrous dysplasia of bone (FDB) was a condition that the normal bone tissue was replaced by benign hyperplastic fibrous tissue; these patients may present with pain, swelling, or pathological fracture. The imaging findings of FDB on CT or MR images have been documented previously, however it was usually misdiagnosed as primary bone malignancy or metastatic tumor due to lack of specificity in routine radiographic examinations. Furthermore, the most common affected sites were extremities, pelvis, femur and craniofacial bones, and the spine is less involved. Here we reported a case with thoracic FD, she presented with chest and back pain for 9 years, the 18F-FDG PET/CT examination revealed abnormal hypermetabolic foci at 8th and 9th vertebrae, and the right ninth posterior ribs; Histopathological examination showed fibrous dysplasia, and she was discharged 1 week later, and was in good health during follow up.

Abordagem cirúrgica de odontoma composto em mandíbula

O odontoma é um tumor odontogênico benigno de origem epitelial e mesenquimal, frequentemente associado a dentes inclusos, germes dentários ou dentes supranumerários. A classificação do odontoma é baseada na sua morfologia, podendo ser classificado como composto quando apresenta múltiplos dentículos. O tratamento consiste na exérese cirúrgica do tumor, preservando as unidades dentárias relacionadas. Diante disso, esse estudo tem o objetivo de relatar a abordagem cirúrgica de um odontoma composto por meio de um estudo descritivo, qualitativo, do tipo relato de caso. Paciente sexo feminino, 13 anos de idade, com exame tomográfico evidenciando massa radiopaca contendo estruturas semelhantes à dentes localizadas na região do dente 43. Ao exame físico apresentava discreto aumento de volume na região lingual do 43 provocando apinhamento dental. O tratamento proposto foi enucleação e curetagem sob anestesia local. Paciente retornou ao ambulatório CTBMF após 8 meses com radiografia panorâmica sugerindo neoformação óssea na região do dente 43 e sem sinais clínicos e radiográficos de recidiva da lesão. Dessa forma, os odontomas são tumores geralmente diagnosticados em exames radiográficos de rotina e podem estar associados a retenções e apinhamentos dentários. O tratamento de escolha consiste na excisão cirúrgica por meio da enucleação associada à curetagem, sendo baixo o índice de recidiva.

Simple bone cyst of the hyoid: A radiological diagnosis and follow-up.

Simple bone cyst (SBC), also known as unicameral bone cyst, is a benign, fluid-filled cystic lesion that mainly appears in the long bones of young patients. Simple bone cysts are considered dysplastic or reactive lesions of bone. The most common locations for SBCs are the proximal humerus and femur. Lesions may occasionally be found in the jawbones. Simple bone cysts often have no clinical impact and are usually detected during routine radiographic examinations unless a gross pathologic fracture occurs. When symptoms develop, they may include mild pain, local tenderness and swelling. Computed tomography (CT) scans demonstrate a central, well-defined, mildly expansile or non-expansile, thin-walled lytic lesion, with little or no marginal sclerosis. Magnetic resonance imaging (MRI) usually confirms the cystic nature of the lesion by showing its fluid content. Cystic masses in the hyoid bone are very rare. Here we report an asymptomatic SBC in the hyoid bone, incidentally discovered in a cone-beam computed tomography (CBCT) examination, which appears to be the 2nd reported case.

RADIOGRAPHIC ASPECTS OF COMPOUND ODONTOMA: CLINICAL CASE

Odontomas are the most common types of odontogenic tumors, and are also defined as a malformation of benign development. They are classified into complex and compound according to their histomorphological characteristics. They are usually asymptomatic and diagnosed by routine radiographic examination. A 10-year-old male sought a radiology clinic for imaging to see what was preventing the eruption of dental element 21. Cone beam computed tomography was performed, with 3-D panoramic reconstruction, with several cuts to better evaluate the region; the area of interest was the maxilla. Thus, according to the left-side sections, the presence of a hyperdense image with the formation of grouped denticles was observed, justifying the delay of the eruption of element 21, which was compatible with the diagnosis of compound odontoma. Odontomas are the most common types of odontogenic tumors, and are also defined as a malformation of benign development. They are classified into complex and compound according to their histomorphological characteristics. They are usually asymptomatic and diagnosed by routine radiographic examination. A 10-year-old male sought a radiology clinic for imaging to see what was preventing the eruption of dental element 21. Cone beam computed tomography was performed, with 3-D panoramic reconstruction, with several cuts to better evaluate the region; the area of interest was the maxilla. Thus, according to the left-side sections, the presence of a hyperdense image with the formation of grouped denticles was observed, justifying the delay of the eruption of element 21, which was compatible with the diagnosis of compound odontoma.

PERIAPICAL BONE DYSPLASIA: A CASE REPORT

Periapical bone dysplasia (PBD) is a benign fibro-osseous lesion that involves apex of vital teeth. Single lesions can occur; however, the multiple foci are more common, affecting anterior regions of the mandible. PBD affects more black women, between 30 to 50 years old, and mainly are discovered during radiographic routine examinations because of usual asymptomatic signs. This is a case of a 48-year-old white female patient referred to the dental service for periodontal condition evaluation. Routine periapical radiographic examination observed numerous radiopaque calcified masses involved by radiolucent halo in apical region of teeth 31, 41, and 42. Sensitivity test showed pulp vitality. After clinical and radiographic evaluation, final diagnosis of the PBD was made. Biopsy was not necessary in this case, which is an invasive procedure in the involved areas and can lead to osteomyelitis. This report emphasis the importance of a correct diagnosis of PBD, avoiding unnecessary and incorrect treatments. Periapical bone dysplasia (PBD) is a benign fibro-osseous lesion that involves apex of vital teeth. Single lesions can occur; however, the multiple foci are more common, affecting anterior regions of the mandible. PBD affects more black women, between 30 to 50 years old, and mainly are discovered during radiographic routine examinations because of usual asymptomatic signs. This is a case of a 48-year-old white female patient referred to the dental service for periodontal condition evaluation. Routine periapical radiographic examination observed numerous radiopaque calcified masses involved by radiolucent halo in apical region of teeth 31, 41, and 42. Sensitivity test showed pulp vitality. After clinical and radiographic evaluation, final diagnosis of the PBD was made. Biopsy was not necessary in this case, which is an invasive procedure in the involved areas and can lead to osteomyelitis. This report emphasis the importance of a correct diagnosis of PBD, avoiding unnecessary and incorrect treatments.

CONSERVATIVE SURGICAL TREATMENT OF BILATERAL ODONTOGENIC KERATOCYST OF THE MANDIBLE: CASE REPORT

Odontogenic keratocysts are benign lesions that present aggressive behavior and recurrent potential. This paper reports a case of bilateral odontogenic keratocyst of the mandible. A 32-year-old male patient presented extensive radiolucent images in mandibular branches discovered on routine radiographic examination. Incisional biopsy of the lesions was performed and, at the same time, a decompression device was installed on the right side and the marsupialized left side. The histopathological exams presented diagnoses of odontogenic keratocysts. After 8 months, there was a marked regression of both lesions and a bilateral surgical procedure was performed for cystic enucleation, peripheral ostectomy, and filling of the surgical defect with biomaterial. After 11 months post-surgery, there were no signs of recurrences. The knowledge by dentists about a correct diagnosis and the possible forms of treatment of keratocyst are important, avoiding the lesions growing to large dimensions and, thus, leading the patient to a significant mutilation.

MUCOEPIDERMOID CARCINOMA WITH BONE COMMUNICATION: A CASE REPORT WITH EMPHASIS IN CLINICAL AND HISTOPATHOLOGIC FEATURES

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor; however, the bone communication in this type of pathology is rare. We describe the case of a 32-year-old female patient with an asymptomatic lesion in anterior mandible incidentally discovered in routine radiographic examinations. A well-defined, unilocular radiolucent lesion in the right posterior mandible was found without dental involvement. The clinical diagnosis was odontogenic keratocyst, and incisional biopsy was performed. Microscopic examination revealed a malignant salivary gland tumor, consisting of mucous cells with broad and clear cytoplasm; epidermoid cells with polygonal shape, eosinophilic cytoplasm, and vesicle nuclei; and intermediate cells with scarce cytoplasm and hyperchromatic nucleus. Clinicopathologic characteristics led to the diagnosis of mucoepidermoid carcinoma. The patient was referred to the reference hospital of Rio Grande do Norte, where he underwent resection of the mandible and currently undergoes radiotherapy.

Sucesso no tratamento endodôntico em incisivo lateral superior com reabsorção radicular interna inflamatória não perfurante: relato de caso

As reabsorções dentárias internas são geralmente assintomáticas e quase sempre diagnosticadas em exames radiográficos de rotina. O objetivo deste estudo é apresentar um relato de caso clínico de um dente acometido por reabsorção radicular interna inflamatória não perfurante, com intuito de divulgar informações que sirvam de subsídios para orientar os profissionais frente a esses casos, auxiliando na conduta terapêutica. Paciente do sexo feminino, 53 anos de idade, foi encaminhada ao curso de especialização da Faculdade CIODONTO após realização de um exame radiográfico periapical de rotina, o qual mostrou reabsorção interna não perfurante à nível de terço médio radicular do dente 12. Radiograficamente foi verificado que o contorno dos limites pulpares sofre uma expansão relativamente simétrica de aspecto balonizante, contornos regulares e arredondados. Após a abertura coronária, foi observado sangramento compatível à polpa vital, irrigando-se, inicialmente, com água de Cal. O preparo biomecânico pela técnica coroa-ápice sem pressão foi realizado e como medicação intracanal foi selecionado o Callen por 30 dias e pasta L&C por 90 dias. Após esse período, foi realizada a obturação dos canais radiculares pela técnica termoplástica híbrida de Tagger e cimento endodôntico à base de hidróxido de cálcio. A proservação foi realizada após 1 ano e o sucesso da terapia endodôntica foi constatado. Dessa forma, de acordo com o protocolo indicado na literatura é permitida a resolução clínica efetiva de dentes acometidos por reabsorção interna não perfurante, mostrando-se uma ótima alternativa de tratamento conservador.

An Interdisciplinary Approach for Management of Trauma-induced External Root Resorption: A Case Report with a Two-Year Follow-up

Root resorption is largely pathologic and known to be initiated by several factors, including pulpal necrosis, trauma, periodontal treatment, orthodontic treatment, and bleaching agents. Incorrect diagnosis can lead to improper management and tooth loss. The treatment should involve the complete suppression of all the resorptive factors and the reconstruction of the defect using a suitable restorative material. The resorptive defect is often detected by the routine radiographic examination. A characteristic radiopaque line generally separates the image of the lesion from that of the root canal because the pulp remains protected by a thin layer of predentin until late in the process. Histopathologically, the lesions contain fibrovascular tissue with resorbing clastic cells adjacent to the dentin surface. Advanced lesions may also display fibro-osseous characteristics with deposition of ectopic bone-like calcifications. This case report presents extensive root resorption in the maxillary left lateral incisor and left canine in a 35-year-old patient. The defect was identified during the routine radiographic examination. The patient revealed a history of trauma 15 years back. Following the examination, the teeth were found to be vital and associated with the moderately deep periodontal pocket in the interdental region. The teeth were managed endodontically, and the resorption defect was restored with a biocompatible material after surgically elevating a flap. Periodontal management was also performed simultaneously by the surgical debridement of the area. Six-month postoperative radiograph revealed an arrest of the resorption and healing of the periodontal defect. Hence, an interdisciplinary management involving endodontic as well as periodontal treatment was performed that helped in saving the teeth with poor prognosis.

Incidental findings of posterior arch defects of the atlas in orthodontic patients: A case series

Congenital defects of the posterior arch of atlas are uncommon anomalies that may go unnoticed. Radiographs and cone-beam computed tomography scans made for orthodontic purposes often show the atlas; therefore, these rare defects might first be noted as incidental findings on orthodontic records. A series of 7 cases of posterior arch defects of atlas (C1) that were detected during routine radiographic examination are presented here. The distribution of the defects was as follows: type A, 2; type B, 1; type C, none; type D, 1; and type E, 3. As the potential complications associated with these defects may be quite concerning, a thorough analysis of the radiographs for these defects is imperative.

Experiences of radiographers working alone in remote locations: A Far North Queensland non-participant observational study

IntroductionRadiographers employed in remote locations such as Far North Queensland (FNQ) can face unique sets of challenges as they often perform radiographic and sonographic diagnostic imaging without onsite radiologists' services. Additionally, the majority of patients presenting to these sites are Indigenous for whom English may be their third language. This non-participant observational study observed two FNQ radiographers' interactions with patients and interprofessional staff, and the radiographers' ability to fit into the Indigenous community during routine radiographic and sonographic examinations which to date have received little attention. MethodsNon-participant observations and semi-structured interviews with radiographers were held at two FNQ hospitals. Consecutive radiographer–patient interactions were observed and recorded on checklists. Interviews were audio recorded and transcribed for thematic analysis. ResultsAcross both remote sites, 24 patients were observed as they underwent diagnostic imaging examinations, with the majority being Aboriginal or Torres Strait Islanders (n = 17/24 (70.8%). In total, eleven general radiography and sixteen ultrasound examinations were observed. Semi-structured interviews highlighted complex issues such as the need for radiographer communication in local dialect, ongoing interprofessional collaborations, overcoming the lack of radiologists' onsite support by providing radiographic reports directly to referring doctors and midwives, and isolation with regard to professional development opportunities. ConclusionsRadiographers working in remote hospitals need to be culturally competent, navigate local indigenous languages and possess excellent interprofessional skills as well as thorough knowledge of imaging pathology to convey findings to referring doctors and allied health professionals. These findings have implications for the entry to practice curriculum. Implications for practiceThis study provides evidence that culturally competent radiographers are capable of undertaking reporting roles to facilitate patient management in the absence of timely radiologists' reports at remote sites.

Erupted Compound Odontoma Associated with Missing Tooth: A Rare Case Report

Odontomas are one of the most frequently found odontogenic tumors that consist of dental tissues. Odontomas have been classified into two types: compound and complex odontomas. They are usually discovered on routine radiographic examination. In rare cases, the odontoma erupt into the oral cavity, called an erupted odontoma. The first case was published in 1980, and since then, there have been not more than 50 cases being reported in the literature. Most of the reported cases are erupted complex odontoma. This case report represents a rare case of an erupted compound odontoma in a young patient who came with the complaint of esthetics in the lower left posterior teeth.

Enucleation after Marsupialization: A case report of Globulomaxillary Cyst

Globulomaxillary cyst found in between the roots of lateral incisor and canine of maxilla and is a non-odontogenic developmental origin. It is usually diagnosed by routine radiographic examination and it is inverted peer shaped radiolucent lesion. Adjacent teeth remain vital. Complete enucleation or marsupialization is a treatment option for this. This case report is to observe the expected results after marsupialization followed by enucleation. An eighteen years old boy noticed a painless swelling for 1 year at the left side of upper lip and we performed surgery enucleation after doing marsupialization. Here, marsupialization done to promote bone regeneration and to avoid injury to vital structures and possible fracture. Patient was followed for 3 months after enucleation and the radiolucent area was gradually reduced.This article reports the management of a globulomaxillary cyst in at two-stage procedure and it was more conservative. It might be a good treatment option for management of globulomaxillary cyst.
 Update Dent. Coll. j: 2020; 10 (1): 25-27

A Bizarre Presentation of Bilateral Mandibular Osteoporotic Bone Marrow Defect (A Case Report)

BACKGROUND: Osteoporotic bone marrow defect of the jaw is an uncommon localized radiolucency that consists of hematopoietic red marrow with varying amounts of fatty yellow marrow. The lesion is usually asymptomatic and accidentally discovered during a routine radiographic examination; however, some studies showed different results.
 CASE REPORT: This is an uncommon case of bilateral mandibular osteoporotic bone marrow defect in a 40-year- old healthy female. One of the defects reoccurred, and it involves dental implants. 
 PLAN OF TREATMENT: Lesion was managed by curettage and the patient was followed up after 1,6,12 months.
 CONCLUSIONS: in order to diagnose FOBMD and differentiate it from other lesions, further researches are needed to help fully understand it, since the exact incident and etiology are not established yet.

Evaluation of patient radiation dose in routine radiographic examinations in Saudi Arabia

The aim of the study was to evaluate the radiation entrance skin dose (ESD) in most radiographic X-ray examinations in Taif City, Saudi Arabia. The study was carried out in 3 different hospitals in Taif City. These hospitals are indicated in this study as I, II, and III. In total, 221 images were acquired at the aforementioned hospitals by using two different techniques of dose assessment, DosCal software and the routine thermo-luminescence (TL) method. A data collection sheet was designed to record technical factors (kVp and mAs) and patient bio-data. The average of ESD for all examinations was 1.67 mGy for both methods, while the average tube voltage was 64.6 kVp. Additionally, the highest ESDs were associated with the examination of the lumbosacral and pelvis to be 7.4 and 6.3 mGy, respectively. The two methods of dose assessment were compared and a correlation coefficient of R2 = 0.93 was found. Although this study concluded that, the ESDs obtained in all examinations were lower than those mentioned in the previous studies, more studies in radiation dose field are required to establish a local diagnostic reference level.

Extra-buccal surgical access for canine removal included in mandibular symphysis: case report

ABSTRACT Included teeth are all the dental elements that arrive the normal time of its eruption, remains immersed within the tissues. Usually found when missing a tooth, or on routine radiographic examinations. In the presence of included teeth, it is necessary to define the best treatment approach, whether it is surgical, through exodontia, or by orthodontic tracings. Inclusive canines, in the symphysis region and near the base of the mandible, are rare and make the use of orthodontic traction techniques contraindicated. Presence of teeth in the intraosseous ectopic position can cause injuries, such as alveolodentary ankylosis, calcium metamorphosis of the pulp and aseptic pulp necrosis, among others. Anamnesis, physical examination (intra- and extraoral) and radiographic examinations such as panoramic, periapical, computed tomography, and occlusal radiographs should be performed to make the diagnosis adequate. In general, the success of the treatment depends on the age of the patient and the position of the canines at the time of the surgical procedure. The objective of this work is the extraction of a lower canine with extra-oral access in an outpatient clinical setting under local anesthesia.