PURPOSE: To assess the relationship between soft tissue asymmetry and bone tissue asymmetry using the standardized photographs and the posteroanterior (PA) cephalometric radiographs in mandibular asymmetric patients. And to clarify that the lack of morphologic balance among different skeletal components can often be masked by compensatory soft tissue contributions. METHODS: Experimental group consisted of 58 patients whose chief complaints were facial asymmetry, they were taken with standardized facial photographs and PA cephalometric radiographs. Control group consisted of 30 persons in the normal occlusion. The reproducibility of the facial photograph was confirmed by model test. The differences of fractional vertical height and horizontal width from standardized facial photographs and PA cephalometric radiographs were compared and analyzed. RESULTS: The difference of fractional vertical bone height was 0.63 and fractional vertical soft height was 0.58 in control group, 3.10 and 2.01 in asymmetric group, respectively. The difference of fractional horizontal bone width was 0.52 and fractional horizontal soft width was 0.70 in control group, 2.51 and 1.70 in asymmetric group, respectively. Both soft and bone tissue showed significant difference between control and asymmetric group (p<0.05). The difference of bone tissue was greater than that of soft tissue (p<0.05) in the experimental group but, not in control group. CONCLUSIONS: Soft tissue components may compensate for underlying skeletal imbalances.
Bone and Bones ; Cephalometry ; Facial Asymmetry ; Humans ; Mandible ; Masks ; Radiography

PURPOSE: We evaluated the fractal dimension changes on bovine rib radiographs according to the decalcification degree and the exposure time in the bovine rib. MATERIALS AND METHODS: Twenty 5 mm thick cross-sectional blocks from bovine rib bone were progressively decalcified in 30 mL 0.1 N hydrochloric acid for 5, 30, and 90 minutes. They were radiographed at three exposure time settings (0.22, 0.36, 0.43 mAs) before and after each decalcification stage. We selected 100 x 100 pixel-sized regions of interests (ROIs) on trabecular bone and calculated fractal dimensions by box-counting method. RESULTS: Repeated measures ANOVA showed that fractal dimensions gradually decreased after acid-induced demineralization and with more exposure (P<0.001). CONCLUSION: The fact that fractal dimensions decrease after decalcification might support the hypothesis that patients with osteoporosis have decreased radiographic fractal dimension in trabecular bone in comparison to normal subjects.
Bone and Bones ; Fractals* ; Humans ; Hydrochloric Acid ; Osteoporosis ; Radiography ; Ribs*

OBJECTIVEIn order to get three dimensional measurements simply an plain X-ray photographs.

METHODSThe multi-layers of bone pieces were made by use of bone saw, and piled up to spiral ladder, which was used as a calibrating module for to living bone in clinics. The relationship between the cortical thickness and gray level of the X-ray photographs was obtained.

RESULTSThe correlation can be described with a cubic regression curve, and it can be simplified to a linear regression equation when cortical thickness is small than 3.8 mm.

CONCLUSIONIt can be realized to get three dimensional measures of the bone on plain X-ray photographs, by use of the bony spiral ladder described here.

Fibrocartilaginous dysplasia (FCD) has occasionally led to a misdiagnosis and wrong decision which can significantly alter the outcome of the patients. A 9-yr-old boy presented with pain on his left distal thigh for 6 months without any trauma history. Initial radiographs showed moth eaten both osteolytic and osteosclerotic lesions and biopsy findings showed that the lesion revealed many irregular shaped and sclerotic mature and immature bony trabeculae. Initial diagnostic suggestions were varied from the conventional osteosarcoma to low grade central osteosarcoma or benign intramedullary bone forming lesion, but close observation was done. This study demonstrated a case of unusual fibrocartilaginous intramedullary bone forming tumor mimicking osteosarcoma, so that possible misdiagnosis might be made and unnecessary extensive surgical treatment could be performed. In conclusion, the role of orthopaedic oncologist as a decision maker is very important when the diagnosis is uncertain.
Bone and Bones/*radiography ; Child ; Diagnosis, Differential ; Femur/radiography ; Fibrocartilage/*radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Osteosarcoma/diagnosis/radiography

Digital substraction technique and computer-assisted densitometirc analysis detect minor change in bone density and thus increase the diagnostic accuracy. This advantage as well as high sensitivity and objectivity which precludes human bias have drawn interest in radiologic research area. The objectives of this study are to verify if Radiographic density can be recognized in linear pattern when density profile of standard periapical radiograph with the aluminium stepwedge as the reference, was investigated under varies circumstances which can be encountered in clinical situations, and in addition to that to obtain mutual relationship between the existing standard radiographic system, and future digital image systems, by confirming the corelationship between the standard radiograph and Digora system which is a digital image system currently being used. In order to make quantitative analysis of the bone tissue, digital image system which uses high resolution automatic slide scanner as an input device, and Digora system were compared and analyzed using multifunctional program, Brain3dsp. The following conclusions were obtained. 1. Under common clinical situation that is 70kVp, 0.2 sec., and focal distance 10cm, Al-Equivalent image equation was found to be Y=11.21X+46.62 r(2)=0.9898 in standard radiographic system, and Y=12.68X+74.59, r(2)=0.9528 in Digora system, and linear relation was confirmed in both the systems. 2. In standard radiographic system, when all conditions were maintained the same except for the condition of developing solution, Al-Equivalent image equation was Y=10.07X+41.64, r(2)=0.9861 which shows high corelationship. 3. When all conditions were maintained the same except for the Kilovoltage peak, linear relationship was still maintained under 60kVp, and Al-Equivalent image equation was Y=14.60X+68.86, r(2)=0.9886 in the standard radiograhic system, and Y=13.90X+80.68, r(2)=0.9238 in Digora system. 4. When all conditions were maintained the same except for the exposure time which was varied from 0.01 sec. to 0.8 sec., Al-Equivalent image equation was found to be linear in both the standard radiographic system and Digora system. The R-square was distributed from 0.9188 to 0.9900, and in general, standard radiographic system showed higher R-square than Digora system. 5. When all conditions were maintained the same except for the focal distance which was varied from 5cm to 30cm, Al-Equivalent image equation was found to be linear in both the standard radiographic system and Digora system. The R-square was distributed from 0.9463 to 0.9925, and the standard radiographic system had the tendency to show higher R-square in shorter focal distances.
Bias (Epidemiology) ; Bone and Bones ; Bone Density ; Humans ; Radiography, Dental, Digital ; X-Ray Film*

OBJECTIVETo evaluate the value of cone beam CT (CBCT) in the treatment of jaw bone cyst.

METHODSTwenty-five patients with jaw bone cyst were included, which were examined by CBCT as an addition of panoramic radiography. Through CBCT, the information about the three-dimensional location, the bone wall of cyst and the relationship between cyst, teeth and some other important anatomical structures were studied, surgical preparations and treatments followed accordingly.

RESULTSThe CBCT images clearly demonstrated detailed information about the cyst, which was verified in the operation and helpful to the surgical preparation and treatment.

CONCLUSIONCBCT is more advantageous in the diagnosis and treatment of the jaw bone cyst than traditional panoramic radiography and periapical film.

OBJECTIVETo compare the mandibular indices differences between periodontitis and non-periodontitis subjects by digital panoramic tomograms in order to find a simple and effective method to evaluate the density of alveolar bone and study the relativity between local bone loss and systemic bone loss.

METHODSStandard digital panoramic tomograms of sixty periodontitis subjects and sixty non-periodontitis subjects were taken. Density and height cortical width (CW) and panoramic mandibular index (PMI) of alveolar bone were measured on the digital panoramic tomograms. SPSS 12.0 was used for statistics analyses.

RESULTSThe periodontitis subjects had lower height of alveolar bone (8.76 mm vs. 11.85 mm, P=0.000), lower density of alveolar bone (106.08 vs. 113.33, P=0.034), thinner cortical width (3.80 mm vs. 4.27 mm, P=0.008), while the difference of PMI between the two groups was not significant (P>0.05). The relativity between both density and height of alveolar bone with CW was significant (P<0.05), but not significant with PMI (P>0.05).

CONCLUSIONThe optical method is a simple and effective method to measure the density of the alveolar bone. Compared with the non-periodontitis subjects, the periodontitis subjects not only have alveolar bone changed significantly but also have thinner cortical width.

OBJECTIVE: To report and assess the usefulness of ultrasound (US) findings for occult fractures of growing bones. MATERIALS AND METHODS: For six years, US scans were performed in children younger than 15 years who were referred with trauma-related local pain and swelling of the extremities. As a routine US examination, the soft tissue, bones, and adjacent joints were examined in the area of discomfort, in addition to the asymptomatic contralateral extremity for comparison. Twenty-five occult fractures in 25 children (age range, five months-15 years; average age, 7.7 years) were confirmed by initial and follow-up radiograms, additional imaging studies, and clinical observation longer than three weeks. RESULTS: The most common site of occult fractures was the elbow (n = 9, 36%), followed by the knee (n = 7, 28%), ischium (n = 4, 16%), distal fibula (n = 3, 12%), proximal femur (n = 1, 4%), and humeral shaft (n = 1, 4%). On the retrograde review of the routine radiographs, 13 out of the 25 cases showed no bone abnormalities except for various soft tissue swelling. For the US findings, cortical discontinuity (direct sign of a fracture) was clearly visualized in 23 cases (92%) and was questionable in two (8%). As auxiliary US findings (indirect signs of a fracture), step-off deformities, tiny avulsed bone fragments, double-line appearance of cortical margins, and diffuse irregularity of the bone surfaces were identified. CONCLUSION: Performing US for soft tissue and bone surfaces with pain and swelling, with or without trauma history in the extremities, is important for diagnosing occult or missed fractures of immature bones in pediatric-aged children.
Adolescent ; Arm Bones/injuries/radiography/*ultrasonography ; Child ; Child, Preschool ; Female ; Fractures, Bone/radiography/therapy/*ultrasonography ; Humans ; Infant ; Leg Bones/injuries/radiography/*ultrasonography ; Male

The incidence of facial bone fracture in children is relatively uncommon compared with that in adults. Nasal bone fracture in children may cause cosmetic or functional disabilities, so the patients should be properly treated. The diagnosis of nasal bone fracture in children is difficult because the pediatric patient does not permit the most gentle examination and x-ray examination. Failure to confirm a suspected fracture on radiography should not always deter treatment. Clinical judgment should overrule other consideration. The advent of computerized tomographic (CT) scanning has improved the radiologic diagnosis of facial fractures. But the facial bone CT is unable to image the nasal structures in detail. So the authors have performed thin section computed tomography in such children, and compares the accuracy of child`s nasal bone fractures of thin section CT scan with traditional CT scan.
Adult ; Child ; Diagnosis ; Facial Bones ; Humans ; Incidence ; Judgment ; Nasal Bone* ; Radiography ; Tomography, X-Ray Computed

Fractures, Bone ; diagnosis ; diagnostic imaging ; surgery ; therapy ; Humans ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography