Brown tumor is usually diagnosed at the terminal stage of hyperparathyroidism. Diagnosis of this tumor is confirmed by endocrinologic investigations along with clinical and radiographic examination. Radiographical differential diagnosis of this tumor includes central giant cell granuloma, aneurysmal bone cyst, metastatic tumor, multiple myeloma, and Paget disease. This report presents a rare case of multiple brown tumors occurring at the maxilla and mandible, which was initially misdiagnosed as central giant cell granuloma. Plain radiographs demonstrated multiple well-defined multilocular radiolucency. CT images showed soft tissue mass with low attenuated lesions, perforation of the lingual cortical plate, and a heterogeneous mass at the right thyroid lobe. These findings were consistent with parathyroid adenoma. The patient had hypercalcemia, hypophosphatemia, and elevated alkaline phosphatase level. Surgical excision of the tumor was performed. No recurrence was observed during a 28-month follow-up.
Alkaline Phosphatase ; Aneurysm ; Bone Cysts ; Diagnosis, Differential ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Hypophosphatemia ; Jaw ; Mandible ; Maxilla ; Multiple Myeloma ; Osteitis Fibrosa Cystica ; Parathyroid Neoplasms ; Recurrence ; Thyroid Gland

PURPOSE: This study was to investigate whether cervical vertebrae can be utilized in evaluating the growth of the maxilla. MATERIALS AND METHODS: Fifty one male patients took lateral cephalometric radiographs once in every two years from the age of 8 till 14. Measured parameters were the concavity depth at the lower border of the third and fourth cervical vertebrae, and three analytical maxillary dimensions. RESULTS: The analysis of the maxillary measurements and the concavity depth at the lower border of the cervical vertebrae in the lateral cephalometric radiographs showed that the measured parameters gradually increased as the patients aged. Moreover, while the parameters of the patients in age 8 and 10 did not show any correlation, those of the patients in age 12 and 14 definitely showed the correlations. CONCLUSION: Although certain correlations were seen in particular parameters, further researches and studies with various parameters and shorter age intervals are needed. The result of this study will help clinicians in making plans and evaluating the proposed treatment plans.
Aged ; Cervical Vertebrae ; Female ; Humans ; Male ; Maxilla

PURPOSE: This study was performed to evaluate the diagnostic ability of ultrasonography in detection of bone defects and new bone formation. MATERIALS AND METHODS: Experimental bony defects were prepared on the parietal bone samples acquired from 3.5 kg New Zealand male rabbits. The defects were evaluated using ultrasonography and CBCT, and examined histologically at interval of 1, 3, 6, and 8 weeks. RESULTS: Ultrasonograph demonstrated hyperechogenicity in the defect area at 3 weeks and broadened hyperechogenicity from the margin of bone defect at 6 and 8 weeks due to new bone formation. On the CBCT images, new bone formation was first observed at 3 weeks around the margin of the defect, and showed gradually increase at 6 and 8 weeks. Histologic findings revealed existence of the fibroblasts and fibrous connective tissue with abundant capillary vessels only at 1 week, but osteoid tissue and newly formed trabecular bone at 3 weeks. Bone remodeling in the defect area was observed at 6 weeks and increased calcification and dense trabecular bone formation was observed at 8 weeks. CONCLUSION: Ultrasonograph proved to be a very useful diagnostic tool in detecting the bony defect and new bone formation. Additionally, ultrasonography provided valuable information regarding the blood supply around the defect area.
Bone Remodeling ; Capillaries ; Cone-Beam Computed Tomography ; Connective Tissue ; Fibroblasts ; Humans ; Male ; New Zealand ; Osteogenesis ; Parietal Bone ; Rabbits

PURPOSE: The aim of this study was to investigate the timing and sequence of eruption of permanent canine and premolars, and to evaluate tooth calcification stage on emergence in Korean children. MATERIALS AND METHODS: The sample was comprised of 1,266 children (male 720, female 546) aged from 7-13 years. Tooth eruption and calcification stages were determined through oral and panoramic radiographic examination, respectively. Probit analysis was used to calculate the timing of tooth eruption and tooth calcification stage from these cross-sectional data. RESULTS: In both males and females, eruption occurred around the time when one third of tooth root or more was formed. The sequence was as follows: first premolar, canine, and second premolar in maxilla, and canine, first premolar and second premolar in mandible. Tooth eruption occurred earlier in girls compared with boys, averaging 0.63 years. CONCLUSION: Eruption sequence is identical in males and females with a trend for females to erupt earlier than males. Tooth eruption becomes earlier over the past decades in Korean children.
Aged ; Bicuspid ; Child ; Dentition, Permanent ; Female ; Humans ; Male ; Mandible ; Maxilla ; Tooth ; Tooth Calcification ; Tooth Eruption ; Tooth Root

PURPOSE: To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. MATERIALS AND METHODS: A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and CO2 laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. RESULTS: Statistically significant differences in the fractal dimensions between the group 1 (0.9340+/-0.0126) and group 3 (0.9783+/-0.0118) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8 (0.9395+/-0.0283) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. CONCLUSION: Treatment of experimental peri-implantitis by using CO2 laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.
Animals ; Bone Regeneration ; Chlorhexidine ; Collagen ; Debridement ; Dental Implants ; Dogs ; Fractals ; Infection Control, Dental ; Lasers, Gas ; Membranes ; Osteogenesis ; Peri-Implantitis ; Skeleton ; Transplants

PURPOSE: The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. RESULTS: DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CONCLUSION: CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.
Cone-Beam Computed Tomography ; Crowns ; Dentigerous Cyst ; Displacement (Psychology) ; Mandible ; Maxilla ; Odontogenic Cysts ; Retrospective Studies ; Root Resorption ; Tooth ; Tooth, Unerupted

PURPOSE: This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. MATERIALS AND METHODS: Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. RESULTS: The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. CONCLUSION: Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.
Cone-Beam Computed Tomography ; Dentigerous Cyst ; Diastema ; Displacement (Psychology) ; Incisor ; Sex Ratio ; Tooth ; Tooth, Supernumerary

PURPOSE: This study was performed to examine the effects of image filter on observer performance by counting the number of holes at each wedge step on a radiographic image. MATERIALS AND METHODS: An aluminum step wedge with 11 steps ranged in thickness from 1.5 mm to 16.5 mm in 1.5 mm increments was fabricated for this study. Each step had 10 notched holes with 1.0 mm diameter on the bottom of the step wedge which were ranged in depths from 0.1 mm to 1.0 mm in 0.1 mm increments. Digital radiographic raw images of the aluminum step wedge were acquired by using CCD intraoral sensor. The images were processed using several types of noise reduction filters and kernel sizes. Three observers counted the number of holes which could be discriminated on each step. The data were analyzed by ANOVA. RESULTS: The number of holes at each step was decreased as the thickness of step was increased. The number of holes at each step on the raw images was significantly higher than that on the processed images. The number of holes was different according to the types and kernel sizes of the image filters. CONCLUSION: The types and kernel sizes of image filters on observer performance were important, therefore, they should be standardized for commercial digital imaging systems.
Aluminum ; Noise ; Radiographic Image Enhancement ; Radiography, Dental ; Task Performance and Analysis

Odontogenic keratocyst (OKC) with secondary inflammation involving the maxillary sinus was presented. Radiological diagnosis of this case was made based on the various findings from the cone-beam computed tomography, computed tomography and magnetic resonance images. There were calcified materials and impacted tooth within the lumen of the lesion, which is not uncommon in OKC. Histopathologic findings confirmed this lesion as OKC with secondary inflammation.
Calcinosis ; Cone-Beam Computed Tomography ; Diagnostic Imaging ; Inflammation ; Magnetic Resonance Spectroscopy ; Maxilla ; Maxillary Sinus ; Odontogenic Cysts ; Tooth, Impacted

This report was to show the radiographic appearances of the fungus ball in a paranasal sinus and to emphasize the scan area of cone beam computed tomography (CBCT) to detect the calcification in the paranasal sinus. A seventy-four-year-old woman visited our department for the implant rehabilitation at both maxillary posterior edentulous region. Pre-operative radiographic examinations including the panoramic, CBCT, and multidector CT images were taken. An opacification in the right maxillary sinus was observed on the multiplanar image of CBCT, however the pre-determined scan area of CBCT in this report hardly showed the calcifications at the central portion of the maxillary sinus. The opacification in the maxillary sinus could be misdiagnosed as chronic maxillary sinusitis if the calcification of fungus ball was not simultaneously detected. The scan area of pre-operative CBCT needs to be enough to scan the paranasal sinus from top to bottom.
Cone-Beam Computed Tomography ; Dental Implants ; Female ; Fungi ; Humans ; Incidental Findings ; Maxillary Sinus ; Maxillary Sinusitis