Mandibular bone depression, also known as Stafne bone cavity, is defined as a bone depression filled mainly with salivary gland tissue. Parotid gland bone defects are infrequently observed. We report the case of a 52-year-old male patient who underwent radiographic examinations due to temporomandibular joint dysfunction, and a radiolucent area was detected in the mandibular ramus, with a provisional diagnosis of traumatic bone cyst or parotid mandibular bone defect. The patient was then referred for magnetic resonance imaging, which demonstrated a hyperintense area eroding the mandibular ramus, which corresponded to glandular tissue. Although the defect was a benign lesion, radiolucencies in the mandibular ramus lead to concerns among professionals, because their radiographic features can resemble various intrabony neoplastic lesions, such as giant cell tumors or benign tumors of the parotid gland.
Bone Cysts ; Cytochrome P-450 CYP1A1 ; Depression ; Diagnosis ; Giant Cell Tumors ; Humans ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Parotid Gland ; Radiography, Panoramic ; Salivary Glands ; Temporomandibular Joint

Purpose: This study was performed to assess and describe the imaging features of 40 cases of Stafne bone defects (SBDs) on computed tomographic (CT) examinations. Materials and Methods: This study collected data, including age and sex, from 40 patients with SBDs who underwent CT exams. The imaging features of the SBDs were assessed in terms of their location, average size, the relationship of their contour with the cortical plate of the lingual mandible, bone margins, degree of internal density, shape, topographic relationship between the defect and the mandibular edge, the distance from the SBD to the base of the mandible, and the Ariji classification (type I, II, and III). Results: The average age was 57.3 years (range, 28-78 years), and the patients were predominantly male (70%). In all cases (100%), the posterior unilateral lingual SBD variant was observed. Within the Ariji classification, type I was the most common (60%). Among the most frequently observed radiographic characteristics were thick sclerotic bone margin across the entire defect contour, completely hypointense internal content, an oval shape, and continuity with the mandibular base with discontinuity of the mandibular edge. Conclusion This study showed that posterior SBDs could present with an oval or rounded shape, complete hypodensity, and thick sclerotic margins. Likewise, SBDs could appear almost anywhere, with minor differences from the classic SBD appearance. It is fundamental for dental practitioners to know the imaging features of SBDs, since they are diagnosed primarily based on imaging.

Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to “radiotherapy” and synonyms combined with keywords related to “panoramic radiography” and “oral diagnosis” and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

Purpose: This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles. Materials and Methods: Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient. Results: High intraobserver and interobserver agreement was found (p<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts. Conclusion Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.

Purpose: This study evaluated maxillary sinus volume changes in military jet aircraft pilot candidates before and after the training program, in comparison with a control group, considering the effects of pressurization, altitude, and total flight hours, through multislice computed tomography. Materials and Methods: Fifteen fighter pilots were evaluated before initiating the training program and after the final approval. The control group consisted of 41 young adults who had not flown during their military career. The volumes of each maxillary sinus were measured individually before and at the end of the training program. Results: When comparing the initial and final volumes in the pilots, a statistically significant increase was observed both in the left and right maxillary sinuses. When evaluating the average total volume of the maxillary sinuses (i.e., the average volume of the right and left maxillary sinuses together), a significant increase in the volume of the maxillary sinuses was observed in the pilot group when compared to the control group. Conclusion The maxillary sinus volumes in aircraft pilot candidates increased after the 8-month training program. This may be explained by changes in the gravitational force, the expansion of gas, and positive pressure from oxygen masks. This unprecedented investigation among pilots might lead to other investigations considering paranasal sinus alterations in this singular population.