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Squamous cell carcinoma arising within a maxillary odontogenic keratocyst: A rare occurrence.

Elnaz JALALI ; Elie M FERNEINI ; Kandasamy RENGASAMY ; Aditya TADINADA

Imaging Science in Dentistry.2017;47(2):135-140. doi:10.5624/isd.2017.47.2.135

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.
Biopsy ; Carcinoma, Squamous Cell* ; Cell Transformation, Neoplastic ; Epithelial Cells* ; Humans ; Maxilla ; Odontogenic Cysts*

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Dentinogenesis imperfecta type II: A case report with 17 years of follow-up.

Francisco José Reis GAMA ; Isabella Sousa CORRÊA ; Claudia Scigliano VALERIO ; Emanuelle de Fátima FERREIRA ; Flávio Ricardo MANZI

Imaging Science in Dentistry.2017;47(2):129-133. doi:10.5624/isd.2017.47.2.129

Dentinogenesis imperfecta is a dominant autosomal hereditary disorder of dentin formation that affects the deciduous and permanent teeth. Its etiology is characterized by inadequate cell differentiation during odontogenesis. The clinical characteristics of dentinogenesis imperfecta are discolored teeth with a translucency that varies from gray to brown or amber. Radiographically, the teeth exhibit pulp obliteration, thin and short roots, bell-shaped crowns, and periapical bone rarefaction. The aim of this report was to present a case of dentinogenesis imperfecta type II that was followed up over a 17-year period. This report also presents scanning electron microscopy images of the enamel and dentin, showing that both were altered in the affected teeth. The disease characteristics and the treatments that were administered are reported in this study to guide dentists with respect to the need for early diagnosis and adequate follow-up to avoid major sequelae.
Amber ; Cell Differentiation ; Crowns ; Dental Enamel ; Dentin ; Dentinogenesis Imperfecta* ; Dentinogenesis* ; Dentists ; Early Diagnosis ; Follow-Up Studies* ; Humans ; Microscopy, Electron, Scanning ; Odontogenesis ; Tooth

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Therapeutic effect of intraductal irrigation of the salivary gland: A technical report.

Chena LEE ; Jo Eun KIM ; Kyoung Hoe HUH ; Won Jin YI ; Min Suk HEO ; Sam Sun LEE ; Soon Chul CHOI

Imaging Science in Dentistry.2017;47(2):123-127. doi:10.5624/isd.2017.47.2.123

PURPOSE: Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. MATERIALS AND METHODS: Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. RESULTS: The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. CONCLUSION: Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.
Humans ; Meals ; Parotid Gland ; Salivary Glands* ; Sialadenitis ; Sialography ; Therapeutic Irrigation

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Comparison of 2 root surface area measurement methods: 3-dimensional laser scanning and cone-beam computed tomography.

Jintana TASANAPANONT ; Janya APISARIYAKUL ; Tanapan WATTANACHAI ; Patiyut SRIWILAS ; Marit MIDTBØ ; Dhirawat JOTIKASTHIRA

Imaging Science in Dentistry.2017;47(2):117-122. doi:10.5624/isd.2017.47.2.117

PURPOSE: The aim of this study was to compare the use of 3-dimensional (3D) laser scanning and cone-beam computed tomography (CBCT) as methods of root surface measurement. MATERIALS AND METHODS: Thirty teeth (15 maxillary first premolars and 15 mandibular first premolars) from 8 patients who required extractions for orthodontic treatment were selected. Before extraction, pre-treatment CBCT images of all the patients were recorded. First, a CBCT image was imported into simulation software (Mimics version 15.01; Materialise, Leuven, Belgium) and the root surface area of each tooth was calculated using 3-Matic (version 7.01, Materialise, Leuven, Belgium). After extraction, all the teeth were scanned and the root surface area of each extracted tooth was calculated. The root surface areas calculated using these 2 measurement methods were analyzed using the paired t-test (P<.05). Correlations between the 2 methods were determined by calculating the Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to assess intraobserver reliability. RESULTS: The root surface area measurements (230.11±41.97 mm²) obtained using CBCT were slightly greater than those (229.31±42.46 mm²) obtained using 3D laser scanning, but not significantly (P=.425). A high Pearson correlation coefficient was found between the CBCT and the 3D laser scanner measurements. The intraobserver ICC was 1.000 for 3D laser scanning and 0.990 for CBCT. CONCLUSION: This study presents a novel CBCT approach for measuring the root surface area; this technique can be used for estimating the root surface area of non-extracted teeth.
Bicuspid ; Cone-Beam Computed Tomography* ; Humans ; Methods* ; Tooth ; Tooth Root

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Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth.

Kıvanç KAMBUROĞLU ; Gül SÖNMEZ ; Zeynep Serap BERKTAŞ ; Hakan KURT ; Doĝukan ÖZEN

Imaging Science in Dentistry.2017;47(2):109-115. doi:10.5624/isd.2017.47.2.109

PURPOSE: The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. MATERIALS AND METHODS: Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a 100×90-mm field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of α=.05. RESULTS: Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant (P>.05). CONCLUSION: Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.
Area Under Curve ; Cone-Beam Computed Tomography* ; Dental Caries ; Dentin ; Diagnosis ; ROC Curve ; Tooth ; Tooth, Deciduous*

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Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint.

Husniye DEMIRTURK KOCASARAC ; Peruze CELENK

Imaging Science in Dentistry.2017;47(2):99-107. doi:10.5624/isd.2017.47.2.99

PURPOSE: Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. MATERIALS AND METHODS: Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. RESULTS: The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. CONCLUSION: The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.
Humans ; Osteoarthritis ; Osteophyte* ; Radiography* ; Radiography, Panoramic ; ROC Curve ; Skull ; Subtraction Technique ; Temporomandibular Joint*

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Dilemma of gonial angle measurement: Panoramic radiograph or lateral cephalogram.

Pillai Devu RADHAKRISHNAN ; Nilambur Kovilakam SAPNA VARMA ; Vallikat Velath AJITH

Imaging Science in Dentistry.2017;47(2):93-97. doi:10.5624/isd.2017.47.2.93

PURPOSE: The purpose of this study was to evaluate the accuracy of panoramic imaging in measuring the right and left gonial angles by comparing the measured angles with the angles determined using a lateral cephalogram of adult patients with class I malocclusion. MATERIALS AND METHODS: The gonial angles of 50 class I malocclusion patients (25 males and 25 females; mean age: 23 years) were measured using both a lateral cephalogram and a panoramic radiograph. In the lateral cephalograms, the gonial angle was measured at the point of intersection of the ramus plane and the mandibular plane. In the panoramic radiographs, the gonial angle was measured by drawing a line tangent to the lower border of the mandible and another line tangent to the distal border of the ascending ramus and the condyle on both sides. The data obtained from both radiographs were statistically compared. RESULTS: No statistically significant difference was observed between the gonial angle measured using the lateral cephalograms and that determined using the panoramic radiographs. Further, there was no statistically significant difference in the measured gonial angle with respect to gender. The results also showed a statistically insignificant difference in the mean of the right and the left gonial angles measured using the panoramic radiographs. CONCLUSION: As the gonial angle measurements using panoramic radiographs and lateral cephalograms showed no statistically significant difference, panoramic radiography can be considered in orthodontics for measuring the gonial angle without any interference due to superimposed images.
Adult ; Female ; Humans ; Male ; Malocclusion ; Mandible ; Orthodontics ; Radiography, Panoramic

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Is the panoramic mandibular index useful for bone quality evaluation?.

Ah Young KWON ; Kyung Hoe HUH ; Won Jin YI ; Sam Sun LEE ; Soon Chul CHOI ; Min Suk HEO

Imaging Science in Dentistry.2017;47(2):87-92. doi:10.5624/isd.2017.47.2.87

PURPOSE: The aim of this study was to determine whether the panoramic mandibular index (PMI) is useful for assessing bone mineral density. We also analyzed the potential correlations between PMI parameters and patient age. MATERIALS AND METHODS: Four observers measured the PMI of both sides of the mental foramen using a picture archiving and communication system and images in the Digital Imaging and Communications in Medicine format. They studied 300 panoramic radiographic images of patients belonging to the following age groups: 40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years. The observers were allowed to zoom in or out and to adjust the contrast of the images. Further, they were instructed to record the reasons for any measurements that could not be made. Then, we conducted a reliability analysis of the measured PMI and assessed the correlations between different patient age groups and the 3 parameters used for determining the PMI from the available data. RESULTS: Among the 600 data items collected, 23 items were considered unmeasurable by at least 1 observer for the following 4 reasons: postoperative state, lesion, unidentified mental foramen, and alveolar bone loss. The intraobserver reproducibility of the measurable data was 0.611-0.752. The mandibular cortical width (MCW) decreased significantly as patient age increased. CONCLUSION: PMI had limited usability when the margin of the mental foramen was not clear. In contrast, MCW, a parameter used for determining the PMI, had fewer drawbacks than the PMI with respect to bone mineral density measurements and exhibited a significant correlation with patient age.
Alveolar Bone Loss ; Bone Density ; Humans ; Mandible ; Radiography

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Application of a newly developed software program for image quality assessment in cone-beam computed tomography.

Marcus Vinicius Linhares DE OLIVEIRA ; António Carvalho SANTOS ; Graciano PAULO ; Paulo Sergio Flores CAMPOS ; Joana SANTOS

Imaging Science in Dentistry.2017;47(2):75-86. doi:10.5624/isd.2017.47.2.75

PURPOSE: The purpose of this study was to apply a newly developed free software program, at low cost and with minimal time, to evaluate the quality of dental and maxillofacial cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: A polymethyl methacrylate (PMMA) phantom, CQP-IFBA, was scanned in 3 CBCT units with 7 protocols. A macro program was developed, using the free software ImageJ, to automatically evaluate the image quality parameters. The image quality evaluation was based on 8 parameters: uniformity, the signal-to-noise ratio (SNR), noise, the contrast-to-noise ratio (CNR), spatial resolution, the artifact index, geometric accuracy, and low-contrast resolution. RESULTS: The image uniformity and noise depended on the protocol that was applied. Regarding the CNR, high-density structures were more sensitive to the effect of scanning parameters. There were no significant differences between SNR and CNR in centered and peripheral objects. The geometric accuracy assessment showed that all the distance measurements were lower than the real values. Low-contrast resolution was influenced by the scanning parameters, and the 1-mm rod present in the phantom was not depicted in any of the 3 CBCT units. Smaller voxel sizes presented higher spatial resolution. There were no significant differences among the protocols regarding artifact presence. CONCLUSION: This software package provided a fast, low-cost, and feasible method for the evaluation of image quality parameters in CBCT.
Artifacts ; Cone-Beam Computed Tomography* ; Methods ; Noise ; Polymethyl Methacrylate ; Quality Control ; Signal-To-Noise Ratio

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Evaluation of the morphology of the canalis sinuosus using cone-beam computed tomography in patients with maxillary impacted canines.

Gokhan GURLER ; Cagri DELILBASI ; Emine Esen OGUT ; Kader AYDIN ; Ufuk SAKUL

Imaging Science in Dentistry.2017;47(2):69-74. doi:10.5624/isd.2017.47.2.69

PURPOSE: The nasopalatine canal is a well-known, important anatomical structure in the anterior maxilla, but this region contains many accessory canals. The canalis sinuosus (CS) is one of these canals; it contains the anterior superior alveolar nerve, along with veins and arteries. The purpose of this study was to evaluate the CS using conebeam computed tomography (CBCT) in patients with maxillary impacted canines. MATERIALS AND METHODS: A total of 111 patients admitted to the Istanbul Medipol University School of Dentistry for the exposure, orthodontic treatment, and/or extraction of an impacted canine were included in this study. CBCT images were obtained for these patients under standard conditions. Axial, coronal, and sagittal sections were evaluated to assess the prevalence of CS, the direction and diameter of the canal, its relation with the impacted canine, and its distance from the alveolar crest. Further, possible correlations with patient gender and age were analyzed. RESULTS: The CS could be detected bilaterally in all the evaluated tomography images. The mean canal diameter was significantly larger in males than in females (P=.001). The CS ran significantly closer to the impacted canine when the canal was located horizontally (P=.03). Variations of the canal, such as accessory canals, were identified in 6 patients. CONCLUSION: CS is an anatomical entity that may resemble periapical lesions and other anatomical structures. Evaluation with CBCT prior to surgical procedures in the anterior maxilla will help to prevent overlooking such anatomical structures and to decrease possible surgical complications.
Arteries ; Cone-Beam Computed Tomography* ; Cuspid ; Dentistry ; Female ; Humans ; Male ; Maxilla ; Maxillary Nerve ; Prevalence ; Tooth, Impacted ; Veins

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