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

Impaction of tooth is a situation in which an unerupted tooth is wedged against another tooth or teeth or otherwise located so that it cannot erupt normally. The supernumerary tooth is also called as hyperdontia and defined as the condition of having additional tooth to the regular number of teeth. The most common supernumerary tooth is a mesiodens, which is a mal-formed, peg-like tooth that occurs between the maxillary incisors. The supernumerary tooth is commonly impacted but they are frequently impacted on maxilla. Ectopic impaction of supernumerary tooth on mandibular condyle, coronoid process, ascending ramus, and pterygomandibular space is very rare condition. In this case, we report a case of impacted supernumerary tooth on mandibular sigmoid notch without definite pathologic change.
Colon, Sigmoid ; Incisor ; Mandibular Condyle ; Maxilla ; Tooth ; Tooth, Supernumerary ; Tooth, Unerupted

PURPOSE: This study was to determine the relationship between age and the mandibular cortical bone thickness on panoramic radiograph. MATERIALS AND METHODS: Panoramic radiographs of 360 patients (180 men and 180 women) over 20 years old, who visited the Chonbuk National University Hospital from January to December in 2007, were assessed. The subjects were divided into 5 age groups. Five indices such as cortical bone thickness at the gonion (GI), antegonion (AI), and below the mental foramen (MI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) were measured on panoramic radiographs. RESULTS: All five indices including GI, AI, MI, PMI, and MCI showed significant differences between third decade and over 8 decade groups (p<0.05). PMI, MI and GI showed significant differences with gender statistically (p<0.05). CONCLUSION: The mandibular cortical bone thickness showed negative correlation with age, and the value of the thickness (PMI, MI, and GI) was greater in men than in women.
Bone Density ; Female ; Humans ; Male ; Mandible ; Radiography, Panoramic

PURPOSE: This study is aimed to evaluate the position of mandibular foramen of mandibula prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. MATERIALS AND METHODS: The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. RESULTS: The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. CONCLUSION: The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.
Anesthesia ; Dental Occlusion ; Humans ; Malocclusion ; Mandible ; Mandibular Nerve ; Orthognathic Surgery ; Osteotomy ; Prognathism ; Tomography, X-Ray Computed

PURPOSE: The research was performed to predict the three dimensional relationship between the impacted mesiodens and the maxillary central incisors and the proximity with the anatomic structures by comparing their panoramic images with the CT images. MATERIALS AND METHODS: Among the patients visiting Seoul National University Dental Hospital from April 2003 to July 2007, those with mesiodens were selected (154 mesiodens of 120 patients). The numbers, shapes, orientation and positional relationship of mesiodens with maxillary central incisors were investigated in the panoramic images. The proximity with the anatomical structures and complications were investigated in the CT images as well. RESULTS: The sex ratio (M : F) was 2.28 : 1 and the mean number of mesiodens per one patient was 1.28. Conical shape was 84.4% and inverted orientation was 51.9%. There were more cases of anatomical structures encroachment, especially on the nasal floor and nasopalatine duct, when the mesiodens was not superimposed with the central incisor. There were, however, many cases of the nasopalatine duct encroachment when the mesiodens was superimpoised with the apical 1/3 of central incisor (52.6%). Delayed eruption (55.6%), crown rotation (66.7%) and crown resorption (100%) were observed when the mesiodens was superimposed with the crown of the central incisor. CONCLUSION: It is possible to predict three dimensional relationship between the impacted mesiodens and the maxillary central incisors in the panoramic images, but more details should be confirmed by the CT images when necessary.
Crowns ; Diagnostic Imaging ; Floors and Floorcoverings ; Humans ; Incisor ; Orientation ; Sex Ratio ; Tooth, Impacted

PURPOSE: To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. MATERIALS AND METHODS: Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, rho (g/cm3), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. RESULTS: CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were rho=0.001H+1.07 with R2 value of 0.999 for Somatom Emotion, rho=0.002H+1.09 with R2 value of 0.991 for Alphard VEGA, rho=0.001H+1.43 with R2 value of 0.980 for i-CAT and rho=0.001H+1.30 with R2 value of 0.975 for Implagraphy. CONCLUSION: CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.
Cone-Beam Computed Tomography ; Linear Models ; Nylons ; Plastics ; Polystyrenes ; Tomography, X-Ray Computed ; Water

PURPOSE: To investigate and compare the prevalence, size, and location of maxillary sinus septa on panoramic and cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: Two hundred patients who had taken both panoramic and CBCT images were included. The location of maxillary sinus septa on the panoramic radiographs were recorded and confirmed on the CBCT images. Also the size of septa was measured on the reformatted CBCT images. RESULTS: The prevalence of the patients who had maxillary sinus septa was 51.0% and they showed 179 septa totally. Among them 51.0% of the patients had one septum, 32.4% two septa, 13.7% three, and 2.9% four. The measured heights of the septa were 4.37+/-2.87 mm, 3.51+/-2.47 mm, and 3.04+/-2.37 mm in the medial, middle, and lateral areas, respectively. It was revealed that 1.0% was located at canine region, 18.0% at first premolar, 25.0% at second premolar, 22.7% at first molar, 19.8% at second molar, and 14.0% at third molar region. Among 213 septa depicted by the panoramic radiographs, only 69.0% were confirmed at the CBCT images. CONCLUSION: Since various heights and courses of the septa can develop in all parts of the maxillary sinus, adequate assessment of the inner aspect of the maxillary sinus is essential to avoid complications during sinus augmentation procedures. CBCT scanning is the preferred radiographic method for detecting the presence of sinus septa.
Bicuspid ; Cone-Beam Computed Tomography ; Humans ; Maxillary Sinus ; Molar ; Molar, Third ; Prevalence ; Radiography, Panoramic

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