Israel Kaffe

Radiologic features of central giant cell granuloma of the jaws.

The radiologic features of central giant cell granuloma (CGCG) have not been clearly defined, and conflicting descriptions appear in the literature. This study analyzes the radiologic and clinical features of 80 cases of CGCG. In nearly 50% of the cases the lesion is located in the posterior area of the jaws, that is, the molar, ramus, and tuberosity, and not in the deciduous teeth-bearing area as was accepted in the past. Only 51% of CGCGs are multilocular, and the frequency of these lesions is significantly higher in the mandible than in the maxilla. The correlation between the lesions size and its locularity is statistically significant, and larger lesions assume a multilocular appearance. Only 6% of the lesions crossed the midline of the jaws, a feature that was considered in the past as typical for CGCG.

Roentgenologic study of the mental foramen

Locating the mental foramen in periapical radiographs is of great clinical importance. One thousand full-mouth intraoral radiographs were examined, and the location of the mental foramen in both the horizontal and the vertical planes was registered. In the horizontal plane 70 per cent of the mental foramina were found to be located between the two premolars, and 22 per cent were in the apical area of the premolars. In the vertical plane the highest percentage of mental foramina was found to be located superior to the level of the apices of the premolars.

Anterior loop of the mental canal: an anatomical-radiologic study.

This study sought to characterize the anatomical dimensions of the anterior mental loop and to determine the accuracy of conventional radiographs in identifying its presence and dimensions. The study group consisted of 46 hemimandibles fixed in formalin. Radiographs of the area between the mental foramen and the midline were obtained and evaluated for each hemimandible, followed by dissection and physical examination of the same area. Anatomically, an anterior loop of the mental nerve was observed in only 13 hemimandibles (28%). The anterior extension of the loop ranged from 0.4 to 2.19 mm. No correlation was found between the radiographic image and the anatomical shape of the loop. Of the radiographically diagnosed loops, 40% were not seen in anatomical examination. In cases with a false radiologic loop, a correlation was found between the diameter of the origin of the incisive canal and the radiologic interpretation of the loop. The radiologic appearance or diagnosis of the anterior mental loop in cadaver mandibles does not disclose the true ramification of the inferior alveolar nerve to the mental and incisive nerve.

Anatomic and radiologic course of the mandibular incisive canal.

The purpose of this article was to define the anatomic and radiographic courses of the incisive mandibular canal and discuss its clinical significance. The study group comprised of 46 hemimandibles fixed in formalin. After radiographic examination, the buccal cortical plate of the mandible was removed leaving the bony frame of the incisive bundle intact. The morphology of the bony walls of the canal was evaluated, as having complete, partial, or no cortical walls. The course of the intraosseous pathway of the canal and its diameter in four different locations were recorded. An incisive bundle was anatomically found in all hemimandibles, travelling within a canal with complete (n = 10), partial (n = 27), or no (n = 9) bony cortical borders. The diameter of the canal ranged from 0.48 mm to 2.9 mm. Radiographically, the canal was either well defined (n = 11, 24%), poorly defined (n = 15, 32%), or undetectable (n = 20, 44%). A statistically significant correlation was found between the anatomic structure of the incisive canal bony borders and its radiographic detectability (p = 0.043). No correlation was found between the anatomic and radiological width of the incisive canal diameter. An incisive canal with a large diameter could have an important role in successful osteointegration and prevention of postoperative sensory disturbances. According to the present study, the ability to interpret the incisive canal from conventional radiographs is limited. Therefore, it is recommended to use conventional tomographs or computerised tomographic dental scans for better imaging of the intermental foraminal area.

Comparison of digital with conventional radiography in detection of vertical root fractures in endodontically treated maxillary premolars: an ex vivo study

OBJECTIVE The purpose of the present study was to compare the diagnostic ability of conventional intraoral film radiography and a charged-coupled device (CCD) sensor in detecting vertical root fractures (VRF) in endodontically treated single-rooted extracted human maxillary premolars. STUDY DESIGN The study consisted of 60 extracted single-rooted endodontically treated maxillary premolars: 30 with clinically confirmed VRF (experimental group) and 30 with no VRF (control group). An intraoral CCD sensor and conventional Kodak Insight Film were used. Two observers evaluated the digital and conventional radiographs twice with an interval of 4 weeks. Specificity and sensitivity for each radiographic technique were calculated and subjected to statistical analysis. Kappa values were calculated for intra- and interobserver agreement. Fishers exact test was used to evaluate detection of VRF. The overall differences in sensitivity and specificity between radiographic techniques were evaluated by McNemar test. RESULTS The specificity of the digital system was significantly better (P = .016) for the second observer at the first reading. There were no significant differences in sensitivity and specificity for both observers between the 2 systems for other readings (P > .05). CONCLUSIONS No difference was found between the intraoral CCD sensor and conventional radiography in detecting vertical root fractures for single rooted maxillary premolars ex vivo.

Radiologic features of central odontogenic fibroma

The central odontogenic fibroma is a rare benign neoplasm that is considered to be derived from mesenchymal dental tissue. This study reviews and analyzes the radiologic features of 51 cases (5 new cases and 46 from the literature). Central odontogenic fibroma appears in both the mandible and maxilla (55% and 45%, respectively). In the maxilla it has a tendency to involve the anterior area, whereas in the mandible the molar and premolar areas are the most prevalent sites. The majority of central odontogenic fibromas are unilocular radiolucent lesions with well-defined borders, but they may also appear as multilocular lesions and in rare instances may exhibit a mixed radiolucent/radiopaque appearance with poorly defined or diffused borders. The great variability in radiologic appearance of the central odontogenic fibroma means that it should be considered in the differential diagnosis of all radiolucencies found in the jaws.

Relationship between the apices of the lower molars and mandibular canal—a radiographic study

The study was performed on forty-six randomly chosen dry mandibles. The molar areas of each mandible were radiographed by the paralleling technique, and an additional radiograph at -20 degrees angulation of the same area was taken. Measurements of the distance between the upper border of the mandibular canal and the root apices of the first and second molars were taken. The location of the mandibular canal in the buccolingual plane was determined. The obtained data were statistically evaluated. Statistically significant symmetry of the relationship of the mandibular canal to the root apices was established between the right and left sides of the same mandible. In the majority of cases the mandibular canal was buccal to the apices of the second molar, and in the first molar area the canal was lingual to the root apices in almost half of the cases. Most frequently, the upper border of the mandibular canal was located 3.5 to 5.4 mm below the root apices of both first and second molars. In no case was the mandibular canal found in close proximity, both in the vertical and in the buccolingual planes, to the first and second molar apices.

Densitometric evaluation of intraoral x-ray films: Ektaspeed versus Ultraspeed

Recently a new speed E intraoral dental x-ray film was introduced by the Eastman Kodak Company in order to reduce the radiation dose to the patient. In the present study the new higher-speed EP21 film was compared with the speed D DF58 film with regard to speed and quality (fog plus base, sharpness, resolution, and contrast) of the resulting images. Results showed no deterioration in the image with 50% dose reduction when the EP21 film was used as compared to the DF58 film. Therefore, this new type of film is highly recommended for routine radiographic examinations.

Recovery of the infraorbital nerve after zygomatic complex fractures: A preliminary study of different treatment methods

The infraorbital nerve (ION) is often involved in trauma to the zygomatic complex (ZC), resulting in sensory disturbance of the area innervated by it. The purpose of the study was to compare the incidence of persistent sensory disturbance after recovery from isolated simple fractures of the ZC, with four treatment methods: 1) closed reduction via subcutaneous approach without fixation; 2) open reduction via subcutaneous approach without fixation; 3) open reduction via oroantral approach and support of the complex by an intraantral Foley catheter; and 4) open reduction via Gillies approach with fixation of the frontozygomatic (FZ) fracture with wire osteosynthesis, and open reduction via Gillies approach with fixation of the FZ fracture with miniplate osteosynthesis. Analysis revealed that patients treated with miniplate osteosynthesis exhibited a trend for higher recovery rate of the (ION) than with the other three methods. No significant differences were found among the other three methods.

Radiologic features of desmoplastic variant of ameloblastoma

Desmoplastic variant of ameloblastoma is a newly described variant characterized by unique histologic and radiographic features. This study reviews and analyzes the clinical and radiographic features of 15 cases of desmoplastic variant of ameloblastoma (14 cases from the literature and one case from our files). Desmoplastic variant of ameloblastoma shows a predilection for the maxilla and has a tendency to occur in the anterior region of the mandible and maxilla. Radiographically, almost all desmoplastic variant of ameloblastomas exhibit a mixed radiolucent-radiopaque appearance. Most show poorly defined or diffused borders and are mistakenly diagnosed as fibro-osseous lesions.