M Ida

Osteomatous changes and tooth abnormalities found in the jaws of patients with adenomatosis coli

Oral findings on the panoramic tomograms of fifty-two patients with adenomatosis coli (AC) are presented. Osteomatous lesions, embedded teeth, and supernumerary teeth were found more frequently in AC patients than in a normal population. The osteomatous lesions were found in more than 80 percent of the AC patients, and the average number of such lesions per patient was 4.7. In a normal population, 15 percent had the osteomatous lesions, and the average number per patient was 1.1. The panoramic tomograms of twelve AC patients who had more than six osteomatous lesions showed very characteristic images. The possibility of early detection of AC through oral radiographic findings is suggested.

MRI of ranulas

Abstract We reviewed the MRI of 20 patients with a ranula (8 simple and 12 plunging) and ten with other cystic masses in the floor of the mouth and/ or suprahyoid portion of the neck (three haemangiomas, two neuromas, one monomorphic adenoma, one lipoma, two lateral cervical cysts and one dermoid cyst). Histological diagnoses were obtained in all cases with the exception of one presumed haemangioma. Ranulas were all well-defined, homogeneous masses giving low signal on T1-and markedly high signal on T2-weighted images. While simple ranulas were all confined to the sublingual space, plunging ranulas were centered on the submandibular space and tended to spill into one or more adjacent spaces. They extended into the sublingual space anteriorly (producung a so-called tail sign) in eight of 12 cases and into the parapharyngeal space superiorly in five. Although they sometimes filled a considerable part of the parapharyngeal space, displacement of surrounding muscles or vessels was usually slight, which was thought to reflect the nature of extravasation pseudocysts. All other cystic masses in our study had one or more MRI finding different from those of ranulas and could be easily differentiated from them.

MRI and clinical findings of posterior disk displacement in the temporomandibular joint

OBJECTIVE The objective of this study was to evaluate the magnetic resonance imaging and clinical findings of patients with posterior disk displacement in the temporomandibular joint. STUDY DESIGN Magnetic resonance and clinical findings of 62 temporomandibular joints (44 patients) with posterior disk displacement were retrospectively analyzed. RESULTS According to the criteria proposed by Westesson et al., 52 temporomandibular joints (84%) were the thin flat disk type and the remaining 10 (16%) were the perforated disk type. Fifteen temporomandibular joints (24%) had a history of luxation. Clicking was observed in 26 temporomandibular joints (42%), all of which were the thin flat disk type (chi-square test, P < .01). Pain was observed in 19% of patients with the thin flat disk type and 60% of those with the perforated disk type (P < .05). CONCLUSIONS Magnetic resonance imaging could clearly reveal the details of posterior disk displacement in the temporomandibular joint. The clinical findings were dissimilar between the thin flat and the perforated disk type.

Usefulness of CT images for diagnosis of odontogenic maxillary sinusitis

To assess the usefulness of CT images for the diagnosis of suspected odontogenic maxillary sinusitis, 52 patients with maxillary sinusitis who had received CT examination were retrospectively analyzed. maxillary sinus ostium was established on coronal CT image in 20 out of 55 lesions in those 52 patients. However, a considerable number of patients who had inflammatory disease not only in the maxillary sinus but also in other paranasal sinuses (38/55) or in the nasal meatus (34/55) were included in those 52 patients. Concerning the opening of the ostium, the clinical diagnosis is frequently different from the diagnosis made using CT. The CT findings of the maxillary sinus ostium, nasal meatus and other paranasal sinuses were thus important in planning the treatment for patients with maxillary sinusitis in dentistry, as in otorhinolaryngology.

A clinicoradiological study of odontogenic carcinomas and their impact on clinical diagnosis

OBJECTIVES To investigate the clinical and radiological characteristics of odontogenic carcinomas (OCs) and evaluate their impact on early clinical diagnosis. METHODS The clinical and radiological features of all patients with OCs in our pathology record from January 1988 to December 2009 were retrospectively reviewed. The impact on a tentative diagnosis before final histological examination of clinical, panoramic and CT features was investigated. RESULTS Of 474 cases with malignant jaw tumours, 417 (88%) were gingival squamous cell carcinomas (SCCs) and 27 (6%) were OCs. The average age of the patients with OCs was significantly lower than that of those with gingival SCCs. 20 OCs were in the mandible and 7 were in the maxilla. 22 OC patients (81%) had pain and/or swelling as an initial symptom of the disease. Although the majority of OCs showed irregularly contoured radiolucency, one-third of the cases showed cyst-like radiolucency totally or partially surrounded by a sclerotic rim on panoramic radiography. Permeative or gross cortical bone destruction and mass extension outside the jaw bone were found on CT and a diagnosis of malignant tumour was more common. Mass extension outside the cortex had a significant influence on malignant diagnosis. However, 22% of the patients were still clinically diagnosed as having osteomyelitis after CT. CONCLUSIONS Although CT was useful to obtain a diagnosis of malignant tumour in OC patients, 22% of patients were clinically diagnosed as having osteomyelitis even after CT. When an osteomyelitis case is resistant to conventional therapy and gross bone destruction and/or mass extension is found on CT, a histopathological examination should be done.