M.M. Littner

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.

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.

Extraction site healing in rats: A radiologic densitometric study

The present study uses a simple, objective method to radiographically evaluate the changes that occur during socket healing in rats. Mandibular left first molars were extracted in 35 Wistar rats, which were then sacrificed at 0, 7, 14, 21, 28, 45, and 60 days after surgery. Mandibles were removed, placed on an ANSI size 2 film, and exposed with an aluminum step-wedge, 0.5 to 3.0 mm. Socket density was measured with a digital densitometer and related to the equivalent density of aluminum. Increased density of the image of the apical and crestal areas of the socket was observed on day 7. Maximum density was reached by day 28 in the apical area; in the crestal area, density increased at a slower rate. The density changes found in the present study agree with the known histologic reports of socket healing in rats. Densitometric evaluation of extraction socket healing, using a step-wedge with 0.5 mm increments, is a useful and reliable tool to objectively assess bone formation and mineralization.

Densitometric measurement of radiopacity of gutta-percha cones and root dentin

National and international standards require that gutta-percha cones be sufficiently radiopaque to be distinguished from natural structures such as dentin and to permit evaluation of the density of the root canal filling. Discs, 1-mm thick, made from 15 commercial and experimental brands of gutta-percha cones, were tested for their compliance with the requirements. The radiopacity of 1-mm thick root dentin slabs was similarly measured with a photo-densitometer. All radiographs were made on D-speed occlusal film and replicated on E-speed film. The mean radiopacity of the gutta-percha discs on D-speed film was 7.26 mm of aluminum equivalent and 7.53 mm on E-speed film, greatly exceeding the minimal requirement of 3 mm. The difference in the values obtained with the two film types was not significant, suggesting that E-speed films may be used for the test. Dentin slabs were uniform in their radiopacity, equivalent to 1 mm of aluminum, confirming previous findings. In view of complaints of insufficient clinical performance, the present minimal requirement for radiopacity of gutta-percha cones seems too low.

Is the radioopacity standard for gutta-percha sufficient in clinical use?

Summary The compliance of 14 commercially available brands or batches of gutta-percha points with the recently elaborated standard for radioopacity of endodontic materials was tested with the densitometer. Results indicated that the radioopacity of all tested samples greatly exceeded the minimum requirements. However, since the performance of some of these brands is less than satisfactory in clinical use, it is suggested that the standard be revised, raising the requirements for radioopacity in conjunction with “usage tests” still to be carried out.

Thermal sensory and pain thresholds in the tongue and chin change with age, but are not altered in burning mouth syndrome

Background: Burning mouth syndrome (BMS) is a chronic orofacial pain syndrome that occurs in middle‐aged and postmenopausal women and poses a therapeutic challenge to dermatologists and dentists. It has been suggested previously that BMS is a small‐fiber neuropathy.

The prevalence of oral cancer in relation to the ethnic origin of Israeli Jews

Smoking, alcohol, and familial background are considered major cofactors in the cause of oral cancer. The purpose of the present study was to determine the relationship between ethnic origin and oral cancer in the Israeli Jewish Population. Data were collected during the years 1970 to 1980 from 342 dental records of patients in Israeli hospitals. Results showed a male/female ratio of 2:1. Of 264 patients with clearly determined ethnic origin, 72% were Ashkenazi, 15% Sephardi, and 13% Eastern ethnic origin. The relative prevalence showed that the risk of the Ashkenazi group to develop oral cancer was at least twice as high as the other two ethnic groups. The increase in occurrence of oral cancer with age in each ethnic group was highly significant (p < 0.001). The most common type of malignancy was squamous cell carcinoma (95%) with 99% of this malignancy occurring in patients in their sixth and seventh decade. A significant (p < 0.02) relationship between site of involvement and ethnic origin was also noted. The tongue was the leading site in the Ashkenazi and Sephardi groups, whereas the lip and alveolar ridges were the most affected sites in the Eastern ethnic group.

Changes in the lamina dura as a manifestation of systemic diseases: report of a case and review of the literature

A case is presented in which the lamina dura completely disappeared around all the roots of the teeth in secondary hyperparathyroidism as a result of chronic renal insufficiency and hemodialysis. The literature concerning the various systemic conditions affecting the lamina dura is discussed. The meaning of its discontinuity or disappearance as a diagnostic consideration is emphasized.

Vitality preservation of an anomalous maxillary central incisor after endodontic therapy

Endodontic treatment of a case of fused immature central incisor with a supernumerary tooth with dens in dente is described. Although a chronic dentoalveolar abscess was diagnosed, vitality test signs were positive. Treatment consisted of pulpotomy with calcium hydroxide paste; after 2 1/2 months a permanent root canal filling was placed in the amputated part. Follow-up 2 years postoperatively indicated that the tooth has maintained its vitality. The periapical area is completely healed, and apical closure is evident.