S. Thomas Deahl

Short-term changes of condylar position after sagittal split osteotomy for mandibular advancement.

OBJECTIVE The goal of this study was to quantify condylar position changes after mandibular advancement surgery with rigid fixation (screws). Radiographic changes in condylar position were determined in all planes (X, Y, and Z). Computed tomography with image reconstruction was used. STUDY DESIGN A consecutive population of patients who elected to have rigid fixation for surgical stabilization method were studied (n = 21). Computed tomography data were acquired in the axial plane through use of abutting 1.5-mm-thick slices. Data acquisition occurred 1 week preoperatively and 8 weeks postoperatively. Measurements were made from 2-dimensional reconstructions. RESULTS The averages were as follows: lateral displacement from midline, 1.2 mm (55% of patients); medial displacement from midline, 1.5 mm (45% of patients; range, 3.2 mm); condyle angle increase from coronal plane, 3.5 degrees (60% of patients); condyle angle decrease from coronal, 4.3 degrees (40% of patients; range, 8.5 degrees); superior rotation of proximal segment, 3.2 degrees (39% of patients); inferior rotation of proximal segment, 8.6 degrees (61% of patients; range, 15.6 degrees); superior displacement, 1.2 mm (60% of patients); inferior displacement, 1.0 mm (40% of patients; range, 2.5 mm); anterior displacement, 1.6 mm (33% of patients); posterior displacement, 1.6 mm (67% of patients; range, 2.8 mm). CONCLUSIONS Changes occurred in all planes, but the most common postoperative condyle position was more lateral; with increased angle, the coronoid process was higher and the condyle was more superior and posterior in the fossa.

Updated quality assurance self-assessment exercise in intraoral and panoramic radiography

This updated self-assessment exercise for the dental team by the Radiology Practice Committee of the American Academy of Oral and Maxillofacial Radiology is intended to produce the highest quality diagnostic radiographs while keeping patient exposure as low as is reasonably achievable. To continue to provide the best radiographic services to patients, those involved in dental radiography need to be aware of the latest changes and advances in dental radiography and need to use them in their practice.

Clinical comparison of two panoramic modalities and posterior bite-wing radiography in the detection of proximal dental caries☆

A clinical study was designed to examine whether the Philips OrthOralix SD (Gendex Dental Systems, Monza, Italy) orthogonal panoramic projection could improve diagnostic accuracy over standard projections in the detection of proximal surface caries. Thirty-five sets of radiographs that demonstrated optimal image characteristics were selected. Using a five-point scale, 18 viewers evaluated whether specified lesions were present or absent. Viewer data was then compared with a consensus radiographic assessment of the state of the proximal areas. Receiver operating characteristic curves were generated with the use of a maximum-likelihood method of fit. The area under the receiver operating characteristic curve was used as the index of diagnostic accuracy. The mean receiver operating characteristic areas for orthogonal and standard projection panoramic and bite-wing radiography to detect the presence of proximal dental caries were 0.68 +/- 0.03, 0.69 +/- 0.03, and 0.79 +/- 0.03 respectively. Critical ratio analysis was used to compare the means for all possible pairings of imaging modalities. In overall performance, conventional bite-wing radiographs gave a significantly greater diagnostic yield for proximal caries than the Philips OrthOralix SD orthogonal or standard panoramic modalities (p > 0.05). The orthogonal projection did not improve diagnostic accuracy in the detection of proximal carious lesions compared with the standard projection.

Asymptomatic, radiologically detected chondrometaplasia in the temporomandibular joint

Asymptomatic loose bodies were detected in the temporomandibular joint of a 62-year-old woman during an examination before comprehensive dental care. The radiologic interpretation was synovial chondrometaplasia (synovial osteochondromatosis). A histologic diagnosis was not obtained, because surgery was unwarranted in view of the lack of symptoms and the benign differential diagnosis. Review of the literature revealed 62 reported cases of temporomandibular joint chondrometaplasia, all of which included one or more of the following: swelling, pain, joint noise, and limited mandibular movement. These reports have described this entity as a rare lesion, but the rate of reports has increased, perhaps because of greater practitioner awareness and increased sensitivity of diagnostic tests.

Panoramic Radiography is Sensitive and Specific for Detection of Calcified Carotid Arteries When Compared With the Screening Test of Color Doppler Ultrasound

Article Title and Bibliographic Information Detection of incidental carotid artery calcifications during dental examinations: panoramic radiography as an important aid in dentistry. Ertas EF, Sisman Y. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:e11-e17. Reviewer S. Thomas Deahl II, DMD, PhD Purpose/Question In dental patients, how does panoramic radiography compare with color Doppler ultrasonography in detecting calcified carotid artery atheromas? Source of Funding Academic Research Project Agency of Erciyes University, Turkey Type of Study/Design Case series Level of Evidence Level 3: Other evidence Strength of Recommendation Grade Not applicable

MRI-detected temporomandibular joint effusion probably reflects inflammatory proteins in the synovial fluid

Abstract Original article Segami N, Miyamaru M, Nishimura M, Suzuki T, Kaneyama K, Murakami K-I. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2. Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:515-21. Level of evidence 2b Purpose To determine whether the degree of MRI-detectable temporomandibular joint effusion correlates with concentrations of synovial fluid protein and proinflammatory cytokines Source of funding Government (Japan) Type of study/design Case-control study