RESUMEN
This case series presents two asymptomatic cases of juvenile angiofibroma which were initially incidentally identified in pre-orthodontic radiographs. Juvenile angiofibroma is an uncommon, locally aggressive benign, vascular neoplasm with invasive growth patterns. Due to the hypervascularity of these tumours, there are biopsy associated risks and multi-slice computed tomography, magnetic resonance imaging and angiography are usually employed for diagnosis. Early pre-symptomatic identification of this lesion facilitates early management and limiting potential life-threatening complications. This highlights the importance of thorough interpretation of dental radiographs, including the evaluation of structures which are not in the primary region of interest. © 2022 Australian Dental Association.
Asunto(s)
Angiofibroma , Neoplasias de Cabeza y Cuello , Neoplasias Nasofaríngeas , Angiofibroma/diagnóstico por imagen , Angiofibroma/patología , Australia , Humanos , Hallazgos Incidentales , Imagen por Resonancia Magnética , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/patología , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: The aim of this retrospective study was to record incidental findings in CBCT scans taken in an older population for pre-implant assessment, and to examine whether these findings would influence the intended dental implant placement. METHODS: 300 consecutive CBCT scans over the age of 40 years was carried out. The incidental findings were grouped into regions as follows: dentoalveolar structures, maxilla and mandible, paranasal sinuses, temporomandibular joint (TMJ), naso/oral-pharyngeal airway, cervical spine and neurovascular canals. The incidental findings are further categories into their significance towards the intended treatment plan. RESULT: Incidental findings were noted on all of the scans. 555 incidental findings (1.85 findings/scan) were identified. The highest number of incidental findings was in the sinuses (34%), followed by dentoalveolar structures (31%), nasal/oral-pharyngeal airway (12%), maxilla and mandible (10%), TMJ (6%), cervical spine (4%) and neurovascular canals (3%). A total of 37% of findings required follow-up. In 12% of cases detection of the incidental findings lead to amendment or abortion of the intended implant treatment plan. CONCLUSION: Incidental findings within and beyond the region of interest are common in CBCT scans. The numbers of incidental findings per scan in an older population is higher than in a younger population.
Asunto(s)
Implantes Dentales , Hallazgos Incidentales , Tomografía Computarizada de Haz Cónico , Humanos , Maxilar , Estudios RetrospectivosRESUMEN
Cone beam computed tomography is widely used in dentistry. Incidental findings are common, with many requiring intervention or monitoring. We present a rare case of previously undiagnosed, asymptomatic multiple myeloma first identified incidentally on cone beam computed tomography and panoramic radiography. This case highlights the diverse range of lesions that may appear on cone beam computed tomography and the importance of radiologic interpretation.
Asunto(s)
Hallazgos Incidentales , Mieloma Múltiple , Radiografía Dental , Tomografía Computarizada de Haz Cónico , Humanos , Mieloma Múltiple/diagnóstico por imagen , Radiografía PanorámicaRESUMEN
Salivary gland aplasia is a rare condition with only a small number of cases reported worldwide. It is more commonly seen in males and can occur either in isolation or association with other defects or syndromes. It may or may not occur with a hereditary background. Scant literature exists detailing the status of sublingual salivary glands in patients with any form of major salivary gland aplasia. This case report describes the clinical and magnetic resonance imaging presentation of a 16-year-old girl with major salivary gland aplasia detailing the status of all six major salivary glands.
Asunto(s)
Glándulas Salivales/anomalías , Xerostomía/etiología , Adolescente , Femenino , Humanos , Imagen por Resonancia Magnética , SíndromeRESUMEN
BACKGROUND: Surgical extraction of third molars is one of the most common oral and maxillofacial surgical procedures performed and may have a number of associated complications. One of these complications is inferior alveolar nerve (IAN) dysaesthesia or impairment of sensory perception (including paraesthesia and/or anaesthesia). Previous studies assume that most clinicians use various combinations of nine radiologic criteria on panoramic radiographs as indicators of the relationship and, therefore, predictors of the risk of postoperative dysaesthesia. Our study assessed both the current radiologic modalities and assessment criteria used by Australian oral and maxillofacial surgeons when determining the proximity of mandibular canal to third molars. METHODS: A survey of all surgeon members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZOMS) practising in Australia was undertaken. RESULTS: Of the 105 questionnaires sent to surgeons, 72 responses (68 per cent) were returned. All surgeons reported using the panoramic radiograph but only 25 per cent considered it sufficiently accurate in determining the relationship between the mandibular canal (MC) and the third molar root, while 61 per cent of surgeons use CT for this purpose but the average frequency of use was very low (five per cent). This study also revealed that the nine radiologic criteria on a panoramic radiograph are used to varying extents by Australian surgeons. Nearly all surgeons use 'change in MC direction' and 'MC narrowing' to determine and close relationship. Thirty-one per cent used superimposition of the MC and the root of the third molar alone and 24 per cent used appearance of contact of the root with the MC alone in the absence of any other radiologic criteria to indicate close or intimate relationship. CONCLUSION: Further research is required to determine the accuracy and observer agreement or reliability of using the nine panoramic characteristics, to determine this relationship and whether the presurgical determination of proximity and position (buccal or lingual) of the canal utilizing CT has any usefulness in determining the surgical protocol or affect on postoperative morbidity.