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OBJECTIVES: In digital intraoral radiography (DIR), images with defects caused by the digital process are sometimes produced. Hence, we analyzed DIR images with defects taken using the photostimulable phosphor (PSP) plate method and then classified these images based on the causes of the defect. The aim of this study was to classify defects in DIR using the PSP plate system, and to discuss the causes of each type of defect and the methods that can prevent their occurrence. METHODS: Images with defects due to the two PSP plate systems (Arcana and Arcana Mira) were selected and classified according to the defect. Image defects caused by geometrical techniques that occur in both the film and PSP plate methods were excluded from this study. Moreover, changes in the rate of occurrence of images with defects over time were analyzed in this study. RESULTS: The defects in images obtained by the PSP plate system were classified into six types, which were further divided into those caused by machine error or human error. Both types of error could influence the diagnostic performance. Machine error accidentally and rarely occurred; thus, the prevention of such errors is difficult. However, human error, especially errors caused by photo-induced discharge, could be prevented using appropriate measures. CONCLUSIONS: In DIR systems using the PSP plate method, human error should be prevented by education and training to improve operation.

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Interpretación de Imagen Radiográfica Asistida por Computador , Radiografía Dental Digital , Humanos , Radiografía Dental Digital/métodos

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INTRODUCTION: Mucoceles are mucous extravasation phenomena resulting from spontaneous ductal rupture or, less commonly, a traumatic cutting of a salivary excretory duct. Occasionally, the appearance of a mucocele closely resembles a neoplastic lesion, and it can be difficult to diagnose. PRESENTATION OF CASE: A 74-year-old Japanese male patient was referred to our clinic with painless swelling related to the upper right canine-premolar area. Preoperative imaging of the lesion revealed that it was fluid-filled and the histopathological biopsy suggested a myxoid tumor. We excised the lesion with the patient under general anesthesia, using safety margins based on the histology of the biopsy specimen to reach the definitive diagnosis and treatment. The final pathological diagnosis was a mucocele in the vicinity with an aberrant small salivary gland. Follow-up visits showed complete healing of the epithelium, and no recurrence has been observed during the subsequent 30 months. DISCUSSION: In cases with a difficult definitive diagnosis based on medical history, diagnostic imaging and pathological examination, it is important to proceed carefully with the possibility of a tumor in mind. CONCLUSION: This case emphasizes that some mucous cysts are challenging for clinicians in terms of diagnosis and treatment due to an uncommon presentation.

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BACKGROUND: Clavicle fractures (CF) after radical neck dissection (RND) for oral cancer are rare but are thought to occur as a result of myotonia and decreased blood supply to the muscles around the clavicle after RND. The current report presents a rare case of a non-neoplastic pathological CF after RND, and discusses the role of imaging examinations for the timely detection of CF. CASE REPORT: An 82-year-old Japanese man underwent RND followed by chemotherapy without radiotherapy for secondary metastasis of the right cervical lymph node after resection of tongue cancer. Computed tomography at 6 months after RND revealed a fracture with bone destruction in the proximal end of the right clavicle. He had no history of trauma at the site of the fracture and no symptoms. The possibility of bone metastasis of the clavicle was considered; however, the bone destruction had not advanced 6 years after the discovery of the fracture. The CF was thus finally considered to be a side effect of RND, rather than metastasis. CONCLUSION: CF is a rare complication following treatment for head and neck cancer but can be caused by neck dissection. Regular imaging examinations, including the clavicular region, are therefore needed before and after surgery to ensure the timely detection of CF.

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Disección del Cuello , Neoplasias de la Lengua , Anciano de 80 o más Años , Clavícula/diagnóstico por imagen , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/cirugía , Metástasis Linfática , Masculino , Neoplasias de la Lengua/diagnóstico por imagen , Neoplasias de la Lengua/tratamiento farmacológico , Neoplasias de la Lengua/cirugía

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INTRODUCTION: Temporomandibular disorders (TMD) are diseases of the temporomandibular joint and masticatory muscles, and are often difficult to be diagnosed because they have various symptoms, pathological conditions and causes. PRESENTATION OF CASE: Herein, we report a 78-year-old male referred to our hospital with a diagnosis of TMD and presenting with facial asymmetry, marked deviation to the right side on vertical mandibular movement and complaints of abnormal perception at the right oral and buccal region. Past medical history revealed that he had undergone a right intracranial trigeminal schwannoma resection 9 years prior. Computed tomography (CT) showed disuse atrophy of the right side of 4 masticatory muscles and 2 suprahyoid muscles controlled by the motor component of the mandibular division (V3) of the trigeminal nerve (TGN). Together with the neurosurgeon, we confirmed that there was no recurrence of the tumor and explained to the patient that the oral and maxillofacial symptoms are after-effects of the operation, and we provided oral hygiene instructions and coordinated cleaning of the inside of the oral cavity. DISCUSSION: Although it is difficult to compare treatment methods from case to case, we believe that in our case, the patient's understanding of the cause of his discomfort contributed significantly to the improvement of his quality of life. CONCLUSION: We experienced a case of masticatory muscle disuse atrophy during long-term follow-up after resection of intracranial trigeminal schwannoma. Further studies are needed to develop the diagnostic and therapeutic protocols for disuse atrophy.