Evaluation of mandibular calcification on 3D volume images

Influence of clinical experience in detecting calcifications of the head and neck region on panoramic radiographs: an app-based evaluation

Introduction

Digital panoramic radiographs (DPRs) are used in dental practice as the first diagnostic tool for the initial detection of head and neck regions soft-tissue calcifications. The aim of this study was to use a self-developed application (App) to evaluate the ability of dental students at different levels of training to examine known DPRs with different soft-tissue calcification.

Methods

A total of known 100 DPRs with (n=50) and without (n=50) calcification were independently evaluated by four groups: preclinical, first clinical and last clinical dental students, and dentists with less than or equal to 1 year of professional experience in the same time (15 min) and examination conditions. Unity software was used to develop the examination App, which allowed to mark areas with calcifications on the DPRs. The data were statistically analyzed between the groups (significance level: P<0.05) for every location, and the detection rate was calculated as a percentage of detected calcifications.

Results

Results revealed that the overall detection rate of calcifications in all groups was 29.17%. Dentists exhibited the highest detection rate (36.46%), followed by the last- (29.69%), first- (32.29%), and preclinical (15.10%) students.

Conclusion

These findings suggest that clinical experience plays a role in the correct detection of soft-tissue calcifications in DPRs. However, deficiencies in radiological training during dental education may contribute to diagnostic errors. As these can become life-threatening risks, the results highlight the need for early training in the dental curriculum to improve diagnostic performance and minimize possible diagnostic errors.

Diagnostic conundrum in an ambiguous posterior mandibular osseous lesion: Case report and radiological review

INTRODUCTION AND IMPORTANCE

Non-odontogenic osseous lesions of the mandible are relatively uncommon entities compared to odontogenic lesions. Although the posterior mandible is not a usual site, it is not rare either for these osseous lesions, making the diagnosis ambiguous, and if misdiagnosed leading to different treatment protocols.

CASE PRESENTATION

A 43-year-old female presented with a hard tissue lesion of the posterior mandible, misdiagnosed as a sialolith of the submandibular salivary gland in two other centers due to overlapping of symptoms, anatomic complexity, and inadequate investigations. The lesion was later diagnosed to be an osteoma of the posterior mandible with added investigations, and surgically excised. Histopathology confirmed the diagnosis.

CLINICAL DISCUSSION

A variety of hard tissue lesions are known to occur in the posterior mandible like Submandibular sialolith, Osteomas, Calcified Submandibular lymph nodes, Phlebolith, and Tonsillolith. However, due to the region's structural complexity, localization of a hard tissue lesion may not always be forthright, even with radiographs. Moreover, in cases with conflicting symptoms, as was in this case there are more chances of misdiagnosis. The reasons for such diagnostic challenges are deliberated with radiological review of posterior mandibular osseous lesions. Recommendations are also suggested for proper investigations, thereby management of these posterior mandibular osseous lesions.

CONCLUSION

Misdiagnosis of these posterior mandibular lesions may lead to the patient undergoing unnecessary surgical procedures as different lesions require different management. Differential diagnosis and adequate protocol for investigations are required.

[Prevalence of idiopathic osteosclerosis in patients cared for at a radiological center in Ayacucho from 2016-2018]

Objective

The objective of this study was to determine, describe and identify the prevalence of radiopaque images compatible with idiopathic osteosclerosis in digital panoramic radiographs taken in patients between the ages of 18 and 50.

Materials and methods

The study design was descriptive, cross-sectional and retrospective. The sample consisted of 500 digital panoramic radiographs taken between January 1, 2016 and December 31, 2018, in the target population aged between 18 and 50 years from Ayacucho - Peru, attended at a private radiological center. The radiographs obtained were analyzed using the Romexis viewer version 5.3 program, and the results were recorded on a data collection sheet. The Chi-square test was used to establish associations among the variables evaluated. A P <0.05 was considered significant.

Results

500 digital panoramic radiographs were analyzed, showing a prevalence of idiopathic osteosclerosis of 17.4%, of which 12% were female and 5.4% male, and according to age, the presence of idiopathic osteosclerosis was more prevalent in the second decade of life.

Conclusions

It is important to have a clear differential diagnostic criterion when distinguishing the different radiopacities such as idiopathic osteosclerosis, which can occur in the jaws, making a precise record of the morphometric characteristics and monitoring over time, taking into account their existence and implication in dental treatments.

An updated review of idiopathic osteosclerosis of the jaws

Objective

: The aim of this study was to update the concepts of the diagnosis of idiopathic osteosclerosis (IO) of the jaws by digital panoramic radiographs and cone beam tomography and describe the impact of this disease on oral and general health.

Methods

A search of the main databases of dental medical research was carried out using the search terms "osteosclerosis, panoramic radiography, cone beam computed tomography, jaws". Articles without language restriction until September 30, 2020 were identified. The prevalence and clinical and radiographic characteristics of IO of the jaws were examined in 2D and 3D imaging studies, as well as the interaction during treatments in the various dental specialties.

Results

We analyzed the current situation regarding the diagnosis of IO, with an update of the diagnostic criteria used to accurately identify IO in the latest generation imaging studies, as well determine its possible interactions in oral an general health.

Conclusions

It is important to have a clear differential diagnosis of IO and be able to distinguish different radiopacities in the maxilla. Accurate reporting and monitoring of the morphometric characteristics are necessary taking into account the impact the presence of IO of the jaws has on future dental treatments.

The imaging role for diagnosis of idiopathic osteosclerosis: a retrospective approach based on records of 33,550 cases

OBJECTIVE

The study aimed to describe the diagnostic imaging features of idiopathic osteosclerosis (IO) to aid in differential diagnosis of similar dentomaxillomandibular conditions.

MATERIALS AND METHODS

An archive of 550 dentomaxillofacial radiographic (panoramic radiography (PR) and cone beam computed tomography (CBCT)) images and 33,000 histopathological records were reviewed to identify IO cases. Chi-square, Student's t test, and ANOVA tests, with a significance of p < 0.05, were applied for comparative analysis. In addition, we analyzed various studies to present a short review.

RESULTS

After meticulous observation, 36 images of 34 patients revealed 60 IO lesions in 31 PR and 5 CBCT. Sex, age group, anatomical site, shape, regularity, and root relationship showed statistical significance: sex and age group (p = 0.046), sex and IO regularity (p = 0.007), age group and IO regularity (p = 0.014), anatomical site and IO shape (p = 0.010), anatomical site and IO regularity (p = 0.003), and IO shape and IO regularity (p = 0.002). We presented a short review from 26 articles, including retrospective, cross-sectional, and longitudinal studies, documenting 2307 patients with 2435 IO lesions from 51,160 imagiological examinations.

CONCLUSIONS

A radiographic diagnostic profile of IO may guide the clinical practitioners in differentiating an incidental radiopacity. PR is a preliminary examination, with CBCT facilitating the IO diagnosis.

CLINICAL RELEVANCE

Knowledge of imaging characteristics variability of idiopathic osteosclerosis is crucial for accurate diagnosis process when incidental radiopacities are found in the panoramic radiographs, thus avoiding unnecessary biopsies. CBCT scans facilitate the interpretation of idiopathic osteosclerosis overlapping the mandibular canal.