Ectopic teeth with disparate migration: A literature review and new case series

Purpose@#Ectopic eruption can be defined as the emergence of a tooth in an abnormal location, where the tooth does not follow its typical eruption pathway. While ectopic eruption within the dentate region is well-documented in the literature, ectopic eruption in non-dentate regions is relatively rare. This study aimed to report 6 cases of ectopic teeth and present a systematic review of the English-language literature on ectopic teeth, emphasizing demographic characteristics, radiographic features, potential complications, and treatment options. @*Materials and Methods@#A literature search was conducted using the PubMed, Medline, Web of Science, and Cochrane databases. The demographic data and radiographic findings of patients presenting with ectopic teeth were recorded. @*Results@#The literature review yielded 61 cases of ectopic teeth, with patients ranging in age from 3 to 74 years. The findings from these previously reported cases demonstrated that the most common location for ectopic teeth was the maxillary sinus, which is consistent with this case series. The Pearson chi-square test was performed to evaluate the correlation between age and location of ectopic teeth, and the results were found to be statistically significant (P<0.05). However, no statistically significant relationship was observed between sex and the location of ectopic teeth. @*Conclusion@#The distinct features of these cases warrant reporting. This study presents the first case of supernumerary teeth in the condyle without any associated pathosis. Another notable characteristic is the pre-eruptive resorption of 2 inverted supernumerary teeth ectopically located in the palate, which predisposes to sinus opacification.

Assessment of alveolar bone changes in response to minimally invasive periodontal surgery:A cone-beam computed tomographic evaluation

Purpose@#The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST). @*Materials and Methods@#Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured. @*Results@#An average alveolar bone gain >0.5 mm following PST was identified using CBCT (P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years. @*Conclusion@#PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.

Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review

Purpose@#The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. @*Materials and Methods@#This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients’ demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). @*Results@#In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion’s size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. @*Conclusion@#CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.

Cone-beam computed tomographic imaging of silent sinus syndrome: A case series and a literature review

While silent sinus syndrome (SSS) is familiar to otolaryngologists and ophthalmologists, it is a rare clinical entity in dentistry and is likely to be underdiagnosed due to dentists’ lack of awareness of this condition. SSS presents a diagnostic challenge to dentists, as patients typically have no history of trauma or sinusitis. The characteristic feature of SSS is a gradual retreat of the maxillary sinus walls, resulting in enophthalmos and hypoglobus. Multidetector (multislice) computed tomography is the imaging modality of choice for SSS and other paranasal sinus diseases. Conebeam computed tomography promises to be an alternative low-dose imaging modality. This report describes 3 cases of SSS in adults, who had no identified clinical symptoms except diminutive and opacified maxillary sinuses, as wellas the inward bowing of the sinus walls as noted on cone-beam computed tomographic imaging.

Radiographic manifestations of fibroblastic osteosarcoma: A diagnostic challenge

Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.

Radiographic features of plasma cell leukemia in the maxilla: A case report

Plasma cell leukemia (PCL) is an aggressive form of multiple myeloma where there is hematogenous spread of abnormal plasma cells into the periphery. This is opposed to multiple myeloma, where the abnormal plasma cells stay in the bone marrow. PCL is more common in males than females, and is also more common in African-Americans than Caucasians. Signs and symptoms of PCL include, but are not limited to, renal insufficiency, hypercalcemia, anemia, lytic bone lesions, thrombocytopenia, hepatomegaly, and splenomegaly. Here, we discussed a case of a 71-year-old Caucasian female recently diagnosed with primary PCL with radiographic features of this disease throughout the body, with an emphasis on the maxillofacial skeleton and relevance from a dental standpoint.

Long-standing chin-augmenting costochondral graft creating a diagnostic challenge: A case report and literature review

To our knowledge, the imaging features of costochondral grafts (CCGs) on cone-beam computed tomography (CBCT) have not been documented in the literature. We present the case of a CCG in the facial soft tissue to the anterior mandible, with changes mimicking a cartilaginous neoplasm. This is the first report to describe the CBCT imaging features of a long-standing graft in the anterior mandible. Implants or grafts may be incidental findings on radiographic images made for unrelated purposes. Although most are well-defined and radiographically homogeneous, being of relatively inert non-biological material, immune reactions to some grafts may stimulate alterations in the appearance of surrounding tissues. Biological implants may undergo growth and differentiation, causing their appearance to mimic neoplastic lesions. We present the case of a cosmetic autogenous CCG that posed a diagnostic challenge both radiographically and histopathologically.

Radiographic manifestations of Mönckeberg arteriosclerosis in the head and neck region

Mönckeberg sclerosis is a disease of unknown etiology, characterized by dystrophic calcification within the arterial tunica media of the lower extremities leading to reduced arterial compliance. Medial calcinosis does not obstruct the lumina of the arteries, and therefore does not lead to symptoms or signs of limb or organ ischemia. Mönckeberg sclerosis most commonly occurs in aged and diabetic individuals and in patients on dialysis. Mönckeberg arteriosclerosis is frequently observed in the visceral arteries, and it can occur in the head and neck region as well. This report describes a remarkable case of Mönckeberg arteriosclerosis in the head and neck region as detected on dental imaging studies. To the best of our knowledge, this is the first case that has been reported in which this condition presented in the facial vasculature. The aim of this report was to define the radiographic characteristics of Mönckeberg arteriosclerosis in an effort to assist health care providers in diagnosing and managing this condition.