Prevalence of bifid mandibular condyle in a selected population in south of Iran

Statement of the Problem: Bifid mandibular condyle [BMC] is a rare anomaly of uncertain origin which may play a role in some defects in temporomandibular joints. Since it may be misinterpreted as fractures or tumors in condylar area, proper diagnosis will help to prevent unnecessary treatments. A comprehensive knowledge about BMC may help to understand the developmental course of condyle and temporomandibular joints more clearly

Purpose: The purpose of this study was to estimate the prevalence of bifidity of condyle in a selected population in Iran by employing dental panoramic view

Materials and Method: Panoramic views of 1000 individuals [767 female, 233 male individuals] were assessed for bifidity. The patients were over 18 years old and had attended the radiology department of Shiraz dental school from September 2012 to March 2013

Results: A total of 35[3.5%] case of bifidity was detected. Unilateral form was much more prevalent [32 unilateral cases versus 3 bilateral]. The left-side bifidity was 3 times more prevalent than the right side. A large number of bifid condyles [63%] have shown symptoms of temporomandibular joint pain or click or both

Conclusion: The prevalence of bifidity in our population was about 3.5%, which was significantly high compared to the other published reports. Symptoms [click and pain] were also much more detected in our study

Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal

PURPOSE: Preoperative radiographic assessment of the mandibular third molars is essential to prevent inferior alveolar nerve damage during extraction. The purpose of this study was to assess the reliability of panoramic signs of association between the roots of teeth and the canal, and to compare the panoramic signs with cone beam computed tomography (CBCT) findings. MATERIALS AND METHODS: CBCT images of 132 impacted mandibular third molars were evaluated to determine the association of the root to the canal. The CBCT findings were compared with the corresponding panoramic images. Logistic regression analysis was used to define the diagnostic criteria of the panoramic images. RESULTS: Among the panoramic signs, loss of the cortical line was the most frequent radiographic sign predicting association (sensitivity: 79.31). Contact of the tooth with the canal was observed in all cases in which the loss of cortical line of the canal or darkening of the roots was found on the panoramic radiographs. CONCLUSION: Darkening of the roots and loss of the cortical line on panoramic radiographs might be highly suggestive of the risk of nerve injury.

Imaging findings in a case of Gorlin-Goltz syndrome: a survey using advanced modalities

Gorlin-Goltz syndrome is an infrequent multi-systemic disease which is characterized by multiple keratocysts in the jaws, calcification of falx cerebri, and basal cell carcinomas. We report a case of Gorlin-Goltz syndrome in a 23-year-old man with emphasis on image findings of keratocyctic odontogenic tumors (KCOTs) on panoramic radiograph, computed tomography, magnetic resonance (MR) imaging, and Ultrasonography (US). In this case, pericoronal lesions were mostly orthokeratinized odontogenic cyst (OOC) concerning the MR and US study, which tended to recur less. The aim of this report was to clarify the characteristic imaging features of the syndrome-related keratocysts that can be used to differentiate KCOT from OOC. Also, our findings suggested that the recurrence rate of KCOTs might be predicted based on their association to teeth.

[Sinonasal inverted papilloma with invasion to the skin and change to Squamous cell carcinoma]

Inverted Papilloma is the most common form of sinonasal Papilloma and accounts for 50-78% of sinonasal Papilloma and estimated to represent 0.5-4% of sinonasal tumors, with greatest potential for local invasion and malignant transformation. Recurrence rate of the disease is about 14 to 75% depending on the treatment modality. It is associated with malignancies usually squamous cell carcinoma in 3 to 24% of cases. The patient is a 43-year old man with chief complaint of trismus and pus drainage on his cheek from six months ago who came to Taleghani hospital in Tehran. Radiographic examinations revealed a mass in his right maxillary sinus involving the medial and lateral sinus walls but the orbital floor was intact. And cortical perforation was seen in Water's radiographic and CT scan. Incision biopsy was done from the palatal ulcer. According to histopathologic features we diagnosed a squamous cell carcinoma on a previous inverted Papilloma. Inverted papilloma has a great potential of recurrence and malignant transformation so a complete surgery and prolonged follow up is highly recommended. In this article patient didn't agree complete surgical removal lesion and attending follow up sessions