Comparison of carotid artery calcification between stroke and nonstroke patients using CT angiographic and panoramic images.

OBJECTIVES: This study aimed to analyze the characteristics of carotid artery calcification (CAC) in stroke and nonstroke patients using computed tomography angiographic (CTA) and panoramic images. METHODS: This is a retrospective study on patients who acquired both CTA and panoramic images at the Neurology Department of Kyungpook National University Hospital, Daegu, South Korea, between 2011 and 2016. The patients were divided into stroke (n = 109) and nonstroke (n = 355) groups based on the final diagnosis. CAC was analyzed in each group based on its presence, shape, and severity using the [Formula: see text]2 test. The differences in age and sex between the two groups were examined using a two-sample t-test. A measure of intraobserver reliability was obtained using Cohen's κ index. RESULTS: CAC was more frequently observed in the stroke group than in the nonstroke group using both CTA (stroke group, 100%; nonstroke group, 23.1%) and panoramic (stroke group, 83.5%; nonstroke group, 16.6%) images. Although scattered CAC shape and mild severity occupied the largest portion in both groups, vessel-outlined CAC was more common in nonstroke patients than in stroke patients. In age and sex analyses, only females patients in their 70 s showed significant differences in CAC shape between the stroke and nonstroke groups. CONCLUSIONS: On both CTA and panoramic images, although CAC is found more frequently in the stroke group, vessel-outlined-shaped CAC in the nonstorke group shows significant differences compared to other shapes.

Giant lipoma of the tongue: A case report and review of the literature.

This report presents the case of a 49-year-old man who presented with giant masses that had recently grown on the bilateral sides of the tongue. A clinical examination revealed rubbery yellowish lesions protruding from the tongue. A panoramic radiograph showed an enlarged soft tissue shadow of the tongue. Computed tomography showed well-defined circumscribed mass exhibiting a homogeneous low density on the bilateral sides of the tongue. On magnetic resonance images, the masses showed a high signal intensity on T1-weighted images and iso-signal intensity with partially hyperintense margin on fat-suppressed T2-weighted images. Surgical excision was performed, and a histopathologic examination confirmed the diagnosis of lipoma. The patient recovered well with no sign of recurrence. A giant lipoma is defined as a lipoma larger than 5 cm in diameter. A literature review of giant lipomas of the tongue is also presented herein.

Recurrent benign cementoblastoma: A case report and literature review.

A 16-year-old male presented with pain in the right posterior mandible on chewing that had lasted for several months. The radiographic features of the lesion included a radiolucent-radiopaque mixed-density mass with a radiolucent rim attached to the root of the mandibular right first molar. The preliminary radiographic diagnosis was benign cementoblastoma, which was confirmed by histopathological examination following surgical excision. The lesion recurred 3 years after treatment; radiographically, it consisted of 3 round foci with mixed radiopacity, each with a radiolucent rim near the root of the mandibular right second premolar and the edentulous postoperative region. The lesion was diagnosed as recurrent benign cementoblastoma and a second surgery was scheduled. This report presented an unusual case of recurrent benign cementoblastoma following surgical excision and extraction of the involved tooth, along with a literature review on reported cases of recurrent benign cementoblastoma with a focus on its clinical features and the best treatment options.

Radiographic study of dermal fillers in the facial area: A series of 3 cases.

In recent years, as interest in maintaining beauty and a youthful appearance has grown, filler procedures such as soft tissue augmentation have become more popular. These fillers are sometimes seen as radiopaque shadows on radiographic images, either due to the fillers themselves or because of secondary reactions; such findings may present a diagnostic challenge to dentists. The present report describes 3 cases of dermal fillers observed in panoramic and cone-beam computed tomographic (CBCT) images. All 3 elderly female patients had filler injected into their cheeks and chin area for cosmetic purposes decades ago. On panoramic images, multiple symmetric radiopacities were observed in the facial area; on CBCT, these calcifications were seen in the subcutaneous tissue in various shapes and with varying density. In conclusion, dentists should be aware of the imaging characteristics of dermal filler, and should be able to differentiate dermal filler from other pathological findings.

Effects of vascular formation during alveolar bone process morphogenesis in mice.

The alveolar bone process is the thickened ridge of bone that bears the teeth and is known to have dynamic functional interactions with surrounding tissues. However, the detailed morphological changes that occur during alveolar bone process development and the underlying molecular mechanisms behind this morphogenesis have not been elucidated. In this study, we examined the detailed morphological changes of the alveolar bone process during mouse development using HE and MTC staining. In addition, we evaluated the precise localization pattern of various signaling molecules involved in blood vessel formation including CD31, α-SMA, VEGF, periostin, and TGF-ß. Innervation of the alveolar bone process was examined following injection of the nerve terminal dye AM1-43. The morphological and immunohistochemical data suggested that there is an intimate relationship between alveolar bone process development and blood vessel formation. To more closely examine the role of blood vessels in alveolar bone process formation, we microinjected mice with a clinically available anti-VEGF antibody, bevacizumab, at PN5 and analyzed the effects 5 days later. Compared to the control animals, anti-VEGF treated animals showed a disruption of the integration of bony tissues to form the alveolar bone process structures, which should contain the periodontal ligaments. Based on these data, we conclude that specific morphogenesis of the alveolar bone process is closely associated with blood vessel formation.

Recurrent osteochondroma of the mandibular condyle: A case report.

A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended.

Multiple simple bone cysts of the jaws: review of the literature and report of three cases.

OBJECTIVES: This study contributes three well-documented cases of multiple simple bone cysts (SBCs) of the jaws and reviews previously published cases. STUDY DESIGN: A comprehensive literature search of multiple SBCs was conducted using the PubMed database. Synonyms of SBC were used as search key words in combination with "mandible or jaw," "bilateral, multiple, multifocal, atypical, and unusual." RESULTS: A total of 34 cases of multiple SBCs (including two asynchronous cases) were identified, including the three new cases reported here. Multiple SBCs primarily occurred in the second decade (52.9%) and bilaterally in the posterior mandible. Lesions demonstrated female predominance (1.8:1) and were frequently accompanied by bony expansion (44.1%) and a multilocular radiolucent appearance (20.6 %). Recurrence was reported in three patients (mean age: 39.3 years old). CONCLUSION: Knowledge of the clinical and radiographic features of multiple SBCs is important in the diagnosis and management of this entity.

Unusual osteoid osteoma of the mandible: report of case and review of the literature.

A 10-year-old boy presented with a swelling on the right side of the jaw. He had undergone excision of the lesion about 10 months ago at a private dental clinic and the swelling began to regrow 4 months after surgery. A panoramic radiograph revealed 4 sclerotic round masses with radiolucent rims surrounded by sclerosis of the right posterior mandible. Computed tomography scan showed 4 round bony masses centered on the buccal cortex and bone marrow space, sclerosis of the adjacent bone and periosteal reaction. He underwent a marginal resection under general anesthesia and the final histopathological report confirmed the diagnosis of osteoid osteoma. Postoperative course was uneventful, and there was no evidence of recurrence at the 5.5-year follow-up. In the review of the literature, 20 osteoid ostemas were found in the jaw and to the best of our knowledge, the present case is the only one showing multifocal nidi.

Odontoma: a retrospective study of 73 cases.

PURPOSE: The purpose of the present study was to retrospectively evaluate the clinical findings and treatment results for impacted permanent teeth associated with odontomas. MATERIALS AND METHODS: We retrospectively investigated 73 odontomas in 72 patients who visited Kyungpook National University Dental Hospital from April 2004 through November 2011. The study was performed using medical records, panoramic radiographs, and pathological reports. Data gathered included age, gender, location, chief complaints, effects on dentition, and treatment of odontoma and the impacted tooth associated with odontoma. RESULTS: Most compound odontomas (46.7%) were found in the second decade and complex odontomas were not related to age. Odontomas showed no gender predilection. Fifty-five cases (75.3%) of odontomas were detected on routine dental radiographs. Sixty percent of compound odontomas occurred in the canine area and 57.1% of complex odontomas in the molar areas. Impaction of permanent teeth (61.6%) was the most common complication on the adjacent teeth. Most odontomas (84.9%) were removed surgically and impacted permanent teeth were managed by surgical removal (53.2%), orthodontic treatment (25.5%), or surgical repositioning (6.4%). There was a statistically significant relation between age and preservation of the impacted permanent teeth associated with odontomas (p<0.01). CONCLUSION: Early detection and treatment of odontomas increase the possibility of preservation of the impacted tooth. Therefore, it would be suggested that periodic panoramic examination during the first and second decade of life might be beneficial for the early detection and better prognosis of odontomas.

Developmental changes in distribution of gamma-aminobutyric acid- and glycine-immunoreactive boutons on rat trigeminal motoneurons. I. Jaw-closing motoneurons.

We have previously described the distribution pattern of inhibitory synapses on rat jaw-closing (JC) alpha- and gamma-motoneurons. In the present study, we investigated developmental changes in inhibitory synapses on JC motoneurons. We performed a quantitative ultrastructural analysis of putative inhibitory synaptic boutons on JC motoneuron somata by using postembedding immunogold labeling for GABA and glycine. In total, 206, 350, and 497 boutons contacting JC motoneuron somata were analyzed at postnatal days 2 (P2), 11 (P11) and 31 (P31), respectively. The size of the somata increased significantly during postnatal development. The size distribution was bimodal at P31. Mean length of the boutons and percentage of synaptic covering also increased during postnatal development, whereas bouton density did not differ significantly among the three age groups. Synaptic boutons on the somata of JC alpha-motoneurons could be classified into four types: boutons immunoreactive for 1) GABA only, 2) glycine only, 3) both GABA and glycine, and 4) neither GABA nor glycine. There was no developmental change in the proportion of putative inhibitory boutons to the total number of studied boutons. However, the glycine-only boutons increased significantly (15.1% to 27.3%), and the GABA-only boutons decreased significantly (17.7% to 2.6%) during the period from P11 to P31. Our ultrastructural data indicate that the inhibitory synaptic input to JC motoneurons is developmentally regulated and that there is a postnatal switch from GABA to glycine. The postnatal changes revealed in the present study could play an important role in the maturation of the oral motor system.