Evaluation and Correlation of Condylar Cortication by Cone-Beam Computed Tomography: A Retrospective Study.

Background: Temporomandibular joint (TMJ) is a ginglymo-diarthroidial joint with fibroelastic cartilage. The chondrogenesis initiates from the 12th week of intrauterine life and the development of condyle is associated with growth. The condylar cortication shows distinct morphological variation for each individual in each stage of their life. The cortical bone around the condyle could be used as a factor for chronological age assessment and it can act as a tool in forensic medicine. Aim and Objective: The study was carried out to evaluate the cortical grading in mandibular condyle using two different applications and to correlate their grades with chronological age. Setting and Design: Hospital-based retrospective observational cross-sectional study. Materials and Methods: The study was carried out in 40 patients and 80 TMJs were assessed for cortication grades in Carestream 3D imaging and Image J applications. These grading from both the applications were correlated with the chronological age. Statistical Analysis: SPSS (Statistical Analysis for the Social Science) - Cohen's Kappa inter-examiner reliability and Spearman's correlation coefficient were used. Results: The radiological assessment of condylar cortication in individual application showed significant results and the relationship of cortication with chronological age showed a significant correlation. Conclusion: The condylar cortication grading is a simple technique and can be used as a factor for chronological age assessment. This is an initial study which used two different applications to view the cortication of the mandibular condyle and to correlate the cortication with chronological age. Hence, a large sample size-based study is required for further research.

Validity of 3-Tesla diffusion-weighted magnetic resonance imaging for distinction of reactive and metastatic lymph nodes in head-and-neck carcinoma.

OBJECTIVES: The objective was to study the relationship of 3-Tesla (3T) diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) value for distinction of reactive and metastatic lymph nodes (LNs) in head-and-neck carcinoma (HNC) patients and to determine the ADC cutoff value for metastatic LNs at various levels. MATERIALS AND METHODS: 3T DW and T1- and T2-weighted imaging sequences were done in 34 patients with biopsy-proven primary HNC of 100 cervical LNs ≥1 cm in diameter. The mean ADC values were compared with histopathologically proven LNs using the independent t-test. ADC cutoff value was evaluated with sensitivity, specificity, accuracy, positive predictive value, negative predictive value and a receiver operating characteristic curve analysis. RESULTS: The mean ADC value of reactive LN was 1.2933 × 10-3 mm2/s and metastatic LN was 0.908 × 10-3 mm2/s. An ADC cutoff value was 0.868 × 10-3 mm2/s with 84% sensitivity, 96% specificity, 93% accuracy, 87.5% positive predictive value, and 94.7% negative predictive value. A significant difference in mean ADC value between reactive and metastatic LNs was noted (P< 0.001). CONCLUSION: 3T DW-MRI is useful in differentiating reactive and metastatic cervical LNs in HNC patients. However, studies with larger sample size have to be performed to validate ADC threshold value with 3T DW-MRI in differentiating between reactive and metastatic LNs for clinical practice.

Prediction of age and gender using digital radiographic method: A retrospective study.

AIM AND OBJECTIVE: To investigate age, sex based on gonial angle, width and breadth of the ramus of the mandible by digital orthopantomograph. MATERIALS AND METHODS: A total of 200 panoramic radiographic images were selected. The age of the individuals ranged between 4 and 75 years of both the gender - males (113) and females (87) and selected radiographic images were measured using KLONK image measurement software tool with linear, angular measurement. The investigated radiographs were collected from the records of SRM Dental College, Department of Oral Medicine and Radiology. Radiographs with any pathology, facial deformities, if no observation of mental foramen, congenital deformities, magnification, and distortion were excluded. RESULTS: Mean, median, standard deviation, derived to check the first and third quartile, linear regression is used to check age and gender correlation with angle of mandible, height and width of the ramus of mandible. CONCLUSION: The radiographic method is a simpler and cost-effective method of age identification compared with histological and biochemical methods. Mandible is strongest facial bone after the skull, pelvic bone. It is validatory to predict age and gender by many previous studies. Radiographic and tomographic images have become an essential aid for human identification in forensic dentistry forensic dentists can choose the most appropriate one since the validity of age and gender estimation crucially depends on the method used and its proper application.

Peripheral Primitive Neuroectodermal Tumour of the Maxilla and Paranasal Sinuses: A Rare Clinical Presentation.

Peripheral Primitive Neuroectodermal Tumours (pPNET) are rare aggressive tumours of neural crest cell origin. These tumours are more common in children and young adults. This is a unique report of one such presentation in a 23-year-old lady occurring in the left side posterior maxilla and Paranasal sinuses along with imaging characteristics, histopathologic features, immunohistochemical aspects and management. Though these tumours are rare, they should be considered in the differential diagnosis of rapidly growing soft tissue masses in young adults. Precise diagnosis with timely management is necessary for good prognosis.

Pediatric oral leiomyosarcoma: rare case report.

Soft tissue sarcomas comprise a group of histologically diverse malignant neoplasms arising from mesenchymal cell lines. Among these, leiomyosarcomas are sarcomas exhibiting smooth muscle differentiation. Occurrence of this neoplasm in the oral cavity is exceedingly rare and its presentation is unusual in children. We present a case report of leiomyosarcoma of the oral cavity in an eight-year old child. Primary oral leiomyosarcoma, being a rare entity in children, this case report emphasizes the prompt recognition of this tumor to institute appropriate multimodality treatment.

Focal lipoatrophy of face: a rare esthetic complaint.

A well-proportioned face combines features that are balanced and symmetrical. Any structural alteration that leads to facial asymmetry causes esthetical and psychological disturbances. Lipoatrophy is one such condition, which results in loss of subcutaneous fat layer and manifests as a depression. Although many subtypes with varying clinical and etiological backgrounds exist, the idiopathic form is rare and facial involvement is the rarest. Computed tomography is one of the accepted diagnostic tools to determine the atrophic layer of facial anatomy. This report presents the clinical types, diagnosis, and management of a case of facial lipoatrophy.