Incidental findings on dental radiographs: dentigerous cyst.

Dentigerous cysts are the second-most-common cysts occurring in the jaws. A dentigerous cyst is formed as a result of fluid accumulation in the reduced enamel epithelium surrounding an unerupted tooth. These cysts typically present as well-defined pericoronal radiolucencies either superior or lateral to the unerupted tooth. Dentigerous cysts involving the posterior maxillary teeth tend to grow into and fill the maxillary sinus and, hence, are discovered late. Posterior mandibular dentigerous cysts commonly extend well into the ramus. There are often no clinical symptoms, with the exception of swelling once the cyst reaches a considerable size.

Panoramic radiographs: a screening tool for calcified carotid atheromatous plaque.

Stroke is the third leading cause of death in the United States, according to a 2005 National Center for Health Statistics report. Atherosclerotic plaque in the cervical carotid artery accounts for a major proportion of strokes and also leads to billions of dollars in direct and indirect costs annually. The carotid bifurcation area, which is a likely site for atherosclerotic plaque accumulation, is well within the field of view of a diagnostic panoramic radiograph. Panoramic radiographs are the most frequently used extraoral images in private dental practices. It is only logical to use this widely available diagnostic tool to screen for calcifications in the cervical carotid arteries. If this oral and maxillofacial manifestation of a systemic disorder is identified during routine dental care and the patient is referred for appropriate follow-up and management, it would help reduce morbidity and bring significant savings in overall health care costs associated with atherosclerosis.

Periodontal pathology associated with asymptomatic third molars.

PURPOSE: We report the prevalence of periodontal probing depth (PD) as a clinical measure of the extent of periodontitis associated with asymptomatic third molars at the initial examination in a cohort of patients enrolled in an institutional review board-approved longitudinal clinical trial. PATIENTS AND METHODS: Three hundred twenty-nine healthy patients were enrolled during a 30-month period. Full mouth periodontal probing that included third molars was conducted to determine periodontal status. Panoramic radiographs were taken to assess the degree of eruption of the third molars and the angulation of third molars compared with the adjacent second molar. Vertical bitewing radiographs were analyzed to detect alveolar bone levels relative to the cementoenamel junction on the distal of second molars. RESULTS: Twenty-five percent (82 of 329) of all enrolled patients, and 34% (14 of 41) of black patients, had at least one PD equal to or greater than 5 mm on the distal of a second molar or around a third molar. PD equal to or greater than 5 mm was associated with periodontal attachment loss of at least 1 mm in every patient; PD equal to or greater than 5 mm was associated with attachment loss equal to or greater than 2 mm in 80 of 82 patients. A higher proportion of patients 25 years old or older had a PD equal to or greater than 5 mm on the distal of second molars or around third molars compared with patients younger than 25 years (33% vs 17%, P =.002). The distals of second molars and third molars in the mandible were affected more often than in the maxilla (25% vs 5%, P =.0001). CONCLUSIONS: Our data indicating that 25% of patients with retained asymptomatic third molars have considerable periodontal pathology in the third molar region were unexpected. National epidemiologic surveys indicate a much lower rate of periodontitis in the population younger than 35 years.