Application Value of 64-slice Multidetector Spiral CT Contrast-enhanced Scan in Maxillofacial Soft Tissue Hypervascular Tumours.

OBJECTIVE: To evaluate the diagnostic ability and clinical imaging features in maxillofacial soft tissue hypervascular tumours by 64-slice multidetector spiral computed tomography (64-MDCT) contrast-enhanced scanning. METHODS: In a retrospective study of 21 cases of hypervascular tumours, the degree of blood supply and indexes were assessed, and the pathological results were used as the diagnostic gold standard to evaluate the sensitivity and specificity of 64-MDCT plain scan and enhanced CT in the diagnosis of oral and maxillofacial soft tissue hypervascular tumours, using the receiver operating characteristic curve to analyse and evaluate the efficacy. RESULTS: Among 21 patients, the diagnostic accuracy of 64-MDCT contrast-enhanced scan was 90.48%, the area under the curve of venous phase CT value was 0.80, the sensitivity was 83.30% and the specificity was 72.73%. CONCLUSION: 64-MDCT contrast-enhanced scan can be used to evaluate the blood supply of maxillofacial soft tissue hypervascular tumours before an operation. The CT value in the venous phase of tumours has the highest diagnostic effectiveness, which can reduce the risk of blood loss during surgery for maxillofacial hypervascular tumours. In addition, it has certain guiding significance for the formulation of clinical treatment plans.

Oral and maxillofacial pain as the first sign of metastasis of an occult primary tumour: A fifteen-year retrospective study.

BACKGROUND: Metastatic adenocarcinoma of the jaw (MAJ) is a rare disease that accounts for 1%-3% of all oral and maxillofacial malignant tumours. Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour. Therefore, early identification of oral and maxillofacial pain by dental professionals is critical. AIM: To explore the clinical and computerized tomography (CT) features of MAJ with oral and maxillofacial pain as the first symptom. METHODS: The medical records of all patients who were treated in our hospital between January 2006 and February 2020, and diagnosed with MAJ with oral and maxillofacial pain as the first symptom, were reviewed retrospectively. Clinical data were collected on age, sex, medical history, clinical manifestations, site of metastasis, and site of the primary lesion. CT features were analysed in detail, and a radiological classification scheme comprising five types: Osteolytic, osteoblastic, mixed, cystic, and alveolar bone resorption was proposed. RESULTS: The primary sites of MAJ were the lungs (n = 6), liver (n = 4), kidneys (n = 2), prostate (n = 1), and gastric cardia (n = 1). Five tumours were classified as the osteolytic type, all with a permeative margin (100%, P < 0.05), and three were classified as the mixed type, mostly with a moth-eaten margin (80%, P < 0.05). The cystic (n = 3) and alveolar bone resorption (n = 1) types had geographic margins, and the osteoblastic type (n = 1) had sclerotic margins. Moreover, nine tumours showed periosteal reaction and five showed a localised soft tissue mass, while the occurrence of jaw expansion was relatively rare. CONCLUSION: MAJ has complex clinical and CT features. Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.

[Comparative study of root canal morphology of mandibular incisors by cone-beam CT and canal staining and clearing technique].

PURPOSE: To compare the root canal morphology of mandibular incisors by using cone-beam CT (CBCT) and canal staining and clearing technique. METHODS: Sixty-one extracted mandibular incisors with complete dental root and apex which received no endodontic treatment and no post crown restoration were selected. Each tooth was radiographed with CBCT, and the root canal system was stained by canal staining and clearing technique. The consistency of the number of root canal, root canal Vertucci type of mandibular permanent incisors between the two methods were compared, and the differences of the detection rate on root canal branch structure between the two methods were analyzed. The results were statistically analyzed with SPSS 17.0 software package. RESULTS: The Kappa value of single and double root canal types between CBCT and canal staining and clearing technique was 0.847 (P<0.001). The Kappa value of Vertucci root canal types between CBCT and canal staining and clearing technique was 0.861 (P<0.001). The detection rates of root canal branch structure were 8.19% and 22.95%, respectively, with significant difference between the two methods (P=0.025). The canal staining and clearing technique was significantly better than CBCT in detection of root canal branch structure. CONCLUSIONS: CBCT can reflect the root canal types nearly perfectly, but inferior to canal staining and clearing technique in detection of root canal branch structure, CBCT is a relatively accurate clinical diagnosis tool of root canal morphology.

[Analysis of mandibular bone mineral density of senile osteoporosis patients].

OBJECTIVE: To investigate the mandibular bone mineral density (BMD) change of senile osteoporosis patients and the relationship between the mandible bone loss and systemic bone loss. METHODS: Forty senile osteoporotic patients (group A), 40 non-osteoporosis control elders (group B) and 40 healthy youths (group C) were included in this study. Standard digital panoramic tomography (SDPTG) was taken for each participant. Cortical width (CW), panoramic mandibular index (PMI), alveolar bone density and alveolar bone height were measured on the SDPTG. Lumbar and hip BMD were measured with dual energy X-ray absorptiometry (DXA). RESULTS: Close relationship was found between CW (3.57 +/- 0.82) and systemic BMD for osteoporosis patients (P < 0.05). All the SDPTG indices including CW, PMI, alveolar bone density and alveolar bone height were different for osteoporosis patients from the healthy youths (P < 0.05). The osteoporosis patients had thinner CW (3.57 +/- 0.82) and smaller PMI (0.29 +/- 0.06) than non-osteoporosis control elders (CW: 4.07 +/- 0.75, PMI: 0.32 +/- 0.07, P < 0.05). The alveolar bone density (105.40 +/- 20.48) and alveolar bone height (10.42 +/- 1.82) of the non-osteoporosis control elders reduced compared with the healthy youths (alveolar bone density: 117.10 +/- 22.23, alveolar bone height: 11.69 +/- 1.63, P < 0.05). CONCLUSIONS: The senile osteoporotic patients had significant mandibular cortical bone loss.

Evaluation of nonsyndromic multiple supernumerary teeth using three-dimensional computerized tomography: a case report and literature review.

AIM: The aims of this report are to present a case of nonsyndromic multiple supernumerary teeth and a discussion of the value of three-dimensional computerized tomography (3D CT) for precise radiographic imaging of the anomaly. BACKGROUND: Multiple supernumerary teeth without any associated syndromes are very rare. Exact radiographic presentations with an associated diagnosis of nonsyndromic multiple supernumerary teeth have not been well published. REPORT: A young Chinese female patient presented with asymmetrical nonsyndromic multiple supernumerary teeth in the premolar and molar regions of her mouth. A 3D CT was used to evaluate the exact location and orientation of these teeth and to guide the treatment strategy. SUMMARY: The use of 3D CT for the evaluation of supernumerary teeth proved to be very useful in determining their size, location, and state of development, as well as their impact on adjacent teeth and tissues in a 15-year-old patient. CLINICAL SIGNIFICANCE: The 3D CT is a very useful radiological tool to assess nonsyndromic multiple supernumerary teeth.

[Evaluation of mandibule bone loss of periodontitis with standard digital panoramic tomogram].

OBJECTIVE: To compare the mandibular indices differences between periodontitis and non-periodontitis subjects by digital panoramic tomograms in order to find a simple and effective method to evaluate the density of alveolar bone and study the relativity between local bone loss and systemic bone loss. METHODS: Standard digital panoramic tomograms of sixty periodontitis subjects and sixty non-periodontitis subjects were taken. Density and height cortical width (CW) and panoramic mandibular index (PMI) of alveolar bone were measured on the digital panoramic tomograms. SPSS 12.0 was used for statistics analyses. RESULTS: The periodontitis subjects had lower height of alveolar bone (8.76 mm vs. 11.85 mm, P=0.000), lower density of alveolar bone (106.08 vs. 113.33, P=0.034), thinner cortical width (3.80 mm vs. 4.27 mm, P=0.008), while the difference of PMI between the two groups was not significant (P>0.05). The relativity between both density and height of alveolar bone with CW was significant (P<0.05), but not significant with PMI (P>0.05). CONCLUSION: The optical method is a simple and effective method to measure the density of the alveolar bone. Compared with the non-periodontitis subjects, the periodontitis subjects not only have alveolar bone changed significantly but also have thinner cortical width.

[Bone density changes in the apical area after rapid orthodontic extrusion of subgingivally fractured tooth].

OBJECTIVE: To evaluate the bone density changes in the apical area of subgingivally fractured tooth after rapid orthodontic extrusion. METHODS: Twelve fractured incisors in 11 patients extended 2 - 5 mm below the gingival line were selected. Two weeks after root canal therapy, the subgingival fragment was lifted up and the fracture line was brought 1.5 - 2.0 mm above the level of the gingival line by means of edgewise fixed appliance. After the extrusion completed, the tooth had been stabilized and held for 6 months. The CT Analyser software was used to measure the bone density changes in the apical area on radiographs once a month. Changes of relative value in bone density was quantitatively analyzed. RESULTS: The average period of extrusion was 11 days. The relative value of bone density in the apical region was -39.6% immediately after extrusion and continuously increased afterwards. In the third month, the value (18.5%) changed most rapidly (P < 0.01). CONCLUSIONS: Under the continuous and proper tooth axial extrusion force, the tooth moved rapidly and steadily. The bone density in the apical area approached normal value within 3 months after treatment.