How important is patch testing with dental materials in real-life clinical practice?

Background: Allergy to dental materials in prostheses and implants that leads to dental device dysfunction is a challenging problem. Objective: In this prospective study, we aimed to investigate the diagnostic role and impact of dental patch test (DPT) results on the outcome of proceeding dental procedures with the collaboration of our allergy clinic and dental clinics. Methods: A total of 382 adult patients with oral or systemic signs or symptoms due to the applied dental materials were included. A DPT with 31 items was administered. The clinical findings after dental restoration according to the test results were assessed in the patients. Results: The most common positivity detected in the DPT was due to metals, among which nickel (29.1%) was the leading cause. The frequency of self-reported allergic diseases and metal allergy was significantly higher in patients with at least one positive result in the DPT (p = 0.004 and p < 0.001, respectively). Clinical improvement after the removal of dental restoration was seen in 82% of the patients who had a positive DPT result, whereas this rate was 54% among paatients with negative DPT results (p < 0.001). The only factor that predicted improvement after restoration was the positivity in the DPT result (odds ratio 3.96 [95% confidence interval, 0.21-7.09]; p < 0.001). Conclusion: Our study showed that a self-reported metal allergy was an important finding to predict allergic reactions to dental devices. Therefore, patients should be questioned for the presence of metal allergy-related signs and symptoms before exposure to the dental materials to prevent possible allergic reactions. Furthermore, DPT results are valuable to guide dental procedures in real life.

Biomechanical Comparison of Titanium and Poly- L -Lactic Acid Trapezoidal Plates Applied in a Subcondylar Fracture Model.

BACKGROUND/AIM: Different types of plates are used in clinical practice for the management of subcondylar fractures. This study aimed to compare the performance of poly- L -lactic acid (PLLA) and titanium trapezoidal plates in the fixation of subcondylar mandibular fractures using finite element analysis. METHODS: Titanium and PLLA trapezoidal plates and screws were placed on the virtual model obtained from computed tomography images of a patient with a subcondylar fracture to perform finite element analysis. The analysis included maximum tension distribution, maximum principal strain, displacement, and deformation of the bone, plates, and screws. RESULTS: The maximum tension distribution and maximum principal stress were found to be significantly higher on the titanium plate than on the PLLA plate and screws. Almost no difference was found between the trapezoidal and PLLA plates regarding the displacement of the fracture fragments at the fracture line. No difference was recorded regarding the displacement of the PLLA and titanium screws. The values of maximal principal strain between the PLLA and titanium materials showed no significant difference. CONCLUSIONS: The trapezoidal PLLA plates can be an alternative to trapezoidal titanium plates due to their functional stability and rigidity.

Smoking habits amongst patients with psoriasis and the effect of smoking on clinical and treatment-associated characteristics: A cross-sectional study.

BACKGROUND: Psoriasis is a multifactorial, chronic inflammatory skin disease where genetic and environmental factors play a role in the pathogenesis. Smoking is one of the critical environmental factors triggering psoriasis. OBJECTIVE: The purpose of the present study was to analyse the smoking habits of patients with psoriasis and the effect of smoking on disease characteristics. METHODS: One hundred and thirty-three patients who applied to the department of Dermatological and Venereal Diseases, Ankara Numune Education and Research Hospital, between May 2018 and May 2019 and were diagnosed with psoriasis participated in the study. Clinical, demographical, and treatment-related characteristics, and smoking habits of patients were recorded. RESULTS: Sixty-seven point six percent of psoriasis patients were smokers. The presence of moderate to severe psoriasis (P = .028), nail involvement (P = .004), administration of systemic treatment (P = .024) and additional cardiovascular disease (P = .038) frequencies was higher in smokers compared to non-smokers. Besides, a positive correlation was observed between the amount of smoking and psoriasis area and severity index (PASI) (P = .003; r = .32). CONCLUSIONS: Smoking has many negative effects on patients with psoriasis including higher PASI levels, increased frequency of nail involvement, and cardiovascular diseases. Questioning cigarette smoking in psoriatic patients and supporting smoking cessation may contribute to reducing the adverse impact of smoking on psoriasis.

A comparative study of surgical drain placement and the use of kinesiologic tape to reduce postoperative morbidity after third molar surgery.

OBJECTIVES: Our aim was to compare the effects of the surgical drain and kinesiotape applications on postoperative morbidity after mandibular third molar surgery in a split-mouth study design. MATERIALS AND METHODS: A single-centre, split-mouth study was performed in 23 patients who needed surgical removal of bilateral mandibular third molars. Each patient was treated with a drain tube on one side of the mandible and Kinesio tape (KT) on the contralateral side. RESULTS: Swelling was significantly greater in the KT group than in the drain group throughout the study period. The groups did not differ significantly in the amount of trismus at any time point. The Visual Analogue Scale (VAS)-measured pain intensity was significantly lower in the drainage group. Patients with KT had greater postoperative discomfort than those with a drain tube. All patients were generally satisfied with their treatments. CLINICAL RELEVANCE: Although both treatments were useful, a surgical drain was significantly more effective at reducing swelling and pain intensity than Kinesio tape. The effects of both on trismus were similar.

Elevated neutrophil to lymphocyte ratio as an indicator of secondary erythema nodosum, a retrospective observational study

Background/aim: Erythema nodosum (EN) is an inflammatory disorder of subcutaneous tissue. Although etiopathogenesis of the disease is unknown, many predisposing factors such as infections, systemic disease, and drugs have been identified. Neutrophil to lymphocyte ratio (NLR) has been shown to be a novel inflammatory marker in many dermatological diseases. The aim of our study is to investigate NLR in EN patients and evaluate its relation to the underlying cause of the disease. Materials and methods: Between 2014 and 2018, clinical and laboratory data of 395 patients diagnosed with EN and 395 controls were extracted from patient files. EN patients were grouped as idiopathic EN and secondary EN (EN with an identified underlying cause). Clinical and laboratory characteristics of the two groups were compared Results: NLR was elevated in EN patients compared to controls (median of 2.38 vs. 1.55, P < 0.001). Among EN patients, NLR was also elevated in patients with secondary EN. In multivariate logistic regression model NLR (> 2.11), RDW-CV (> 13.65), and CRP (> 5.5) were identified as risk factors for secondary EN (relative risks were 17.16, 2.69, and 2, respectively). Conclusion: Elevated NLR (> 2.11) may be used as a parameter to discriminate secondary EN from idiopathic EN.

The role of IFIH1 gene rs1990760 and rs2111485 single-nucleotide polymorphisms in generalized vitiligo predisposition

Background/aim: Interferon-induced helicase (IFIH1) is a gene locus that has been recently defined as a candidate for susceptibility to generalized vitiligo (GV). The objectives of this study were to assess the association of IFIH1 gene, rs2111485, and rs1990760 single-nucleotide polymorphisms (SNP) with susceptibility to GV and the autoimmune diseases accompanying GV. Materials and methods: We prospectively studied GV patients and frequency-matched healthy controls by age and sex. The genotypes of the participants were determined for rs1990760 and rs2111485 SNPs of IFIH1. Dominant, recessive, and additive models were evaluated for each SNP adjusted for age and sex. Results: The patients and their controls were observed to be in the Hardy­Weinberg equilibrium for SNP1 (2q24.2, rs1990760, IFIH1, T/C) and SNP2 (2q24.2, rs2111485, IFIH1, G/A), respectively (all P > 0.7). For SNP1, every T allel addition was significantly associated with 1.53 times protectiveness in terms of vitiligo risk (P = 0.033). As for SNP2, every G allel addition was associated with 1.42 times protectiveness, close to statistical significance (P = 0.100). Conclusions: We detected that for SNP1, each T allel and for SNP2, each G allel are protective in terms of vitiligo development. Hereby, we confirmed that IFIH1 gene locus has a role in GV susceptibility.

Juvenile-Onset Early-Stage Mycosis Fungoides-Associated Follicular Mucinosis: A Case Report.

We report a juvenile case of mycosis fungoides with prominent follicular mucinosis (FM). The patient was a 9-year old boy who presented with a 2-month history of enlarging alopecic patch with fine scales on the scalp. Dermatologic examination revealed orange-tan slightly palpable plaques with follicular prominence on his trunk. The patient and his family were not aware of these asymptomatic truncal plaques. Histopathologic examination of both-scalp and trunk-lesions revealed folliculotropic lymphocytic infiltration with mucin. Immunohistochemical study showed that lymphocytic infiltration was CD4 dominant. Flow cytometry analyses of peripheral blood were normal. Any abnormal populations and Sézary cells were not observed on blood smear. Polymerase chain reaction testing showed monoclonality for the T-cell receptor4-[Latin Small Letter Rams Horn] gene. Our patient had the clinical and histopathological diagnosis of follicular mycosis fungoides-associated follicular mucinosis.

Acceleration of Fracture Healing in Experimental Model: Platelet-Rich Fibrin or Hyaluronic Acid?

In this study, we compared the bone-healing effects of the local application of platelet-rich fibrin (PRF) and hyaluronic acid (HA) to bilateral tibial fractures in rats. Twenty-three adult male Sprague-Dawley rats were used. Twenty-two animals were randomly allocated to a control group (n = 6) and 2 study groups: PRF (n = 8) and HA (n = 8). The 23rd rat was used as a donor to obtain PRF. Each group was divided into 2 subgroups for histomorphometric and radiologic assessments at 2 and 6 weeks. Foreign body reaction, necrosis, inflammation, new bone formation, and fibrosis were investigated as bone healing parameters in terms of histopathologic analysis. The difference between the groups for these parameters was evaluated. The radiologic evaluation was performed by comparing the 3-dimensional reconstruction images of the fracture sites between the study and control groups. Histomorphometric evaluation showed that at 2 weeks postoperatively, the control group showed lesser bone formation (26.1 ±â€Š6.6%) when compared to the study (HA: 54.7 ±â€Š9.7%; PRF: 75.3 ±â€Š19.2%) groups and PRF group showed highest total ossification. At 6 weeks postoperatively the PRF group showed lesser total ossification (50.7 ±â€Š28.2%) when compared to control (76.3 ±â€Š21.7%) and HA group. The HA (88.8 ±â€Š13.3%) showed highest total ossification. In the control group, fibrosis was more prominent at week 6, whereas in the HA and PRF groups the amount of ossification increased. In contrast to histopathologic healing, radiologic bone healing did not differ significantly among the study and control groups 2 weeks after surgery, whereas at 6 weeks, the results of radiologic bone formation were in accordance with those of histopathologic bone healing.

Dermoscopy as a first step in the diagnosis of onychomycosis.

INTRODUCTION: Over the years, clinical studies have provided new knowledge about the dermoscopic features of the diseases of cutaneous annexes. It seems that dermoscopy has opened a new morphological dimension in the diagnosis and management of hair disorders and onychopathies. AIM: To identify and describe dermoscopic features of onychomycosis. MATERIAL AND METHODS: A total of 81 consecutive patients with onychomycosis (55 men and 26 women) were prospectively enrolled in the present study. For each patient, all fingernails and toenails were evaluated in clinical and dermoscopic examinations. Mycological tests were performed by potassium hydroxide (KOH) preparation. Mann-Whitney U and χ2 tests were used for the statistical analysis, with a significance threshold of p < 0.05. RESULTS: Dermoscopic examination of the patients' nails revealed the following: jagged proximal edge with spikes of the onycholytic area (51.9%), longitudinal streaks and patches (44.4%), subungual hyperkeratosis (27.2%), brown-black pigmentation (9.9%) and leukonychia (1.2%). Jagged proximal edge, subungual hyperkeratosis and leukonychia were positively associated with the onychomycosis type. CONCLUSIONS: Onychomycosis accounts for up to 50% of all consultations for onychopathies. Fast and effective diagnostic approaches are needed in everyday clinical practice. Dermoscopy can provide immediate and accurate information in the diagnosis of onychomycosis. We suggest that dermoscopy should be taken as a first step toward the diagnosis of onychomycosis.

Coexistence of Adult Onset Eruptive Syringoma and Bilateral Renal Cell Carcinoma: A Case Report.

Eruptive syringoma is an unusual variant of syringoma, which usually presents before or during puberty. It typically occurs in large numbers as multiple yellow-brown-colored papules, which may show spontaneous regression. Because some authors have proposed that it could present as a reactive process of eccrine ducts to an inflammatory reaction caused by an unknown trigger, the exact pathomechanism is still unclear. There are also reports in the literature on the association of eruptive syringoma in Down syndrome, diabetes, milium, sarcoidosis, and psychiatric disorders. Some reports in the literature highlighted the association of eruptive syringomas and neoplasms. We describe here a case of adult-onset eruptive syringoma in a 53-year-old man and discuss the possibility of its association with renal cell carcinoma as a paraneoplastic phenomenon.

A Case of Plasma Cell Granuloma Located on the Gingiva.

Plasma cell granuloma (PCG) is an uncommon benign tumor of unknown etiology, primarily located in the lungs. We report a case of PCG on the gingiva mimicking benign and malignant tumors in a 56-year-old woman. Histopathological examination revealed a relatively sharp circumscribed inflammatory cell infiltration under the mucosa-containing plasma cells, predominantly those including Russell bodies. Plasma cells are stained by CD138 immunohistochemistry. Polyclonal status of the lesion was confirmed by kappa and lambda light chaining. The typical histopathological and immunohistochemical findings in combination with the clinical features were consistent with PCG, about which the literature reports very few cases.

Eruptive Disseminated Porokeratosis in a Patient With Type 2 Diabetes Mellitus.

Porokeratosis includes a group of heterogenous disorders that represents distinct clinical subtypes of the same genetic pattern. Although entire pathogenesis of porokeratosis still remains unknown, certain factors including ultraviolet radiation and immunosuppression are suggested to be some of the factors inducing this disorder. Eruptive disseminated porokeratosis is a recently described form of porokeratosis, which frequently occurs in the presence of immunosuppresion or malignancy. The authors report here a unique case with sudden onset eruptive disseminated porokeratosis associated with diabetes mellitus.

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease.

BACKGROUND: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches. MAIN OBSERVATIONS: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease. CONCLUSIONS: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population.

Serum Levels of IL-35, One of the Newest Members of Interleukin-12 Family of Cytokines, in Patients With Vitiligo.

INTRODUCTION: Vitiligo is a chronic skin disorder in which immune dysregulation has been reported as one of the major etiopathological factors. Interleukin-12 (IL-12), IL-23 and IL-27 of IL-12 cytokine family were identified as critical cytokines in the pathogenesis of many autoimmune and inflammatory skin diseases including vitiligo. IL-35 is one of the newest member of IL-12 cytokine family. OBJECTIVES: The purpose of our study was to examine serum IL-35 levels in addition to serum IL-12, IL-23, IL-27 levels in the vitiligo patients and control group, and to investigate the relationship of these cytokines with the characteristics of vitiligo. METHODS: Serum IL-12, IL-23, IL-27 and IL-35 levels of 87 vitiligo patients and 70 healthy volunteers were analyzed using the enzyme-linked immunosorbent assay (ELISA). We compared the IL-12 cytokine family levels in the patient and control groups, and investigated the relationship of these levels with the characteristics of vitiligo. RESULTS: Patients had higher levels of IL-12 (31.2 versus 20.1, P < 0.001) and IL-35 (9.6 versus 8.1, P = 0.031). Patient and control groups had similar levels of IL-23 (P = 0.78) but were correlated with the Vitiligo Area Scoring Index (VASI) (P = 0.022, r = 0.35). Patients had lower levels of IL-27 (207.6 versus 258.7, P < 0.001). In addition, the levels of serum IL-27 were correlated negatively with the Vitiligo Disease Activity (VIDA), and positively with disease duration (P = 0.007, r = 0.30). CONCLUSIONS: Differences of serum levels between Vitiligo patients and healthy controls, significant relationships with the characteristics of vitiligo suggest that the IL-12 cytokine family may play a role in the pathogenesis of vitiligo.

Panton-Valentine leucocidin gene carriage among Staphylococcus aureus strains recovered from skin and soft tissue infections in Turkey.

OBJECTIVES: Regardless of methicillin resistance, Panton-Valentine leucocidin (PVL)-positive Staphylococcus aureus isolates are associated with various types of infections and outbreaks. Limited data exist about the PVL content of S. aureus strains in Turkey. In this multicentre study, we aimed to assess the PVL positivity and antimicrobial susceptibilities of S. aureus isolates recovered from skin and soft tissue samples of both community and nosocomial origin in the study period, 2007-08. METHODS: Two hundred and forty-two [92 community-acquired (CA) and 150 hospital-acquired (HA)] isolates were included in the study. Analysis of mecA and PVL was carried out using PCR. All isolates underwent susceptibility testing according to the CLSI. RESULTS: Out of 242 isolates, 77 were mecA positive. PVL was not found among methicillin-resistant S. aureus (MRSA) isolates, but 8 (5.3%) HA methicillin-susceptible S. aureus (MSSA) and 14 (15.2%) CA-MSSA, mostly isolated from furuncles (71.4%), were positive for PVL. Among PVL-positive strains, the penicillin resistance rate was 90.9%. Low resistance rates, <10%, were detected for erythromycin, fusidic acid and co-trimoxazole. PVL-positive strains showed higher rates of susceptibility to erythromycin, gentamicin and rifampicin than negative isolates. CONCLUSIONS: Based on the findings of this study, infection related to PVL-carrying CA-MRSA is not at an alarmingly high level, but population-based surveillance studies should be done to determine the real status.

Serum IL-17 levels in patients with rosacea.

BACKGROUND: Rosacea is a chronic inflammatory skin disease characterized with increased serum and tissue inflammatory mediators. IL-17 is a well-known inflammatory mediator that plays important roles in pathogenesis of inflammatory skin diseases. Previous studies reported that Th17 pathway is activated in rosacea and IL-17, one of Th17 signature cytokines, is elevated in tissue samples of rosacea patients. OBJECTIVES: The aim of this study was to investigate serum IL-17 levels in rosacea patients and to study its relationship with disease characteristics. METHODS: Sixty patients diagnosed with rosacea and 60 healthy controls were included in the study. Serum IL-17 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean serum IL-17 level was 8.03 pg/mL (SD = 1.47) in rosacea patients and 7.37 pg/mL (Sd = 1.19) in controls. Serum IL-17 levels were significantly higher in rosacea (p = 0.002). Serum IL-17 levels were similar among patients with erythematotelangiectatic (ET) and papulopustular (PP) rosacea (8.02 vs 8.06, p = 0.83). Serum IL-17 levels did not correlate with rosacea severity (p = 0.59, r = 0.07 in ET rosacea; p = 0.88, r = 0.02 in PP rosacea), age of onset (p = 0.58, r = -0.07), and disease duration (p = 0.37, r = -0.11). Primary features and global assessments did not correlate with serum IL-17 levels (all p > 0.05). Among secondary features, edema showed a significant negative correlation with serum IL-17 concentrations (p = 0.037, r = -0.26). CONCLUSIONS: Our study showed increased serum IL-17 levels in rosacea patients and a significant correlation between IL-17 concentrations and secondary features of the disease suggesting IL-17 may contribute to pathogenesis of rosacea and may be a new target for rosacea treatment.

Telogen effluvium in daily practice: Patient characteristics, laboratory parameters, and treatment modalities of 3028 patients with telogen effluvium.

BACKGROUND: Telogen effluvium (TE) is a common form of non-scarring alopecia, characterized by excessive shedding of telogen club hairs. OBJECTIVES: The aim of the present study was to investigate patient characteristics, laboratory parameters, and treatment strategies in TE. METHODS: Electronic records of 3028 patients were retrospectively analyzed. Demographic and clinical data, as well as serum parameters screening for iron, vitamin B12, vitamin D, folate and zinc deficiencies, thyroid function, and ANA titers, were evaluated. RESULTS: In the study group, the most frequently performed test type was serum ferritin level (82.3%), followed by complete blood count (81%), both of which revealed that 6.2% of the patients had iron deficiency anemia. 4.6% of the patients had thyroid dysfunction. In screened patients, vitamin and mineral deficiencies were as follows: vitamin D (72.2%), vitamin B12 (30.7%), folate (4.4%), and zinc (2.1%). Women were more likely to be prescribed vitamin D replacement therapy. Iron replacement was the most frequently ordered treatment, comprising 37.5% of total prescriptions. CONCLUSION: To the best of our knowledge, this is the most comprehensive retrospective study having the largest number of patients with TE. Our results will not only help to augment knowledge about TE, but also provide a diagnostic algorithm for the laboratory and clinical workup of patients with TE.

Serum levels of survivin in patients with psoriasis and their relation to disease characteristics.

BACKGROUND: Psoriasis is a chronic inflammatory disease in which T helper 1 (Th1) and Th17 cells play a major role in its pathogenesis. Studies have shown that keratinocytes in psoriatic tissue are resistant to apoptosis and have a high proliferation rate. Survivin is a multifunctional protein belonging to an apoptosis inhibitor family, which has significant effects on the immune system, such as activation of dendritic cells and T cells and immunomodulation. OBJECTIVES: To investigate a possible relationship between serum survivin levels and psoriasis disease characteristics and severity. MATERIALS AND METHODS: The present study included 84 patients with psoriasis who did not receive any systemic treatment for psoriasis in the last three months and 84 volunteers without psoriasis. Demographic data, smoking status, and alcohol consumption of the participants were questioned, and body mass index (BMI) was calculated. In the patient group, disease duration, family history, accompanying arthritis, and nail involvement were questioned and psoriasis area severity index (PASI) scores were calculated. Serum survivin levels were measured in all subjects. RESULTS: Serum survivin level was significantly higher in the patients compared to the controls (p = 0.008). There was no relationship between serum survivin level and disease duration, family history, joint involvement, nail involvement, BMI, and PASI score (all p-values > 0.05). Serum survivin levels were significantly higher in smokers than non-smokers and in alcohol consumers than patients that did not drink alcohol in the psoriasis group (p = 0.034 and p = 0.006, respectively). CONCLUSION: Serum survivin levels were higher in psoriasis patients than the control group. This finding suggests that this molecule, which is both immunomodulatory and an apoptosis inhibitor, may play a role in the pathogenesis of psoriasis. Significantly high serum survivin level in psoriasis patients who smoke suggests that smoking may act through survivin. More comprehensive studies are needed to evaluate the role of survivin in the pathogenesis of psoriasis and its relationship with smoking.

Evaluation of CT and MRI Imaging Results of Radicular Cysts, Odontogenic Keratocysts, and Dentigerous Cysts and their Contribution to the Differential Diagnosis.

AIM: This study aimed to evaluate the contribution of the MRI and CT results to the differential diagnosis of histopathologically different odontogenic cysts. BACKGROUND: Odontogenic cysts are commonly seen in the jaw bone and their surgical operations have an important place in the practice of maxillofacial surgery; treatment options for these cysts differ according to their histopathology. Differential results that can be obtained from the radiological evaluations of different cyst groups will allow the surgeon to plan a more accurate approach at the beginning of the operation. In this study, computed tomography (CT) and magnetic resonance imaging (MRI) results of different cyst groups were interpreted together with their histopathological diagnosis. METHODS: CT and MRI results of 17 patients aged between 19-61 were evaluated, whose histopathological diagnosis consisted of 3 radicular cysts (RC), a total of 9 odontogenic keratocysts (OKC) of which 4 were inflamed, and a total of 5 dentigerous cysts (DC) of which one of them was inflammatory. RESULTS: In the CT scan, all cysts showed lytic, a sclerotic surrounding, and showed MRI peripheral enhancement, whereas solid nodular enhancement was only observed in OKCs. Edema and/or air in the surrounding bone medulla was observed in the infected lesions. OKC was heterogeneous, whereas RC and DC were more homogeneous. Diffusion restriction was observed to be frequent in OKCs. The OKCs were ellipsoidal in appearance and were located parallel to the long axis of the bone, and their dimensions were observed to be larger than the other cysts. OKCs may be accompanied by unerupted teeth. Radicular cysts were located perpendicular to the long axis of the bone and were globular in appearance, and their dimensions were smaller and more homogeneous compared to the OKCs. Dentigerous cysts are also accompanied by an unerupted tooth, and their peripheral enhancement is minimal and homogeneous. However, dentigerous cysts can be dense in content and smaller in size, and ellipsoidal localization is more common than OKCs. CONCLUSION: In addition to classic panoramic radiography in the evaluation and differential diagnosis of maxillary and mandibular lesions, CT and MRI evaluations can provide helpful information to the surgeon and pathologist in making the diagnosis and may further help plan the operation.