RESUMO
Unilateral condylar hyperactivity is a growth disorder which is characterised by a progressive asymmetry in the mandibula and in some cases also secondarily in the maxilla. Various forms are hemimandibular hyperplasia, hemimandibular elongation and a hybridform. In deciding on a plan of treatment, it is important to determine whether there is a question of continuous and/or excessive condylar activity, possibly with the help of a skeletal scintigraphy.
Assuntos
Assimetria Facial/etiologia , Assimetria Facial/prevenção & controle , Mandíbula/anormalidades , Côndilo Mandibular/anormalidades , Humanos , Hiperplasia/etiologia , Hiperplasia/prevenção & controle , Hipertrofia/etiologia , Hipertrofia/prevenção & controle , CintilografiaRESUMO
This report describes a large solitary bone cyst involving the mandibular ramus, presenting with a history of recurrent hypoaesthesia of the lower lip and a multilocular, multilobular radiological aspect with cortical expansion and possibly cortical perforation.
Assuntos
Cistos Ósseos/cirurgia , Hipestesia/etiologia , Mandíbula/cirurgia , Doenças Mandibulares/cirurgia , Nervo Mandibular/fisiopatologia , Cistos Ósseos/complicações , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/patologia , Feminino , Humanos , Hipestesia/diagnóstico por imagem , Hipestesia/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Doenças Mandibulares/complicações , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/patologia , Radiografia , Resultado do Tratamento , Adulto JovemRESUMO
This study aimed to compare different analytical methods and identify the optimal analysis method to distinguish patients with unilateral condylar hyperactivity (UCH) from those with inactive condyles. Single-photon emission computed tomography (SPECT) scans of patients with progressive and nonprogressive mandibular asymmetry (each group, n=26), were analyzed using the region of interest technique. Sensitivity, specificity and receiver operating characteristic (ROC) curves were calculated for the different analytic methods. The ROC curve illustrates that UCH can be diagnosed significantly better by determining the percentile bone activity in both condyles. The area under the curve (AUC) of the percentile comparison between the affected and contralateral condyles was 0.93+/-0.04, that for the condyle/clivus ratio was 0.75+/-0.07 and for the condyle/cervical spine (CS) ratio 0.57+/-0.08. Sensitivity for the condyle/clivus ratio was 65% and specificity 61%. Sensitivity for the condyle/CS ratio was 85% and specificity 31%. For the percentile difference of the condyles, sensitivity and specificity were 88%. For UCH patients, direct comparison of bone activity between the affected and contralateral condyle in SPECT scans is the analysis method of choice. Comparison of condylar bone activity to reference bone activity does not have additional value in the diagnosis of UCH.
Assuntos
Assimetria Facial/diagnóstico por imagem , Lâmina de Crescimento/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Côndilo Mandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adolescente , Adulto , Área Sob a Curva , Estudos de Casos e Controles , Criança , Estudos de Coortes , Assimetria Facial/etiologia , Feminino , Lateralidade Funcional , Lâmina de Crescimento/anormalidades , Humanos , Masculino , Côndilo Mandibular/anormalidades , Côndilo Mandibular/crescimento & desenvolvimento , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/etiologia , Curva ROC , Sensibilidade e Especificidade , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/patologia , Tomografia Computadorizada de Emissão de Fóton Único , Adulto JovemAssuntos
Cistos/cirurgia , Doenças Labiais/cirurgia , Ducto Nasolacrimal/cirurgia , Doenças Nasais/cirurgia , Cistos/diagnóstico , Cistos/patologia , Feminino , Humanos , Doenças Labiais/diagnóstico , Doenças Labiais/patologia , Pessoa de Meia-Idade , Ducto Nasolacrimal/patologia , Doenças Nasais/diagnóstico , Doenças Nasais/patologia , RecidivaRESUMO
OBJECTIVE: Evaluation of dental behaviour of anxious children after treatment at a Special Dental Care Centre. DESIGN: Retrospective, descriptive study. SETTING: Dutch Special Dental Care Centre (SBT). METHODS: A representative sample of parents was interviewed 1-2 years after their child's treatment at the centre about their present behaviour with respect to the home dentist. RESULTS: Results were analyzed using Analysis of Variance. Results indicate that within 1-2 years more than 90% of the children visited a home dentist, 80% of them had to be treated curatively and 60% of the treatment was performed using local anaesthesia. Retrospectively, the parents report a decrease of their child's dental anxiety, when leaving the SBT. The level of anxiety is unchanged after 1-2 years visiting a home dentist. For the children there was a significant relation between dental anxiety as reported by the parents and not visiting a home dentist. The high prevalence of curative treatment might indicate that children in this group belong to a caries risk group and might need extra preventive attention. CONCLUSIONS: After the initial treatment at the special dental care centre most children return to their home dentist. The children in this group referred for dental anxiety, belong to a caries risk group and might need extra preventive attention.