Bone apposition at the mandibular angles as a radiological sign of bruxism: a retrospective study.

BACKGROUND: The main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations (bone apposition in combination with directional change) in the mandibular angle region in bruxism patients. Another aim was to describe and detect different morphological characteristics of the jaw angles. METHODS: Two hundred panoramic radiographs were studied: 100 images of adults with clinically diagnosed bruxism (73 women, 27 men, age range 21-83 years), 100 images of a comparison group consisting of adolescents (66 girls, 34 boys, age range 12-18 years). RESULTS: The morphological changes of the 400 jaw angles could be classified into four degrees. In the adult group, almost half of mandibular angles showed bone apposition. Conversely, the prevalence in the control group was zero. The localization of the appositions corresponds to the insertions of the masseter and medial pterygoid muscles at the mandibular angle. CONCLUSIONS: The bone apposition at the mandibular angles should be interpreted as a functional adaptation to the long-term increased loads that occur during the contraction of the jaw closing muscles due to bruxism. Hence, radiologically diagnosed bone apposition may serve as an indication or confirmation of bruxism.

[New rules for diagnostic monitors in oral and maxillofacial radiology in Switzerland - a statement of the Swiss Association of Dentomaxillofacial Radiology]. / Neue Regeln für Monitore zur Befundung dentaler und maxillofazialer Röntgenbilder ­ Eine Stellungnahme der Schweizerischen Gesellschaft für Dentomaxillofaziale Radiologie (SGDMFR).

A considerable number of new regulations for oral and maxillofacial radiology was introduced in Switzerland roughly three years ago. The rules had to be followed immediately (date of entry was 1 January 2018) without any transition period. Since then, additional guidance papers have been published by the Swiss government. A current guidance paper is focusing on diagnostic monitors. Different demands for these must be met, which are related to the respective medical field, the type of imaging technology, and also environmental factors. Together with the many other regulations already enacted mainly in 2018 this is another piece of the puzzle on the road to perfecting regulations in oral and maxillofacial radiology with the aim to improve patient care.

Influence of surface anesthesia of the nasal cavity on oral tissues in the anterior region - a pilot study.

Nasal surface anesthesia is a simple, non-invasive method with a not yet fully understood effect on oral tissues. Should it prove to be successful in dental medicine, it could replace or at least complement the more invasive injection anesthesia, especially in children after dental trauma. The local anesthetic Tenaphin (tetracaine hydrochloride and naphazoline nitrate) was applied to 105 patients prior to ear, nose and throat medical diagnosis or therapy. After different exposure times, the influence on the oral tissues in the anterior region was examined by a dentist in the context of a pilot study. The effect of the mucosal anesthesia increased in the canine and anterior region the further mesial the tooth was located and the longer the application time was. In the buccal and palatinal area the effect increased from apical to incisal. The pulps of the central incisors and the canines were better anesthetized than those of the lateral incisors. Nasal surface anesthesia has the potential to replace the more invasive injection anesthesia in the anterior region of the upper jaw or to complement it. Dosage and exposure time will have to be investigated in more detail.

Establishment of national diagnostic reference levels in dental cone beam computed tomography in Switzerland.

OBJECTIVES: The aim of this study was to establish diagnostic reference levels (DRLs) in the field of dental maxillofacial and ear-nose-throat (ENT) practices using cone beam CT (CBCT) in Switzerland. METHODS: A questionnaire was sent to owners of CBCTs in Switzerland; to a total of 612 institutions. The answers were analyzed for each indication, provided that enough data were available. The DRLs were defined as the 75th percentile of air kerma product distribution (PKA). RESULTS: 227 answers were collected (38% of all centers). Third quartile of PKA values were obtained for five dental indications: 662 mGy cm² for wisdom tooth, 683 mGy cm² for single tooth implant treatment, 542 mGy cm² for tooth position anomalies, 569 mGy cm² for pathological dentoalveolar modifications, and 639 mGy cm² for endodontics. The standard field of view (FOV) size of 5 cm in diameter x 5 cm in height was proposed. CONCLUSIONS: Large ranges of FOV and PKA were found for a given indication, demonstrating the importance of establishing DRLs as well as FOV recommendations in view of optimizing the present practice. For now, only DRLs for dental and maxillofacial could be defined; because of a lack of ENT data, no DRL values for ENT practices could be derived from this survey.