Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know.

The differential diagnosis of a masticator space (MS) lesion is broad, owing in part to the multiple structures contained within such a small region. It is also because the MS is adjacent to many of the other deep spaces within the head and neck, which can act as gateways for disease spread. Therefore, emergency radiologists must be familiar with anatomy of the MS, as well as adjacent spaces in order to provide an accurate diagnosis to the referring clinician. This article illustrates the anatomy and common pathologies within the MS using a case-based multimodality approach. Common masticator space pathologies can be categorized into inflammatory/infectious, neoplastic, and vasoformative lesions. Important imaging features of MS lesions and patterns of disease spread will be discussed, with the aim of making this complex deep space more approachable in the emergent setting.

Stafne bone defects radiographic features in panoramic radiographs: Assessment of 91 cases

Background: To evaluate 91 cases of Stafne bone defect (SBD) in panoramic radiographs (PR) to determine the prevalence of different SBD variants, considering age, gender, and side. Additionally, to assess the most frequent imaging features of SBD. Material and Methods: Participant data were collected from 91 SBD cases with PR imaging. First, SBDs were classified according to their location, as anterior, posterior, or ramus variant. SBD imaging features were classified according to radiographic imaging findings, assessing margins, degree of internal radiolucency, shape, topographic relationship between the defect and mandibular border, location of the defect according to mandibular teeth, and locularity. The topographic relationship between the SBD and the mandibular canal was described for the inferior variant only. Mean sizes were also described. Results: A total of 92 SBD cases were evaluated from 91 radiographs. One case presented multiple defects. Mean patient age was 60.80 years. Men were more affected than women. The most frequent SBD variant was the posterior variant, and the least frequent was the ramus variant. The most observed radiographic features were thick sclerotic bone margin in the entire contour of the defect, partially radiolucent internal content, oval shape, continuity with mandible base without discontinuity of mandible border, third molar region location, and unilocular shape. With the posterior variant only, the most common topographic relationship between the defect and the upper wall of the mandibular canal was the defect located below the upper wall and continuous with the inferior wall of the mandibular canal. Conclusions: The knowledge of common SBD radiographic imaging features in PR can help dental practitioners with the differential diagnosis of SBD

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Single stage correction of bilateral tessier 4 cleft.

Tessier facial clefts are among the rarest facial clefts reported in literature and many contradicting issues have always been rising over the management and surgical approaches involved during the craniofacial cleft repair. Among the craniofacial clefts Tessier no. 4 is an extremely rare facial anomaly, and there are very few evidence which clearly describe the surgical approaches and techniques. Often these type of craniofacial clefts yield very poor surgical results, and they require multidisciplinary sequential corrective surgeries. This article presents a rare case of an 18-month-old baby with bilateral Tessier no. 4 clefts and its successful rehabilitation.

[APPLICATION OF THREE-DIMENSIONAL CEPHALOMETRIC ANALYSIS IN ORTHOGNATHIC SURGERY].

OBJECTIVE: To establish a model of three-dimensional (3-D) cephalometric analysis to study dentomaxillofacial deformities. METHODS: Between January 2012 and October 2013, 15 patients with dentomaxillofacial deformities were treated using 3-D cephalometric analysis in orthognathic surgery plan. There were 7 males and 8 females with an average age of 23.6 years (range, 17-37 years), including 4 cases of mandibular protrusion with maxillary deficiency, 4 cases of maxillary protrusion with mandibular deficiency, 2 cases of long face syndrome, and 5 cases of facial asymmetry. CT images were reconstructed by Mimics software. The anatomical landmarks were located, the reference planes and analysis planes were defined and the 3-D coordinate was established. The distance and degree between landmarks and analysis planes which defined in the measure project were measured. RESULTS: Based on the 3-D CT quantitative analysis methods, cephalometric analysis project was defined in the 3-D coordinate. 3-D cephalometric analysis provided a convenient and precise method for the clinical measurement of dentomaxillofacial morphology, and reduce the time in preoperation analysis. CONCLUSION: The model of 3-D CT cephalometric analysis can provide precise information in the diagnosis and treatment planning of orthognathic surgery.

Intraoral vertical ramus osteotomy improved the stomatognathic function in an elderly patient with mandibular protrusion: a case report.

This article reports the successful surgical-orthodontic treatment of an elderly patient with dentofacial deformity and signs and symptoms of temporomandibular disorder (TMD). The patient was a 63-year-old woman with a concave profile due to mandibular protrusion. To correct skeletal deformities, the mandible was posteriorly repositioned by employing intraoral vertical ramus osteotomy (IVRO) following presurgical orthodontic treatment. After active treatment for 31 months, the facial profile was significantly improved and satisfactory occlusion was achieved. In addition, TMD symptoms of clicking sounds on the left side and difficulty in mouth opening were resolved. Regarding the findings of magnetic resonance imaging, anterior disc displacement in the opening phase was improved in the temporomandibular joint on the left side. Furthermore, stomatognathic functions were also improved without any aggravation of age-related problems. In conclusion, surgical repositioning of the mandible using IVRO leads to both morphological and functional improvements even in elderly patients.