A Literature Review of the Rare Coexistence of Central Giant Cell Granuloma with Aneurysmal Bone Cyst: A Case Report.

INTRODUCTION: Central giant cell granuloma (CGCG) is a benign bone tumor that occurs more in young females and anterior of the mandible. It can be unilocular or multilocular with wispy-septation, undulating borders, cortical expansion, and perforation. Central giant cell granuloma in association with other benign lesions of the jaws is named hybrid lesion. An aneurysmal bone cyst (ABC) is a rare, rapidly growing benign tumor that is commonly developed in young females and the mandible molar and ramus regions. It is usually a well-defined cyst-like expansile lesion with an internal structure similar to CGC lesions in radiographic features. CASE REPORT: A 17-year-old girl was referred to the radiology department for panoramic radiography at the end of orthodontic treatment. The complete opacification of the right maxillary sinus, root resorption, and periodontal ligament widening was evident in panoramic radiography. Cone-beam computed tomography revealed a soft-tissue mass and displacement of the lateral nasal wall. The lesion was multilocular with wispy septation and ground glass in some parts. On T2-weighted magnetic resonance imaging, a heterogeneous mass with low to intermediate signals and fluid-fluid levels were observed. The patient underwent surgical curettage, and the histopathological diagnosis was the coexistence of CGCG and ABC. CONCLUSION: An unusual view of the coexistence of CGCG and ABC could be a lesion with ground glass pattern calcification. Hybrid lesions with the coexistence of CGCG and ABC are rare, and only six cases are reported in the literature in this regard.

Evaluation of condylar positions in patients with temporomandibular disorders: A cone-beam computed tomographic study.

PURPOSE: This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. RESULTS: The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. CONCLUSION: The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.

The efficacy of magnetic resonance imaging and color Doppler ultrasonography in diagnosis of salivary gland tumors.

Background and aims. Although salivary gland tumors are not very common, early diagnosis and treatment is crucial because of their proximity to vital organs, and therefore, determining the efficacy of new imaging procedures becomes important. This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI) and color doppler ultrasonography parameters in the diagnosis and differentiation of benign and malignant salivary gland tumors. Materials and methods. In this cross-sectional study, color doppler ultrasonography and MRI were performed for 22 patients with salivary gland tumor. Demographic data as well as MRI, color doppler ultrasonography, and surgical parameters including tumor site, signal in MRI images, ultrasound echo, tumor border, lymphadenopathy, invasion, perfusion, vascular resistance index (RI), vascular pulse index (PI) were analyzed using Chi-square test, Fisher's exact test, and independent t-test. Results. The mean age of patients was 46.59±13.97 years (8 males and 14females). Patients with malignant tumors were older (P < 0.01). The most common tumors were pleomorphic adenoma (36.4%), metastasis (36.4%), and mucoepidermoid carcinoma (9%). Nine tumors (40.9%) were benign and 13 (59.1%) were malignant. The overall accuracy of MRI and color doppler ultrasonography in determining tumor site was 100% and 95%, respectively. No significant difference observed between RI and PI and the diagnosis of tumor. Conclusion. Both MRI and ultrasonography have high accuracy in the localization of tumors. Well-identified border was a sign of benign tumors. Also, invasion to adjacent structures was a predictive factor for malignancy.

Ultrasonographic findings of masseter muscle in females with temporomandibular disorders.

OBJECTIVES: The aim of this study was to evaluate of ultrasonographic findings of masseter muscle in females with temporomandibular disorders. Sonographic features were compared in those with myofacial pain disorder (MPD) and temporomandibular click, as well as healthy women. METHODS: Sixty-three females referred to the Prosthetic Department of Dental Faculty of Mashhad University of Medical Sciences (22 with MPD, 21 with click, and 20 control subjects) aged from 20 to 40 years were evaluated. The masseter muscle thickness in each group was measured bilaterally at rest and maximum contraction by a real-time ultrasound imaging technique. The type of the internal pattern of the masseter muscle in sonography was classified to 3 types (I, II, and III) according to the visibility, widths, and echogenicity of internal echogenic bands. RESULTS: In the right-side masseter, thickness in the control group was greater than that in the MPD group (P = 0.033). There was no significant difference about the thickness of the masseter at rest and at maximum contraction between both sides in control and MPD groups; however, in the click group, the difference was significant. Also, the muscle thickness of either right or left side at rest and at maximum contraction was significant. There was a significant difference between control and MPD groups (P < 0.001) as well as MPD and click groups (P < 0.001) in the type of the internal pattern. CONCLUSIONS: There were obvious ultrasonographic changes of the masseter muscle in females with MPD, which might be related to the muscle inflammation.

Evaluation of the relationship between vertical facial height and the morphology of the temporomandibular joint in skeletal class 3 patients.

Class 3 patients may have relatively high prevalences of temporomandibular disorders; therefore, joint morphology can be important for their orthodontic-surgical treatments. The aim of this study was to evaluate the relationship between facial height and TMJ morphology in skeletal class 3 patients.

Doppler sonography confirmation in patients showing calcified carotid artery atheroma in panoramic radiography and evaluation of related risk factors.

BACKGROUND AND AIMS: The purpose of this study was to identify patients at the risk of cerebrovascular attack (CVA) by detecting calcified carotid artery atheroma (CCAA) in panoramic radiography and evaluating their risk factors. MATERIALS AND METHODS: A total of 960 panoramic radiographs of patients above 40 years old were evaluated. Doppler Sonography (DS) was performed for patients who showed calcified carotid artery atheroma (CCAA) in panoramic radiogra-phy in order to determine the presence of CCAA and the degree of stenosis. Cardiovascular risk factors in both groups of patients with CCAA (12 subjects) and without CCAA (3 subjects) were compared using a questionnaire filled out by the patients. Statistical analysis including Fisher and independent t-test applied for data analysis. RESULTS: Fifteen patients (30 sides) showed calcification in their panoramic radiographs, and underwent DS which revealed CCAA in 16 sides (12 patients). Two patients (13.33%) showed stenosis greater than 70%. Among the risk factors, only age showed a significant association with the occurrence of carotid calcified atheroma (P=0.026). CONCLUSION: Considering the results, dentists should refer especially elderly patients with radiographically identified atheromas for further examinations, as asymptomatic CCAA might be associated with high degrees of stenosis.

Correlation between cervical vertebral and dental maturity in Iranian subjects.

Determination of the skeletal maturation is extremely important in clinical orthodontics. Cervical vertebral maturation is an effective diagnostic tool for determining the adolescent growth spurt. The aim of this study was to investigate the correlation between the stages of calcification of teeth and the cervical vertebral maturity stages.

A comparison of the accuracy of digital and conventional radiography in the diagnosis of recurrent caries.

AIM: The purpose of this laboratory research was to compare the accuracy of digital and conventional bitewing radiographs in the diagnosis of recurrent caries under class II amalgam restorations. METHODS AND MATERIALS: This study involved 82 posterior intact teeth in which class II amalgam boxes were prepared. Carious lesions were simulated in half of the proximal boxes in the intersection between the facial or lingual wall and the gingival floor or midway between the facial and lingual walls. The other half of each tooth specimen served as a control. The prepared boxes were then restored with a Tytin FC (Kerr, USA) amalgam. The teeth were radiographed in the bucco-lingual direction to obtain images comparable to bitewing. Digital radiographs made with an intraoral CCD sensor and conventional radiography with dental E film were used. Three expert observers evaluated both types of images for the diagnosis of recurrent caries. RESULTS: Sensitivity and specificity values for direct digital radiography were 73 and 95 percent at the buccal and lingual line angles, respectively, and 29 and 90 percent at the mid-gingival floor, respectively. These corresponding values for conventional radiography were respectively 63 and 93 percent at the buccal line angle, 61 and 93 percent at the lingual line angle, and 44 and 95 percent at the mid-gingival floor. The total sensitivity and specificity values were 58 and 93 percent for digital radiography and 56 and 93 percent for conventional radiography. The overall accuracy was 76 percent for digital and 75 percent for conventional radiography. No significant difference in specificity or sensitivity was found between the digital and conventional radiography (p=0.104). Separately, no significant difference was seen between the buccal line angle and the mid-gingival floor, but a significant difference was seen between the two methods in the lingual line angle (p=0.004). CONCLUSION: The digital and conventional bitewing radiographs had similar diagnostic accuracy for the diagnosis of recurrent caries. Lesions located at the buccal or lingual line angle were more easily detected than those at the mid-gingival region. CLINICAL SIGNIFICANCE: Although there was no significant difference between digital and conventional radiography in the diagnosis of recurrent caries, digital radiography requires less ionizing radiation, making this method of imaging suggested for routine dental practice.