Multiple microlithiasis in bilateral parotid glands as the initial clinical manifestation of primary Sjögren's syndrome.

We report a rare case of Sjögren's syndrome (SS) with multiple microliths in the bilateral parotid glands. A 41-year-old man presented to our department with mild pain in the region of the right parotid gland. The dental examination was negative except for the parotid regions. The right region was moderately swollen and the left mildly swollen. Plain radiography revealed multiple calculi in the bilateral parotid glands. Ultrasonography showed heterogenic parenchyma, with microliths and cystic lesions in the parotid glands and heterogenic echotexture in the submandibular glands. Immunologic tests and the Schirmer test confirmed the diagnosis of SS. As the patient had no classic symptoms of SS, the bilateral multiple microliths were the first sign, facilitating the final diagnosis. Early diagnosis of SS is highly relevant because the proper therapy can be initiated. Adequate follow-up and, especially, control of the disease activity by identifying the predictive factors, are the primary objectives of SS management, enabling personalized treatment of this malignant disease. This case is a good example of how detection of calcifications in the bilateral parotid glands by plain radiography can help diagnose SS at an early stage.

[Difficulties in differential diagnosis of dentin dysplasia. Case report]. / A dentin dysplasia differenciáldiagnosztikai nehézségei. Esetismertetés.

In cases of periapical lesions of unknown origin we have to keep in mind the possibility of dentin dysplasia. From the differential diagnostic point of view of differential diagnosis it is important to recognize this disease as it significantly influences the treatment modality. It is an anomaly of unknown etiology that could affect both deciduous and permanent dentition. Dentin dysplasia presentation varies clinically and radiologically. A rare manifestation which affects 1: 100000 patients is spontaneously occurring either as periapical abscess or odontogenic cyst. The affected teeth could become mobile and eventually lost. Dentin dysplasia is a genetic disease which shows autosomal dominant inheritance and characterized by abnormal formation of dentin structure which occurs during tooth development. For this article we have reviewed available literature and PubMed database. Dentin dysplasia increases the risk of early tooth loss and associated with it esthetic and functional disturbances. As a result it can influence the psychological and social status of the patients and affect their quality of life.

[Calcifications in the maxillofacial area]. / Meszesedések a maxillofaciális régióban.

Among patients presenting for dental treatment we could reveal various calcifications on panoramic x-rays or on cone beam computed tomography (CBCT) Calcifications is more likely to occur in vessels, ligaments, glandular tissues and is usually associated with chronic inflammation or scarring. The purpose of this article is to describe the imaging characteristics of commonly observed calcifications of the maxillofacial area with presenting our own cases such as: tonsilloliths, calcified lymph nodes, elongeated styloid process (calcified stylohyoid chain), phleboliths, carotid atheromas, calcified laryngeal cartilage.

Comparative evaluation of cone-beam CT equipment with micro-CT in the visualization of root canal system.

The aim of this study was to compare three different cone-beam CT (CBCT) instruments used in dental clinical practice with micro-CT as gold standard. Three female monkeys' (Macaca fascicularis) skulls were selected and scanned by the tested CBCT-s. The most apical visible root canal level on the CBCT images was used as reference level (RL). After the image acquisition by CBCT-s dental jaw sections were scanned by micro-CT at a resolution of 17 µm. Out of the left second and third molars 25 root canals were selected and analysed by three observers at RL and following cross sectional parameters were determined: area of the lumen, major and minor diameters, aspect ratio and mean thickness. Results suggest that only high resolution CBCT instruments allow dentists detecting the full length of the root canal.

[The clinical importance of the mandibular canal course variations]. / A canalis mandibulae lefutádának variációi és azok klinikai jelentosége.

The authors review the literature relating to anatomical variations of mandibular canals. They compare the results of their examinations with the literature data. The proportion of duplicated mandibular canal observed during macroscopic examinations of mandibles proved to be substantially higher than that revealed by X-ray pictures. The knowledge of the course of the mandibular canal and its anatomical variations is of great importance in certain oral surgical interventions, such as preprosthetic operations and the insertion of enosseal implants, and during the planning of removable dentures prepared in cases involving extensively atrophied mandibles. The authors review the possible consequences of the injury of accessory mandibular canal.

Atypical courses of the mandibular canal: comparative examination of dry mandibles and x-rays.

Knowledge of the course of the mandibular canal and its anatomic variations is of great importance in oral surgery, especially in preprosthetic operations and the insertion of endosteal implants and during the planning of removable dentures prepared in cases involving extensively atrophied mandibles. We review the literature on duplicated mandibular canals, which is based exclusively on radiologic findings. Then, we compare this with an examination of dry mandibles and further radiologic studies. The incidence of duplicated mandibular canals observed in macroscopic examinations of mandibles was substantially higher than that revealed by radiographs. One case involving a novel variation, a triple mandibular canal, is reported.

[Factors impeding obstructed teeth in their eruption. Case report]. / Az áttörésükben visszamaradt fogak elótörését akadályozó tényezók (Esetismertetés).

With preparation of six study cases the objective of the authors was to abrow colleagues' attention to the fact that teeth remained in impactio and retention might cause complaints not only due to normal anatomical reasons but some complications might occur resulting from anomaly of development. The authors consider the topic extremely important by reason of the case's varieties and the clinical observations made recently and frequently. An increased attention to this case is reasonable since eruption of teeth might happen in case of removal of obstructic fact in time, permanent row of teeth returns to normal, and adequate dental arch might develop. It is also obvious that medical treatment of impact abnormalities derived from anomaly has lack of exact therapy theories, only general protocol can be provided.

Antimicrobial efficacy of various root canal preparation techniques: an in vitro comparative study.

In this study, we compared the antimicrobial efficacy of various root canal preparation techniques and instruments in the root canals of 40 human first maxillary premolars extracted for orthodontic reasons. After extirpation of the pulp, teeth were sterilized in an autoclave. Then, the root canals were infected with Enterococcus faecalis suspension and the teeth incubated at 37 degrees C for 24 h. Thereafter, the teeth were divided into five groups: preparation with K-file or K-Nitiflex file (step-back technique; groups 1 and 2), K-reamer (standardization technique; group 3), irrigation only (group 4), and no treatment (group 5). Before and after treatments, samples were taken for culture. Results were evaluated after 24-h incubation in E67 selective culture medium. We observed a considerable reduction in bacterial population after mechanical preparation. No significant differences were seen among the efficacy of the various preparation techniques and files used.

[Gardner syndrome. Case reports]. / Gardner-szindróma. Esetismertetés.

The authors discuss 3 cases of Gardner-syndrome, outlining malignized large intestine polyposis, multiplex osteomas and the different skin tumours as the main features. The earliest symptoms suspecting the clinical picture are usually dental and/or mandibular lesions and draw the attention to the highly malignant polyposis.