- There are normally 20 primary teeth and 32 permanent teeth. Two systems are used to number teeth - the Zsigmondy system and FDI notation.
- All teeth consist of a crown covered in enamel and a root covered in cementum. Inside is the pulp and periodontal ligament.
- Dental disorders seen on radiographs include tooth abnormalities like amelogenesis imperfecta and dentinogenesis imperfecta. Cysts like radicular cysts and dentigerous cysts appear as well-defined radiolucencies. Odontogenic keratocysts are irregularly shaped and lack the ballooning appearance of other cysts.
An overview of various pathological processes affecting the Jaw Bones- Maxilla and Mandible including odontogenic cysts and tumours including their radiological findings!
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
ORN is an inflammatory condition of bone that occurs after the bone has been exposed to therapeutic doses of radiation usually given for a malignancies.
An overview of various pathological processes affecting the Jaw Bones- Maxilla and Mandible including odontogenic cysts and tumours including their radiological findings!
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
ORN is an inflammatory condition of bone that occurs after the bone has been exposed to therapeutic doses of radiation usually given for a malignancies.
A cyst is an epithelium-lined sac containing fluid or semisolid material. In the formation of a cyst, the epithelial cells first proliferate and later undergo degeneration and liquefaction. The liquefied material exerts equal pressure on the walls of the cyst from within. Cysts grow by expansion and thus displace the adjacent teeth by pressure. May can produce expansion of the cortical bone. On a radiograph, the radiolucency of a cyst is usually bordered by a radiopaque periphery of dense sclerotic bone. The radiolucency may be unilocular or multilocular. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of Malassez or the remnants of the dental lamina.
Jaw lesion radiology ppt ppt . This powerpoint presentation includes important anatomy, radiographs and important pathology of jaw lesion with its imaging feature as well as its Xray ct mri image. This will help alot. this will help for radiology resident as well as ent resident and event dentist.
This presentation will give you a detailed knowledge about the various techniques that can be performed for imaging various aspects and diseases of TM Joint.
A cyst is an epithelium-lined sac containing fluid or semisolid material. In the formation of a cyst, the epithelial cells first proliferate and later undergo degeneration and liquefaction. The liquefied material exerts equal pressure on the walls of the cyst from within. Cysts grow by expansion and thus displace the adjacent teeth by pressure. May can produce expansion of the cortical bone. On a radiograph, the radiolucency of a cyst is usually bordered by a radiopaque periphery of dense sclerotic bone. The radiolucency may be unilocular or multilocular. Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. The source of epithelium is from the enamel organ, the reduced enamel epithelium, the cell rests of Malassez or the remnants of the dental lamina.
Jaw lesion radiology ppt ppt . This powerpoint presentation includes important anatomy, radiographs and important pathology of jaw lesion with its imaging feature as well as its Xray ct mri image. This will help alot. this will help for radiology resident as well as ent resident and event dentist.
This presentation will give you a detailed knowledge about the various techniques that can be performed for imaging various aspects and diseases of TM Joint.
Dental common disease on x-ray | by Dr.mohammad nameerDenTeach
Powerpoint include informations about oral disease and how it represent on dental radiographic image, (caries - cysts - hypercementosis - ...etc)
Shared by: Dr.mohammad nameer
Also you can follow us and learn dentistry on:
www.denteach.com
Dental anomolies /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This report, prepared by the student at the College of Dentistry, Hassan Atheed , in the third phase discusses scientific topics, but it maybe did not be 100% complete.
A radiograph is only one part of the diagnostic process. Usually one does NOT make a diagnosis solely from a radiograph. A diagnosis is made by the clinician once all the diagnostic information has been collected and analyzed collectively. An interpretation or a differential diagnosis is made from the radiograph.
One examines a radiograph and NOT an X-ray. Bear in mind that an X-ray cannot be seen. X-ray is a photon / beam of energy.
حسن عضيد
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Radiopacities not necessarily contacting teeth/ dental implant coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Radiological aspects of periodontal disease/cosmetic dentistry coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
BENIGN ODONTOGENIC TUMORS OF MAXILLOFACIAL REGION/endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2.
In the primary dentition, there are normally 20
teeth; in adult dentition there are 32.
Using one of two systems - Zsigmondy
system, which uses single digits for the
permanent dentition and letters for the primary
(deciduous) dentition,
Federation Dentaire International (FDI)
notation, which assigns double digits for each
tooth
3.
Part of a panoramic radiograph showing the permanent
dentition of a normal 18-year-old. The teeth in the upper left
quadrant have been numbered 1–8. The third molars are
unerupted, incompletely formed and impacted.
4.
Part of a panoramic radiograph showing the dentition in a 6-year-old child. The
deciduous teeth in the upper left quadrant have been labelled A–E. The first permanent
molars (labelled 6) and the lower central incisors have erupted. All four primary first
molars and the primary lower second molars are carious.
5.
All teeth consist of a crown and a root.
The crown is covered with a layer of enamel with a composition of
97 per cent mineral, thus being the most radio-opaque tissue in the
body.
The bulk of the tooth consists of dentine, which is 70 per cent
mineralized.
The root is covered by a thin layer of cementum, which has a
similar radiodensity to dentine and so is indistinguishable from it.
Lying within the centre of the tooth is the radiolucent soft tissue
of the pulp, which runs from the pulp chamber in the crown along
each root canal to the root apex, through which enter the
neurovascular bundles.
The tooth is supported in the jaws by the periodontal ligament, as
a narrow radiolucent line. These fibres are inserted into a thin
layer of dense bone lining the tooth socket (lamina dura), which
appears as a linear radio-opaque structure, and is continuous with
the cortical bone of the alveolar crest.
6.
7.
Disorders of tooth eruption
The commonest cause for failure of full
eruption is insufficient room in the dental arch
to accommodate the erupting tooth.
Alternatively a tooth may be prevented from
erupting by, for example, a tumour, cyst or
supernumerary tooth.
Delayed eruption occurs in certain endocrine
disorders, e.g. hypothyroidism and some
genetic abnormalities, e.g. Down's syndrome.
Multiple failure of eruption of the permanent
dentition is found in cleidocranial dysplasia
8.
Panoramic radiograph of cleidocranial dysplasia in
an adult. There are numerous unerupted teeth
including several supernumeraries.
9.
Hypodontia (oligodontia)
Anodontia
It is seen in association with cleft lip and
palate, Ellis-van Creveld (chrondo-ectodermal
dysplasia) and facial-digital syndromes.
Marked absence of teeth is seen in hydrotic
ectodermal dysplasia.
Hyperdontia - presents as either supplemental
or supernumerary teeth.
10.
Amelogenesis imperfecta is a developmental
disorder of enamel formation affecting all or
most of the teeth.
Varying degrees of hypoplasia from being
pitted to almost complete absence of enamel
when the crown appears angular.
Alternatively, the enamel may be of normal
thickness but be hypomineralized such that its
radiographic density is similar to that of
dentine.
11.
Intra-oral (bitewing) radiographs showing marked
hypoplasia and pitting of the enamel, whilst the
dentine appears normal. Several of the teeth are
carious.
12.
Dentinogenesis imperfecta is a developmental
anomaly of collagen formation.
The teeth are discoloured, having a brown or
purple hue. The enamel chips away and the
teeth rapidly wear down.
The initial radiographic appearance shows
bulbous crowns and large pulp
chambers, which soon calcify with abnormal
dentine so that little or none of the root canal is
visible.
Although the teeth may appear sound, they
are prone to infection resulting in pulpal
necrosis and periapical radiolucencies.
associated with osteogensis imperfecta.
13.
A panoramic radiograph of a young adult with
dentinogenesis imperfecta. The teeth have bulbous
crowns, short stumpy roots and sclerosis of the root canals.
14.
DENTAL CARIES
Dental caries is caused by microbial action on sugar
with the formation of acid, which causes progressive
demineralization of the teeth, initially of the
enamel, and then the dentine with destruction of their
organic components.
Radiographic detection of dental decay requires
images with good contrast and resolution. Despite its
limitations, intra-oral radiographs are valuable in the
detection and monitoring.
A carious lesion appears as a radiolucent zone, which
represents an area of demineralization. An approximal
lesion develops in the enamel just below the contact
point with an adjacent tooth and has a triangular shape
with the apex pointing towards the dentine.
If left untreated, the caries reaches the pulp chamber
and the weakened crown eventually crumbles away.
15.
Periapical
granuloma at the
apex of the grossly
decayed upper
right lateral
incisor. Although
well defined, its
margins are not
corticated. Note
the loss of the
lamina dura at the
tooth apex. There
is a similar but
smaller lesion at
the apex of the
exfoliating upper
right first
premolar root and
the upper right
central incisor is
markedly carious.
16.
Odontogenic and non-odontogenic cysts
Common findings - slow-growing lesions, i.e.
they are radiolucent, well defined and often
have a cortical margin.
they have raised intracystic pressure and
expand by tissue fluid transudation, and so
appear as circular or oval in shape.
Jaw cysts tend to displace structures
17.
Radicular cysts are the most common of the
odontogenic cysts.
They are derived from the cell rests of Malassez.
develop at the apex of a nonvital tooth
Any tooth can be affected but the majority are
found on the permanent anterior teeth or first
molars.
When small (less than 15 mm in diameter) they
resemble periapical granulomas but, unlike
granulomas, can enlarge well beyond this size.
In many cases extraction of the causative tooth
brings about resolution, but when this does not
happen, the cyst is then termed a ‘residual cyst’.
Thus a residual cyst found in an edentulous part of
the jaw, has a well-defined, circular radiolucency
usually with a cortical margin.
18.
Part of a panoramic radiograph showing a corticated radiolucent lesion
associated with the carious root of the upper left second
premolar, extending into the maxillary antrum above the hard
palate, consistent with a radicular cyst. Note the periapical radiolucency
(granuloma/abscess) on the upper left second molar.
19.
Dentigerous cyst (follicular cyst) - arises from
the reduced enamel epithelium, the tissue
which surrounds the crown of an unerupted
tooth.
It is thus found only on teeth that are
buried, particularly mandibular third molars
and maxillary canines.
Cystic enlargement of the tooth follicle
produces a pericoronal radiolucency, which is
attached to the tooth at its neck, with the crown
appearing to lie within the cyst lumen;
however with large cysts this relationship may
not be apparent.
20.
Part of a panoramic radiograph of a dentigerous cyst arising on a lower
left wisdom tooth, which is unerupted and lying horizontally. It appears
as a well-defined, circular radiolucency attached to the tooth at its neck.
The inferior alveolar canal has been displaced inferiorly.
21.
Odontogenic keratocysts arise from remnants of the dental
lamina, the precursor of the tooth germ.
The cyst lining has a higher mitotic activity and is thought to
enlarge by mural growth and so behaves more like a benign
neoplasm and is now classified as such.
It appears as a unilocular or
multiloculated, elongated, irregularly shaped radiolucency
with a scalloped, well-defined margin.
It lacks the more ballooning characteristics of the other
odontogenic cysts, which is an important diagnostic feature.
Keratocysts occur most often in the lower third
molar/ramus region, where they may displace, or
occasionally replace an unerupted wisdom tooth.
Recurrence is common (15–20 per cent) so radiographic
follow-up is necessary for several years.
On CT, attenuation values of cyst fluid are higher than most
other jaws cysts due to its high protein (keratin)
content, ranging from 30–200 Hounsfield Units, with
longstanding, multilocular cysts having the higher value.
22.
Part of a panoramic
radiograph of an
odontogenic keratocyst
which appears as a
loculated radiolucency
extending from the
condylar neck to the
lower first molar
region. There is
thinning of the bony
cortices but no jaw
expansion, a feature
associated with
odontogenic
keratocysts. Note the
displaced lower right
third molar.
24.
Multiple odontogenic keratocysts are a feature
of Gorlin-Goltz syndrome which also
includes multiple basal cell naevi, calcification
of the falx, bifid ribs, synostosis of the
ribs, kyphoscoliosis, temporal and parietal
bossing, hyperptelorism, and shortening of the
metacarpals.
25.
Part of a panoramic radiograph showing multiple odontogenic keratocysts consistent withGorlinGoltz syndrome. All four third molars have been extensively displaced and a lateral facial view
showed the upper right one to lie posteriorly close to the orbit.
26.
OKC in a 41-year-old man with basal cell nevus syndrome (Gorlin-Goltz syndrome).
Contrast material–enhanced CT scan shows multiple cysts (arrows) in the mandible.
Cystic lesions (arrowheads) are also identified within the maxilla. CT also demonstrated
a calcified falx and large frontal sinuses, findings that helped establish the diagnosis.
27.
The nasopalatine cyst is probably the
commonest non-odon-togenic cyst.
believed to arise from epithelial residues in the
nasopalatine canal.
It appears as a round, well-defined, midline
radiolucency between, but not associated
with, the upper central incisor teeth.
28.
Three lesions that may resemble jaw cysts but have
no epithelial lining are sometimes considered with
jaw cysts.
Solitary bone cyst occurs during the first 2
decades of life, mainly in the premolar/molar
regions of the mandible.
Its margin is less well defined than those of
odontogenic cysts and its superior border arches
up between the roots of the adjacent teeth.
Tooth displacement and root resorption is
uncommon. At surgery an empty cavity is
found, which subsequently heals after bleeding has
been induced.
29.
Part of a panoramic radiograph showing a partially corticated radiolucency in the right
mandible involving the apices of the second premolar and first and second molars
diagnosed as a solitary bone cyst. Note the characteristic scalloping between the roots of
the first and second molars.
30.
Aneurysmal bone cyst is considered to be a
reactive lesion of bone and is characterized by a
fibrous connective tissue stroma containing many
cavernous blood-filled spaces.
It is rare and occurs mainly in the young, with over
90 per cent occurring before 30 years of age.
It is typically found in the posterior region of the
mandible as a well-defined, multilocular, often
septated, circular radiolucency. It has a tendency
to produce marked cortical expansion.
Computed tomography (CT) or magnetic
resonance imaging (MRI) shows the presence of
fluid levels due to the presence of blood-filled
cavities.
31.
Stafne's bone cavity is asymptomatic and typically
found in men over the age of 35 years.
It forms a depression in the lingual cortex of the
mandible just in front of the angle and below the
inferior dental canal.
Its origin is controversial and it has been postulated
that it arises from pressure from the submandibular
salivary gland, however whilst some may contain
salivary gland tissue a number develop anterior to the
gland.
On plain radiographs, it appears as a well
defined, punched out, dense radiolucency, which
rarely exceeds 2 cm in diameter. Its appearance is
characteristic and so does not require further imaging
or biopsy. However, if CT or MRI is performed, the
cavity is often found to contain fat.
32.
Part of a panoramic
radiograph showing a
corticated
radiolucency between
the inferior alveolar
canal and the lower
border of the
mandible due to the
presence of a Stafne
bone cavity. The 3D
CT (B) shows the
depression on the
lingual aspect of the
mandible.
33.
Static bone cavity (Stafne cyst) in a 35-year-old man. CT scan
reveals a cortical defect (arrow) in the lingual surface of the right
mandibular angle, a finding that does not represent a true cyst.
34.
Odontomes are developmental malformations or
hamartomas consisting of dental hard tissues or toothlike structures.
Most are diagnosed in the second decade of life and
frequently impede tooth eruption.
There are two main types. The compound odontome
consists of a collection of small discrete teeth called
denticles and is found typically in the anterior region of
the maxilla,
Complex odontome consists of a randomly arranged
mass of enamel, dentine and cementum found
predominantly in the lower premolar/molar region.
Both types are densely radiopaque due to the presence of
tooth enamel and are surrounded by a thin radiolucent
36.
Odontogenic tumours are uncommon, mostly
benign and arise from either the odontogenic
epithelium, odontogenic epithelium and
ectomesenchyme, or primarily ectomesenchyme.
The commonest is the ameloblastoma, which
accounts for 11%.
It occurs mainly in patients between 30–50 years of
age with most (80 per cent) forming in the
molar/ramus region of the mandible.
When the maxilla is involved, it has the potential
to spread insidiously to involve the infratemporal
fossa, orbit and skull base, thus a thorough
assessment is essential.
37.
Part of a panoramic radiograph showing an
ameloblastoma, which appears as an
expansile, multilocularradiolucency involving the left body
of the mandible.
38.
Unilocular or multilocular radiolucency, but typically contains
septa or locules of variable size to produce a honeycombed
appearance.
The margin is well defined, often corticated but when
large, produces jaw expansion with perforation of the bony cortex.
A useful diagnostic feature is knife-edge resorption of the tooth
roots by the tumour, which can be quite marked.
The lesion is locally aggressive and requires a wide excision
margin.
Multislice CT can be used to differentiate ameloblastoma from
odontogenic keratocysts because of higher density increase during
the arterial phase.
On T1-W images with gadolinium enhancement and T2-W
images, there is good conspicuity of the tumour margin with the
soft tissues, the lesion having a moderate to high signal.
Very rarely undergoes malignant transformation with metastases
occurring in the lungs.
39.
An axial CT on bone window settings of a large cystic ameloblastoma of
the right side of the mandible showing marked thinning and expansion of
the bone. Note the presence of root resorption.
40.
Odontogenic myxoma is a benign but locally
aggressive tumour of odontogenic
mesenchyme occurring mainly in those
younger than 45 years of age.
Most occur in the mandible in the premolar
molar region.
The lesion is usually well defined, unilocular
and contains a variable number of internal
coarse trabeculations to produce a reticular
pattern.
41.
Panoramic radiograph shows an expan-sile, ellipsoid, partially
corticated, lucent lesion with heterogeneous internal
mineralization in the right posterior aspect of the mandibular
body and extending into the lower ascending ramus (arrows).
42.
Calcifying epithelial odontogenic tumour - well
defined and contain variable amounts of focal
mineral deposits.
more common in men, occurs in middle life and is
found mainly in the premolar/molar region of the
mandible.
Adenomatoid odontogenic tumour - affects
females in the second decade of life and typically
occurs anteriorly, especially in the maxilla and is
associated with an unerupted tooth.
well defined and contain variable amounts of focal
mineral deposits.
43.
Fibrous dysplasia is a localized abnormality in which
cancellous bone is replaced by fibrous tissue containing
varying amounts of calcified tissue.
When the jaws are affected, the maxilla is involved
twice as frequently as the mandible.
An immature lesion is largely radiolucent and may
mimic a dental cyst, typically having an orange peel or
ground-glass texture.
On radiographs the margins are usually
indistinct, blending in with the normal adjacent bone.
It may displace teeth or prevent their eruption.
44.
Large lesions produce jaw expansion, with
thinning of the bony cortices and displacement
of the antral floor.
It can resemble both a cemento-ossifying
fibroma, which is better defined, and an
osteosarcoma, which produces destructive
changes.
45. CHAPTER 63 -Dental and Maxillofacial Radiology from Adam: Grainger & Allison's ...
Figure 63.22 Axial CT on bone window setting of fibrous dysplasia of the anterior aspect of the mandible. Ther
Axial CT on bone window setting of fibrous dysplasia of the
anterior aspect of the mandible. There is thinning and expansion
of the bony cortical plates. The lesion shows areas of low
attenuation, lingual to the teeth, due to the presence of fibrous
46.
Cherubism is a rare dysplasia of bone that
develops during the first decade of life.
It occurs bilaterally in both jaws, but more
commonly affects just the mandible.
It develops in the posterior aspects of the jaws
as a multilocular, honeycombed, expansile
radiolucency.
Tooth displacement is common. It regresses
spontaneously after skeletal growth ceases.
47.
Periapical cemento-osseous dysplasia and florid
cemento-osseous dysplasia are similar
conditions, with the latter being a more extravagant
version of the former.
Women, particularly of Afro-Caribbean origin, after 25
years of age.
Characterized by the formation of multiple deposits
around the tooth roots and the mandible is more
frequently involved than the maxilla.
Teeth are clinically sound, radiolucent lesions form at
the apices of the teeth, which resemble periapical
granulomas.
Gradually cemental-like tissue is deposited within so
that it become increasingly radiopaque but is
surrounded by a thin, peripheral radiolucent
zone, which helps distinguish it from sclerosing
osteitis.
48.
The appearance of florid cemento-osseous
dysplasia is similar to periapical cemental
dysplasia but the lesions are larger, may
produce jaw expansion, are more
numerous, and often in both the maxilla and
mandible. May resemble Paget's disease of
bone.
49.
Osteomyelitis of the jaws is uncommon.
It may develop from a dental abscess or complicate
tooth extraction.
In acute osteomyelitis, there is thinning and
discontinuity of the bony trabeculae to produce illdefined, patchy areas of radiolucency within the
cancellous and cortical bone.
With time bony sequestrae form and are
recognized as irregularly shaped islands of bone
set against a region of radiolucency.
50.
The features of osteomyelitis are more readily
visualized on CT, which also is useful to show
periosteal bone formation.
On MRI, the marrow usually shows a low signal
intensity on T1 and a high signal on T2 weighted
images.
If the disease becomes chronic, the bone becomes
diffusely affected and extensively involved with
sclerosis of the marrow spaces. CT will
demonstrate the internal structure and the
presence of sequestration.
51.
Part of a panoramic radiograph of the right mandible of a patient
who developed acute osteomyelitis following the extraction of a
premolar root 3 weeks previously. There are three sequestra in the
alveolar portion of the mandible.
52.
Hyperparathyroidism of the jaws results in a
general demineralization of the bone, creating a
‘ground glass’appearance, loss of the lamina
dura, formation of brown tumours, and
subperiosteal erosions at the angle.
Haematological replacement disorders may affect
the jaws. In moderate to severe thalassaemia, the
jaws become radio-lucent with the presence of
coarse trabeculations due to marrow hyperplasia
and the maxillary antrum is reduced in size. The
skull takes on a granular appearance, with
thickening of the diploic spaces and occasionally a
‘hair on end’appearance.
53.
Panoramic radiograph of a case of thalassaemia. There is marked
increase in the height of the mandible, which is composed of
coarse trabeculae enclosing large marrow spaces and the small
maxillary sinuses. Note the generalized loss of the lamina dura
and the periodontal abscess on the distal root of the lower right
first molar.
54.
Cemento-ossifying fibroma - Its behaviour varies
from those showing slow growth to others being
quite aggressive.
Occurs mainly in young adults, mostly in the body
of the mandible.
The radiographic appearance depends on its
degree of mineralization, and typically contains a
wispy or tufted bony trabecular pattern. The lesion
is encapsulated and so appears well
defined, helping to distinguish it from fibrous
dysplasia.
55.
Bone window setting of an axial CT of a cemento-ossifying fibroma of
the mandible showing mainly buccal expansion and thinning of both
cortical plates, which remain intact. The lesion is of mixed attenuation as
it contains areas of fibrosis, mineralization, and coarse bony
trabeculations.
56.
Osteomas of the maxillofacial bones and jaws are
usually slow-growing, painless and thus
discovered by chance.
In the jaws, osteomas more commonly affect the
mandible than the maxilla and, whilst any site can
be involved, they tend to be found posteriorly on
its medial aspect.
CT assists in showing the site of origin and
provides three-dimensional (3D) topographic
detail.
Multiple osteomas are a feature of Gardner's
syndrome (familial adenomatous polyposis) and
precede the formation of intestinal colonic
polyposis.
58.
Osteosarcoma is uncommon in the jaws(7 %)
It tends to be slower growing and occurs about 10
years later than osteosarcoma of the long bones.
The mandible is more commonly affected than the
maxilla. Maxillary lesions tend to arise from the
alveolar ridge, and mandibular ones in the body.
It has a destructive appearance and its density varies
from being radiolucent, to patchily radio-opaque or
predominantly sclerotic.
An important early dental radiographic sign is
widening of the periodontal ligament space due to
tumour spread along the periodontal
ligament, however this feature is also seen in other
sarcomas (e.g. fibrosarcoma Ewing's sarcoma).
59.
When the periosteum is elevated a ‘hair-onend’, sunray or onion skin appearance may be
visible. CT is required to demonstrate
accurately tumour calcification, bone
destruction, and bone reaction ( Fig. 63.28
), whilst MRI (T1- and T2-weighted images)
will provide better information on the
intramedullary and extraosseous components
of the tumour.
60. Pag
Bone window
setting of an
axial CT of
osteogenic
sarcoma of the
left mandibular
ramus. There is
bone
destruction in
the region of
the sigmoid
notch. The
lesion contains
areas of
neoplastic bone
formation and
extends
medially
towards the
lateral
pterygoid
plate, posteriorl
y to the styloid
process, and
laterally
resulting in
facial swelling
61.
Extranodal
lymphoma
of the
maxilla
shown on a
bone
window
setting axial
CT at the
level of the
alveolus.
Although a
few areas of
the lesion are
well
defined, the
overall
appearance
is destructive
with loss of
much of the
buccal
alveolar
plate.