Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Detection of dental restorations on panoramic radiographs using a no-code computer vision platform","authors":"Dr. Manal Hamdan ,&nbsp;Mrs. Jennifer Bjork ,&nbsp;Mrs. Reagan Saxe ,&nbsp;Ms. Caroline Miller ,&nbsp;Ms. Francesca Malensek ,&nbsp;Ms. Rakhi Shah","doi":"10.1016/j.oooo.2024.11.064","DOIUrl":"10.1016/j.oooo.2024.11.064","url":null,"abstract":"<div><h3>Objective</h3><div>To use a no-code computer vision platform (LandingLens) to develop, train, and evaluate an artificial intelligence model specifically designed for the detection of dental restorations on panoramic radiographs. No-code computer vision platforms, driven by deep learning neural networks, offer a versatile solution that effectively addresses challenges associated with the need for extensive machine learning expertise, expensive training costs, and operational proficiency.</div></div><div><h3>Study Design</h3><div>Institutional review board approval was obtained for this study. A convenient sampling method was employed to select one hundred panoramic radiographs from the AxiUm records of the dental school. Exclusion criteria were applied to ensure the selection of diagnostic radiographs. Accurate labeling of dental restorations was performed by calibrated dental faculty and students, with subsequent final review by a radiologist.</div><div>The radiographs were randomly split into training (70%), development (20%), and testing (10%) subgroups. The model was trained for 40 epochs using a medium model size. Data augmentation techniques such as horizontal flip and vertical flip were employed to enhance the training process.</div></div><div><h3>Results</h3><div>At a confidence threshold of 0.95, the model achieved a sensitivity of 86.64%, specificity of 99.78%, accuracy of 99.63%, and precision of 82.4%. These metrics indicate the model's ability to accurately detect dental restorations on a limited set of panoramic radiographs.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential of no-code computer vision platforms in radiology. However, further research and validation are required to evaluate performance on larger and more diverse datasets, as well as for other detection tasks. Continued exploration of these platforms can contribute to advancements in dental imaging by democratizing computer vision development.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e92"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of having conventional 2-dimensional radiographs reviewed by oral and maxillofacial radiologists","authors":"Dr. Ben Bartlett ,&nbsp;Dr. Hassem Geha ,&nbsp;Dr. Rujuta Katkar","doi":"10.1016/j.oooo.2024.11.069","DOIUrl":"10.1016/j.oooo.2024.11.069","url":null,"abstract":"<div><div>The following examples reflect the importance of periodic imaging, review of radiographs, and knowing when to refer to an oral and maxillofacial radiologist for further evaluation. In the first case, a 26-year-old male dental student obtained a panoramic radiograph in September 2019, stating “I would like to get a pano since I have never had one.” The radiographic findings were reported by a general dentist as “No pathology present. Patient has no missing teeth.” Two years later, the patient, now the proud owner of a cone beam computed tomography (CBCT) machine, noticed changes in the left posterior maxillary area and had a CBCT acquired and sent the volume for a report. The area ended up being a plum-sized OKC that required extensive surgical intervention and follow-up. In the second case, A 79-year-old female patient complained of pain on chewing from a crown that was seated in November 2021, but clinical pain originated from #31. The patient developed a large fluctuant swelling in late December 2021/early January 2022 that had cervical lymph node involvement. #31 displayed bone loss on the PA and had 10 mm + pocketing, class III mobility, and heavy occlusal contact with #2. #31 was extracted on January 16, 2022 and a bovine graft was placed. Her discomfort somewhat resolved, but chewing discomfort returned 1/30/22. A PA taken February 4, 2022, revealed that bone loss has extended to #30. These periapical radiographs were never sent for review until February 2022, when a CBCT volume was acquired and sent for review. The findings were highly suggestive of an aggressive process such as gingival carcinoma invading the bone. The patient was the referring doctor's mother, and no follow-up information was provided due to the sensitive nature of the case.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e94"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venolymphatic malformation in the buccal space: magnetic resonance imaging features","authors":"Dr. Srinitha Singanamala ,&nbsp;Dr. Suresh Mukherji ,&nbsp;Dr. Mehrnaz Tahmasbi ,&nbsp;Dr. Madhu Nair","doi":"10.1016/j.oooo.2024.11.044","DOIUrl":"10.1016/j.oooo.2024.11.044","url":null,"abstract":"<div><h3>Clinical Presentation</h3><div>Venolymphatic malformation in the buccal space is relatively rare. A 27-year-old male with a soft, compressible mass in the right posterior maxilla causing facial asymmetry and gingival bleeding underwent pre- and post-contrast magnetic resonance imaging (MRI), revealing a heterogeneous but predominantly cystic lesion involving the right buccal space, extending superficially as also deeply to involve the buccinator and the anterior masseter, and inferiorly to the buccal space and inferolateral aspect of the right pterygomaxillary fissure. No osteolysis was identified. Slightly increased signal on T1 is noted from proteinaceous material or blood products as some areas show fluid levels. It is more conspicuous on the contrast-enhanced T1-weighted images with fat suppression. It appears to have primarily high T2 signal. There are focal areas of decreased T1 and T2 signal that are non-enhancing and may represent calcified phleboliths. No evidence of dilated vascular structures is identified suggesting a high-flow lesion.</div></div><div><h3>Differential Diagnosis</h3><div>Includes capillary, venous, lymphatic, and arteriovenous vascular lesions, hemangioma. For phleboliths: calcified lymph nodes, atherosclerosis, sialoliths, cysticercosis, miliary skin osteomas etc.</div></div><div><h3>Diagnosis and Management</h3><div>The diagnosis was confirmed via clinical evaluation, MRI, and aspiration. Findings were consistent with a low-flow, venolymphatic malformation involving the right buccal space and right pterygomaxillary fissure. The lesion was embolized and resected.</div></div><div><h3>Conclusion</h3><div>Although diagnosis of most cases of venolymphatic malformation may not be difficult, it can be challenging if superimposed with trauma, hemorrhage, or infection. Risk of severe hemorrhage exists if extraction in the region is performed. Dynamic contrast-enhanced MRI has greater specificity of diagnosis in that it can differentiate between low-and high-flow lesions. Management of vascular malformations is based on the lesion's vascular anatomy, anatomical location, and involvement with surrounding structures. Non-invasive intervention includes endovascular embolization, sclerotherapy and laser therapy.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e84"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental age assessment using Demirjian and Cameriere's methods in an Iranian population","authors":"Dr. Hoda Rahimi ,&nbsp;Dr. Zahra Mohammadi ,&nbsp;Dr. Shahryar Shahab ,&nbsp;Dr. Mohammad Javad Kharazifard ,&nbsp;Dr. Ali Kavosi ,&nbsp;Dr. Zeinab Azizi","doi":"10.1016/j.oooo.2024.11.037","DOIUrl":"10.1016/j.oooo.2024.11.037","url":null,"abstract":"<div><h3>Objective</h3><div>Considering the genetic and physiological status of different geographical areas, different age estimation methods may produce different results. This study aimed to compare the 2 dental age (DA) estimation methods of Cameriere and Demirjian among 6- to 14-year-old children in Tehran in 2017-2018.</div></div><div><h3>Study Design</h3><div>This cross-sectional analytical study was conducted on 306 panoramic images from 153 girls and 153 boys. The DA of participants was estimated by Cameriere's and Demirjian's methods. The data were statistically analyzed by the paired sample <em>t</em>-test, repeated measures analysis of variance, and the independent <em>t</em> test. Finally, a formula suitable for Iranian society was developed on the basis of the results of regression analysis.</div></div><div><h3>Results</h3><div>The mean age estimation error was +0.89 years for Demirjian's method (+0.86 in boys and +0.93 in girls) and −0.20 years for Cameriere's method (−0.20 in boys and −0.10 in girls). There was a significant difference between the DA calculated by Cameriere's and Demirjian's methods and the chronological age. There was no significant difference between Cameriere's and Demirjian's methods in this regard. The formula developed in this study could estimate the age of participants with an accuracy of above +0.008 (+0.009 in boys and +0.006 in girls). However, the results indicated no significant difference between the proposed formula and Cameriere's method in the accuracy of age estimation.</div></div><div><h3>Conclusion</h3><div>The accuracy of Cameriere's method was greater than that of Demirjian's method, but the formula proposed for Iranian society was more accurate than both of them. The Cameriere method underestimated and the Demirjian method overestimated the age.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e81"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beam hardening and scatter artifact with metal objects inside and outside the field of view in cone beam computed tomography (CBCT) imaging","authors":"Dr. Revanth Chada ,&nbsp;Dr. Mehrnaz Tahmasbi ,&nbsp;Dr. Madhu Nair ,&nbsp;Dr. Matthew J. Kesterke ,&nbsp;Dr. Poorya Jalali","doi":"10.1016/j.oooo.2024.11.050","DOIUrl":"10.1016/j.oooo.2024.11.050","url":null,"abstract":"<div><h3>Objective</h3><div>to compare the objective and subjective appearance of artifacts produced by metal objects inside and outside the limited field of view (FOV) of a common region of interest.</div></div><div><h3>Study Design</h3><div>Metal objects (titanium implants, zirconium implants, and zirconium crucibles) were positioned in the cadaver specimen's left maxilla and imaged using an Accuitomo 170 cone beam computed tomography (CBCT) unit with limited FOV (40 × 40 mm). Scans were obtained in standard mode for different groups (control group with no metal objects, various combinations of titanium implants, and zirconium implants/crucibles). Sixteen scans (7 with the metal object inside FOV, 7 with the metal object outside FOV, 2 controls) were obtained. Objective measurements evaluated artifacts calculating the standard deviation (SD) of grayscale values using Image J software. Two observers rated paired images for beam hardening/scatter artifacts for subjective tests. Nonparametric tests (Wilcoxon signed-rank and rank sum tests) compared grayscale values and Fleiss kappa coefficient measured intraobserver/interobserver agreement.</div></div><div><h3>Results</h3><div>Objective test showed no significant difference in SD of grayscale values between images with metal objects inside and outside FOV (<em>P</em> &gt; .05). The SD was significantly greater for slices at the metal object level than those apical to the level of metal objects (<em>P</em> &lt; .05). However, subjective comparison of the 2 image groups (metal objects inside and outside FOV) showed subtle differences in beam hardening intensity in the region immediately adjacent to the metal objects.</div></div><div><h3>Conclusion</h3><div>Overall, images with metal objects outside the FOV did not significantly differ in artifact compared to images with metal objects inside the FOV. However, the quality of the image immediately adjacent to the metal object can be improved by strategically avoiding the metal in the FOV.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Pages e86-e87"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of screening the submandibular glands of patients with suspected Sjögren disease by salivary gland ultrasonography","authors":"Dr. Addi Yin ,&nbsp;Dr. Dena Abderbwih ,&nbsp;Dr. Ghaidaa Badabaan ,&nbsp;Dr. Seunghee Cha ,&nbsp;Dr. Anita Gohel","doi":"10.1016/j.oooo.2024.11.034","DOIUrl":"10.1016/j.oooo.2024.11.034","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the accuracy and correlation of ultrasonographic findings of the parotid salivary glands compared to submandibular salivary gland with positive lip biopsy and/or sialography in patients suspected of Sjögren disease (SjD).</div></div><div><h3>Study Design</h3><div>This study included 100 patients with clinical signs of SjD (age range 5-81 years). Salivary gland ultrasonography (SGUS) was performed on the parotid and submandibular glands and the results were graded by using the novel semiquantitative US score (0-3) by Jousse-Joulin et al (<em>Ann Rheum Dis</em>. 2019;78:967-973). A positive lip biopsy with focal lymphocytic sialadenitis with a focus score of ≥1 and unstimulated salivary flow rate (USFR) below 0.1 mL/min measured by sialometry were defined to be positive for hyposalivation. Out of 100 patients, 45 met our inclusion criteria. The data were analyzed for prevalence and a correlation between positive biopsy and/or USFR and positive SGUS indicative SjD-like changes. The Clarius ultrasound scanner L15 and Sonosite X-Porte Ultrasound System were used for this study.</div></div><div><h3>Results</h3><div>SGUS imaging in the parotid glands was positive in 27% of suspected SjD cases. Of those SGUS-positive cases, USFR was positive in 40% of cases and 42% with positive lip biopsy. SGUS findings in the submandibular glands were positive for SjD-like changes in 78% of patients with suspected SjD. Of these SGUS-positive cases showing the submandibular gland abnormalities, 78% of patients had positive USFR and 61% of patients indicated a positive lip biopsy. There was a statistically significant correlation between positive USFR and SGUS positivity in the submandibular salivary glands of patients with suspected SjD.</div></div><div><h3>Conclusion</h3><div>SGUS imaging of not only the parotid glands but also the submandibular salivary glands aid differential diagnosis of patients with suspected SjD even if SGUS is ordered due to recurrent parotitis in the first place.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e80"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic findings of myeloid sarcomas (chloroma)","authors":"Dr. Meeru Kumar ,&nbsp;Dr. Srinitha Singanamala ,&nbsp;Dr. Funda Yilmaz ,&nbsp;Dr. Joshua Fountain ,&nbsp;Dr. Hui Liang","doi":"10.1016/j.oooo.2024.11.045","DOIUrl":"10.1016/j.oooo.2024.11.045","url":null,"abstract":"<div><h3>Clinical Presentation</h3><div>A 47-year-old woman in remission for acute myeloid leukemia (AML) after chemotherapy and hematopoietic stem cell transplant presented with recurrent headaches and vision loss over the last 6 months. Computed tomography revealed multiple diffuse high-density regions suggestive of neuro-parenchymal hematomas. Magnetic resonance imaging demonstrated multiple diffuse hypointense (T1) and hyperintense (T2) regions involving the middle cranial fossae, cribriform plates, the posterior ethmoidal air cells and upper olfactory recesses, and the left cavernous sinus and sellar region including the anterior clinoid process and greater wing of the sphenoid. A diffuse leptomeningeal enhancement and bilateral oculomotor and trigeminal nerve involvement was also evident along with mild communicating hydrocephalus, flattening of the optic disc and mild paranasal mucositis.</div></div><div><h3>Differential Diagnosis</h3><div>include chloromas (recurrent leukemia with extramedullary involvement), hematomas and primary or metastatic neoplasms such as neuroblastomas and lymphomas.</div></div><div><h3>Diagnosis and Management</h3><div>Magnetic resonance imaging is particularly useful in the diagnosis and follow-up imaging of cerebrospinal chloromas as computed tomography findings may be indeterminate. Diagnostic confirmation was via histology and immunohistochemistry, demonstrating specific molecular markers. The patient received 5 cycles of chemotherapy with high dose methotrexate, hydrocortisone and cytarabine.</div></div><div><h3>Conclusion</h3><div>Myeloid sarcomas, also known as chloromas, are extramedullary tumor-like proliferations of primitive myeloid cells. These myeloperoxidase rich, greenish masses represent a rare and unique presentation of AML (2.5-9%). Considered a distinct entity from classic leukemic infiltrates, these may occur either concurrently/ as a precursor to AML or even more rarely in AML remission cases, especially those treated with hematopoietic stem cell transplant like the case presented here. Their development in AML remission may represent a suboptimal response to chemotherapy or a graft-vs.-leukemia response. The propensity for involvement of the maxillofacial structures is noteworthy and important for oral radiologists to recognize. A multidisciplinary approach involving radiologists, hematologists/ oncologists and pathologists is required for accurate diagnosis and appropriate management.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Pages e84-e85"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental finding of a rare persistent craniopharyngeal canal: a case report and literature review","authors":"Ms. Yuedi Yu ,&nbsp;Mr. Zacharie Rahhal ,&nbsp;Mrs. Kanika Awasthi ,&nbsp;Dr. Satoko Matsumura","doi":"10.1016/j.oooo.2024.11.047","DOIUrl":"10.1016/j.oooo.2024.11.047","url":null,"abstract":"<div><h3>Clinical Presentation</h3><div>A 22-year-old female patient presented to our oral and maxillofacial surgery clinic for mandibular prognathism and to have Le Fort I orthognathic surgery. The patient has multiple congenital anomalies affecting the skull and face, including craniosynostosis, frontonasal dysplasia with a midline cleft palate and lip, orbital deformities, and hypertelorism. Cone beam computed tomography scanning was taken for preoperative evaluation. Incidentally, it showed a well-defined vertical bony conduit extending from the floor of sell turcica to the roof of the nasopharynx with a corticated and intact margin. The bony conduit was elliptical on the axial section, and exhibited a 2.42 mm diameter and a 4.95 mm length in the sagittal section.</div></div><div><h3>Differential Diagnosis</h3><div>Benign nonodontogenic cyst; Rathke cleft cyst (Rathke pouch migration), neurenteric cyst.</div></div><div><h3>Diagnosis and Management</h3><div>On the basis of the imaging characteristics and associated craniofacial anomalies, a diagnosis of type I persistent craniopharyngeal canal (CPC) was rendered. No treatment was required at this time, and the patient was advised to follow up as necessary.</div></div><div><h3>Conclusion</h3><div>Persistent CPC is a rare congenital abnormality resulting from the failure of regression of Rathke pouch during the prenatal period, with a prevalence of up to 0.42%. According to our literature review, approximately 166 cases of have been documented since its initial report in 1949. Reported by Abele et al, the size of the defect can range from 0.7 mm to 31.0 mm and correlates with the severity and prognosis. Persistent CPC is associated with craniofacial anomalies (e.g., cleft lip and palate, ectopic adenohypophysis, cephalocele, tumors) and orbital malformations (e.g., optic atrophy, morning glory disc anomaly). Because of its rarity and potentially life-threatening conditions, accurate diagnosis and timely treatment are crucial. Cone beam computed tomography and magnetic resonance imaging are the recommended diagnostic modalities.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e85"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental finding of ossification of the vascular pedicle after maxillofacial reconstruction with free fibular flap: case series","authors":"Mrs. Kanika Awasthi ,&nbsp;Ms. Yuedi Yu ,&nbsp;Mr. Zacharie Rahhal ,&nbsp;Dr. Satoko Matsumura","doi":"10.1016/j.oooo.2024.11.048","DOIUrl":"10.1016/j.oooo.2024.11.048","url":null,"abstract":"<div><h3>Clinical Presentation</h3><div>Case 1: An 18-year-old male patient presented to our oral and maxillofacial surgery clinic for implant consultation after having the left mandibulectomy with free fibula flap reconstruction to treat low-grade myofibroblastic sarcoma. The neck was asymptomatic with no significant clinical expansion. One month after the surgery, a panoramic radiograph and a cone beam computed tomography revealed a curved, tube-like calcification inferior to the mandibular surgical region.</div><div>Case 2: A 28-year-old female patient presented to our oral and maxillofacial surgery clinic for a follow-up of the right maxillectomy with free fibula flap reconstruction to treat odontogenic myxoma. The cheek and the neck were asymptomatic with no significant clinical expansion. Cone beam computed tomography was taken 4 months after the surgery and revealed a linear, irregularly curved radiopaque entity from the maxillary surgical region to the neck.</div></div><div><h3>Differential Diagnosis</h3><div>Ossification of the vascular pedicle, peroneal artery atherosclerosis, new bone formation, retained surgical material, including bone fragments.</div></div><div><h3>Diagnosis and Management</h3><div>The radiographic and clinical findings were consistent with heterotopic ossification of the vascular pedicle. No treatment is required in these cases since asymptomatic.</div></div><div><h3>Conclusion</h3><div>We present 2 cases with heterotopic ossification of the vascular pedicle after previous segmental maxillectomy and mandibulectomy with the free fibula flap. This condition's exact etiology is variable; tumor-related surgery, trauma, congenital anomalies, and radiotherapy influence it. Glastonbury et al. reported that a modified harvesting procedure by removing the fibular periosteum did not develop flap ossification. Their theory explains it occurs more frequently in younger patients. Essentially, it mimics recurrent tumors clinically, and surgical removal is required when clinical symptoms such as trismus and severe pain occur. Because of its advantage, the free fibular flap is commonly used and the first choice for maxillofacial reconstruction. Knowing these imaging features is critical to differentiate from arteriosclerotic plaque, retained foreign body, or especially recurrence.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e86"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniocervical findings in osteogenesis imperfecta","authors":"Dr. Michelle Briner Garrido ,&nbsp;Dr. Kenneth Abramovitch","doi":"10.1016/j.oooo.2024.11.052","DOIUrl":"10.1016/j.oooo.2024.11.052","url":null,"abstract":"<div><h3>Introduction</h3><div>Craniocervical abnormalities are significant complications of osteogenesis imperfecta (OI), an uncommon bone disease that is usually caused by mutations in collagen type I encoding genes.</div></div><div><h3>Objective</h3><div>To assess craniocervical anomalies and associated clinical findings in patients with moderate-to-severe OI using 3-dimensional cone beam computed tomography scans.</div></div><div><h3>Study Design</h3><div>Cross-sectional analysis of cone beam computed tomography scans in 52 individuals with OI (age 10-37 years; 32 female) and 40 healthy controls (age 10-32 years; 26 female). Individuals with a diagnosis of OI type III (severe, n = 11), type IV (moderate, n = 33), and noncollagen OI (n = 8) were recruited through the Brittle Bone Disorders Consortium. Controls were recruited through the orthodontic clinic of the University of Missouri-Kansas City School of Dentistry.</div></div><div><h3>Results</h3><div>OI and control groups were similar in mean age. The cranial base angle was increased in the OI group (OI: mean 148.6° (standard deviation 19.3); controls: mean 130.4° (standard deviation 5.7; <em>P</em> = .001), indicating a flatter cranial base. Protrusion of the odontoid process into the foramen magnum (n = 7, 14%) and abnormally located odontoid process (n = 19, 37%) were observed in the OI group but not in controls. Low stature, expressed as height z score (<em>P</em> = .01), presence of dentinogenesis imperfecta (<em>P</em> = .04), and being male (<em>P</em> = .04) were strong predictors of platybasia, whereas height z score (<em>P</em> = .049) alone was found as a positive predictor for basilar impression as per the Chamberlain measurement.</div></div><div><h3>Conclusion</h3><div>The severity of the phenotype in OI, as expressed by the height z score, correlates with the severity of cranial base anomalies such as platybasia and basilar impression in moderate to severe OI. Screening for cranial base anomalies is advisable in individuals with moderate to severe OI, with special regards to the individuals with a shorter stature and DI.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 3","pages":"Page e87"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}