Florid osseous dysplasia (FOD) is an uncommon, benign, cemento-osseous lesion of the jaws. The etiology of FOD is still unknown. It is often asymptomatic and may be identified on routine dental radiographs. The classic radiographic appearance of FOD is amorphous, lobulated, mixed radiolucent/radiopaque masses of cotton-wool appearance with a sclerotic border in the jaws. In our case the lesion was found incidentally on routine periapical radiographs taken for restored teeth and edentulous areas. For further and detailed examination, a panoramic radiograph and cone-beam computed tomograph (CBCT) were taken. The panoramic radiograph and CBCT revealed maxillary bilateral and symmetrical, non-expansile, well-defined, round, radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth. Our aim in presenting this case report was to highlight the importance of imaging in diagnosis of FOD.
In this study, we formulate a new proposal that complements previous classifications in order to assist dental practitioners in performing a differential diagnosis based on patients' radiographs. We used general search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks to find relevant studies by using keywords such as "jaw disease," "jaw lesions," "radiolucent rim," "radiolucent border," and "radiolucent halo." More than 200 articles were found, of which 70 were broadly relevant to the topic. We ultimately included 50 articles that were closely related to the topic of interest. When the relevant data were compiled, the following eight lesions were identified as having a radiolucent rim: periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, cemento-ossifying fibroma, osteoid osteoma, osteoblastoma, odontoma, and cementoblastoma. We propose a novel subcategory, jaw lesions with a radiolucent rim, which includes eight entities. The implementation of this new category can help improve the diagnoses that dental practitioners make based on patients' radiographs.
Heegyun Kim;Jiyoung Kwon;Hyun-Jung Kim;Soram Oh;Duck-Su Kim;Ji-Hyun Jang
Restorative Dentistry and Endodontics
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제49권2호
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pp.13.1-13.7
/
2024
Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제29권5호
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pp.330-337
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2003
This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.
Park, Ji-Hoon;Kim, Young-Kyun;Yun, Pil-Young;Yi, Yang-Jin;Yeo, In-Sung;Lee, Hyo-Jung;Park, Jin-Young
Journal of Korean Dental Science
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제2권2호
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pp.12-17
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2009
Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.
Purpose: The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods: The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results: A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions: The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.
Dental pulp infection is most commonly caused by extensive dental caries, and some bacterial species invade root canals; bacterial components and products are thought to be associated with the pathogenesis of periapical periodontitis. A principle driving force behind pulpal disease response appears to lie in the host immune system's to bacteria and their products. We examined the production of interleukin $1{\beta}$ (IL-$1{\beta}$) and tumor necrosis factor ${\alpha}$(TNF-${\alpha}$) from human peripheral mononuclear cells, lymphocytes and monocytes stimulated by heat-killed Acitnobacillus actinomycetemcomitans (ATCC 29523), Porphyromonas gingivalis (ATCC 33277) and Prevotella intermedia (ATCC 25611), and also by their sonicated bacterial extracts (SBE), respectively. The effects of three strains of heat-killed bacteria and their SBEs on the morphology of cultured blood cell lines HL-60 (KCLB 10240) and J774A.1 (KCLB 40067) were observed under the inverted microscope. Ultrastructural changes of J774A.1 exposed to heat-killed P. intermedia and its SBE were investigated using transmission electron microscopy. Production of IL-$1{\beta}$ was reduced in human peripheral mononuclear cells after stimulation by sonic bacterial extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. Heat-killed and sonic extract of P. gingivalis inhibited the production of TNF-${\alpha}$ in peripheral mononuclear cells. Production of TNF-${\alpha}$ was inhibited in peripheral monocytes after stimulation by sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia. HL-60 and J 774A.1 cells showed granular degeneration after treatment with heat-killed and sonic extracts of A. actinomycetemcomitans, P. gingivalis, and P. intermedia Chromatin margination and shrinkage were observed in 774A.1 treated with heat-killed P. intermedia. Cell wall structure and organelles were destroyed and vacuoles were formed in cytoplasm in J774A.1 treated with P. intermedia sonic extract. These results suggest that A actinomycetemcomitans, P gingivalis and P intermedia may have an important role in the formation and progression of pulpal diseases via both modulation of production of IL-$1{\beta}$ and TNF-${\alpha}$ from blood mononuclear cells and cytopathic effects.
Ultrasound images are noninvasive, can be observed in real time, have no radiation exposure, do not cause pain, and are not restricted in use depending on the patient's prosthetic implant or medical condition. Since the use of ultrasound in the dental field was first applied for tooth preparation in 1957, the use of diagnostic ultrasound for the first time in 1963 has been reported. Currently, it is used in the diagnosis of soft tissue lesions such as malignant tumor or salivary gland disease, fine needle aspiration test, temporomandibular joint disease, lymph node metastasis, measurement of muscle thickness and inflammatory diseases, differentiation of periapical cyst and granulation tissue, measurement of periodontal tissue thickness. The ultrasound image can be visualized in real time. The clinician can explain the structure to the patient while consulting the patient and consult the patient. When injecting the drug into a specific site or aspirating a specific site or substance, So that it can be confirmed and practiced. Recently, ultrasonic equipment specialized in the dental field has been developed and marketed, and it is expected that the use of ultrasonic waves will become active in the dentistry. In the future, development of popular equipment with size and frequency suitable for dental diagnosis and various researches on maxillofacial ultrasonic anatomy. If clinical studies are continuously carried out to demonstrate efficacy, ultrasound is expected to aid in accurate diagnosis and treatment throughout the dentistry.
Bacteria have been regarded as one of the most important factors in pulpal and periapical diseases. Streptococci are frequently isolated facultative anaerobes in infected root canals. Recently molecular biological techniques have been rapidly progressed. This study was designed to apply the molecular biological tools to the identification and classification of streptococci in the endodontic microbiology. Streptococci isolated from infected root canals were identified with both Vitek Systems and API 20 STREP. Identification results were somewhat different in several strains of streptococci. Eighteen streptococci and enterococcal was difficult so to digest plasmid DNA using Hind III and EcoRI to differentiate strains by restriction enzyme analysis of plasmid DNA. 16S rDNA of chromosome was amplified by polymerase chain reaction(PCR) and then restricition fragment length polymorphism(RFLP) using several restriction enzymes was observed. The molecular mass of 16S rDNA of chromosomal DNA was approximately 1.4kb. There were three to five RFLP patterns using eight restriction enzymes. RFLP patterns digested with CfoI which recognizes four base sequences were identical in all stains. Hind III which recognizes six base sequences could not digest the 16S rDNA. Restriction enzymes which recognize five base sequences were suitable for RFLP pattern analysis. At least three different restriction enzymes were needed to compare each strains. 16S rDNA PCR-RFLP was simple and rapid to differentiate and classify strains and could be used in the epidemiological study of root canal infections.
Purpose: Convolutional neural networks (CNNs) have rapidly emerged as one of the most promising artificial intelligence methods in the field of medical and dental research. CNNs can provide an effective diagnostic methodology allowing for the detection of early-staged diseases. Therefore, this study aimed to evaluate the performance of a deep CNN algorithm for apical lesion segmentation from panoramic radiographs. Materials and Methods: A total of 1000 panoramic images showing apical lesions were separated into training (n=800, 80%), validation (n=100, 10%), and test (n=100, 10%) datasets. The performance of identifying apical lesions was evaluated by calculating the precision, recall, and F1-score. Results: In the test group of 180 apical lesions, 147 lesions were segmented from panoramic radiographs with an intersection over union (IoU) threshold of 0.3. The F1-score values, as a measure of performance, were 0.828, 0.815, and 0.742, respectively, with IoU thresholds of 0.3, 0.4, and 0.5. Conclusion: This study showed the potential utility of a deep learning-guided approach for the segmentation of apical lesions. The deep CNN algorithm using U-Net demonstrated considerably high performance in detecting apical lesions.
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