Background: In the past decades, X-rays have been used widely for diagnosis in dentistry. However, it is well-known that ionizing radiation causes damage (including single- and double-strand breaks) to DNA and DNA–protein crosslinks and induces cellular death. Therefore, outlining the cytogenetic effects induced by X-rays is necessary to identify the degree of cancer risk and minimize potential risks to patients and clinicians. Objectives: To evaluate and compare mutagenicity (micronucleus) and cytotoxicity (karyorrhexis, pyknosis, and karyolysis) in exfoliated buccal mucosa cells of patients following conventional full mouth series of radiographs. Study Design: The study group consisted of 30 patients exposed to conventional full mouth radiographs. Materials and Methods: Cytological smears were taken from the buccal mucosa and gingiva of the study group just before exposure to X-rays and 10 days after exposure to X-rays. The samples were stained with the paponicolaou method and accessed for micronuclei and karyolysis, pyknosis, and karyorrhexis. Results: The mean micronuclei frequency in buccal mucosa and gingiva of the group was increased after exposure but the difference was not significant statistically (P > 0.05). The mean of other nuclear alterations indicating cytotoxicity after exposure to full mouth radiographs was significant (P < 0.05). There was significant difference in micronuclei and other nuclear alterations after exposure on comparing buccal mucosa with gingiva, with the mean of difference being high in buccal mucosa than the gingiva. Conclusion: Dental diagnostic radiographs can induce significant cytotoxicity, and to some extent, genotoxic effect after exposure, hence, they have to be advised only when necessary and avoid frequent exposure of full mouth radiographs on the same patient.

Background: Ultrasonography is well-known for its application in medicine, and has been recently gaining importance for its use in the orofacial region. Aims and Objective: The present study aims to determine the efficacy of ultrasonography in diagnosing soft tissue swellings of the head and neck. Materials and Methods: Thirty patients with the head and neck soft tissue swelling were included in the study and all were subjected to ultrasonography. Various findings were recorded such as shape, boundary, echo-intensity, ultrasound architecture, presence of necrosis, posterior echoes, ultrasound characteristic of lesion, and vascularity, and an ultrasonography diagnosis was made. After obtaining final diagnosis sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the test was calculated in various types of swelling. Results: In case of an inflammatory swelling, ultrasonography had a sensitivity of 100%, specificity of 89.5%, PPV of 84.6%, NPV of 100%, and accuracy of 93.3%. In cystic swellings, ultrasonography had a sensitivity of 85.7%, specificity of 100%, PPV of 100%, NPV of 95.8%, and accuracy of 96.67%. In nonodontogenic benign tumor, ultrasonography had a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. In malignant swellings, ultrasonography had a sensitivity of 80%, specificity of 100%, PPV of 100%, NPV of 96.2%, and accuracy of 96.67%. Conclusion: From the present study, it can be concluded that ultrasonography is highly accurate in diagnosing benign neoplasms, followed by soft tissue cystic swellings and malignant neoplasms, followed by inflammatory swellings of the head and neck region.

The current case reports of an iatrogenic cervicofacial and mediastinal subcutaneous emphysema (SCE) after endodontic retreatment of a maxillary canine with the usage of a rubber dam. A 79-year-old woman was brought to the hospital with a swelling of the right side of her face and neck. A computed tomography (CT) was performed, and she was directly treated with intravenous antibiotic chemotherapy. Clinical examination and CT revealed a pronounced cervicofacial and mediastinal SCE. After treatment with intravenous antibiotic chemotherapy, the patient showed a decrease of the SCE and was discharged from the hospital. SCEs should be diagnosed at the earliest possible stage to manage an appropriate treatment. In case of misinterpretation of the signs and symptoms or a misdiagnosed SCE, it can become life threatening for patients. Therefore, every clinician should consider preventive measures to avoid such complications.

Radiotherapy is the main treatment modality for nasopharyngeal carcinoma. However, ionizing radiation is itself a known carcinogen, and sarcomas can be a complication of treatment. Radiation-induced osteosarcomas in the head and neck are particular rare. Imaging studies of radiation-induced sarcomas in patients with head and neck carcinoma have been limited to case reports and relatively small case series. We report an unusual case of a radiation-induced osteosarcoma of the mandibular ramus following radiotherapy for nasopharyngeal carcinoma with computed tomography (CT) and magnetic resonance imaging (MRI). These findings can be helpful for differentiating osteosarcoma from other tumors of the mandible.

Odontogenic myxoma (OM) is a locally invasive benign tumour of the jaw originating from primordial mesenchymal tooth forming tissues. The average age for patients with OM is 25–30 years. OM has a predilection for posterior mandible. When it occurs in the maxilla, it is more invasive than that in the mandible. The recurrence rate of OM ranges between 10–33% with an average of 25%, hence, proper treatment design and close postoperative follow-up for the initial 2 years has been recommended. This is a case of a 30-year-old female showing a large expansile, rapidly growing lesion on the left side of the face involving left mandibular body and ramus. OM cases of this size and such rapid growth are very few in literature, and hence, makes this case one of the rare cases. Radiological investigations helped us to arrive at a diagnosis which was verified later by pre and postoperative histopathological examination. The patient was treated with left hemi-mandibulectomy and reconstruction was done using free fibula graft with titanium implant. The patient is presently under follow-up.