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   2017| May-August  | Volume 5 | Issue 2  
    Online since August 29, 2017

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Evaluation of paranasal sinus diseases by computed tomography and its histopathological correlation
Sarabpreet Singh Kanwar, Mukta Mital, Prashant K Gupta, Sonal Saran, Nishtha Parashar, Akanksha Singh
May-August 2017, 5(2):46-52
Context: Paranasal sinus (PNS) diseases affect a wide range of population and include a broad spectrum of diseases ranging from inflammatory conditions to neoplasms, both benign and malignant. Since their clinical assessment is fraught by the surrounding bony structures; diagnostic radiology is of paramount importance. Aims: This study aims to evaluate the spectrum of PNS diseases on computerized tomography (CT) and correlate their clinical and histopathological findings. Settings and Design: A prospective study one at tertiary care hospital. Subjects and Methods: All patients underwent noncontrast CT (NCCT) of PNSs on multi-detector CT Philips Ingenuity Core 128 multi-slice unit and subsequently underwent functional endoscopic sinus surgery by Hopkins Rod 0° 4 mm endoscope with camera system after that procured specimen was sent for its histopathology. This histopathological diagnosis was correlated with CT diagnosis. Their clinical significance was analyzed statistically. Statistical Analysis Used: All obtained data were compiled in tabulated manner and results were expressed as mean ± standard deviation for the statistical analysis, using Statgraphics Centurion (Version 6.2), Statpoint Technologies, Inc. Virginia 2019. Results: A maximum number of patients were in the age group of 21–30 years. The predominant chief presenting complaint was a headache, followed by nasal discharge. The most common CT diagnosis was chronic sinusitis. Maxillary sinus was the most frequently involved sinus and most common CT inflammatory pattern observed was of sinonasal polyposis. Conclusions: This study proved that CT is an excellent imaging modality for evaluating the normal anatomy, variants, and pathologies of the PNSs with a potential pitfall for the diagnosis of fungal sinusitis.
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Cone beam computed tomography (CBCT) aided diagnosis and surgical management of a complex odontome in the mandible
Abhishek Madhavan, Senthil Balasubramani, Sankran Sudhakar, Shreenivas Sundar
May-August 2017, 5(2):53-57
Mandible is the most common site for various osseous pathologies in the head and neck region. Radiopaque masses undergo a transformation in three stages a radiolucent, mixed radiolucent-radiopaque, and completely radiopaque. In this case, a radiopaque mass was noted incidentally on an orthopantomogram in the posterior mandible and to further ascertain its operability a cone beam computed tomography (CBCT) imaging was performed which revealed the true nature and extent of the pathology. CBCT by its virtue of multidimensional imaging capability not only portrays more information at a lower patient dose than CT but also helps alleviate a surgical dilemma in treatment planning. In addition, it also helps identify the progression of pathology, its exact dimensions and hence prevents unnecessary second surgery.
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Reliability of panoramic radiographic indices in identifying osteoporosis among postmenopausal women
D Akshita, V Asha
May-August 2017, 5(2):35-39
Objective: Osteoporosis has several manifestations in the jaw bones, and these changes can be identified by the dentists on panoramic radiographs by measuring various mandibular indices. This study was undertaken to assess the reliability of the panoramic based mandibular indices in assessing low bone mineral densities. Materials and Methods: A cross-sectional study was conducted among 43 postmenopausal women aged 45 years and above. Orthopantomogram (OPG) and dual-energy X-ray absorptiometry (DEXA) scans were performed for all the patients. Mental index (MI), gonial index (GI), antegonial index (AI), panoramic mandibular index (PMI), and mandibular cortical index (MCI) were measured and compared with the T-scores obtained from the DEXA scan. Results: The study showed that, MCI was reliable in identifying postmenopausal women with low bone mineral density (BMD) (P = 0.01). Conclusion: MCI had high diagnostic accuracy (93%) in identifying postmenopausal women with low BMDs.
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Management of large periapical lesion due to trauma using triple antibiotic paste
Abidin Talha Mutluay, Merve Mutluay
May-August 2017, 5(2):58-61
Introduction: Mechanical instrumentation and chemical irrigation alone is not considered enough to eliminate microorganisms in the deeper layer of root canal system. Therefore, antibacterial medicaments are required for complete disinfection of root canal dentin. Case Presentation: Triple antibiotic paste application (metronidazole, ciprofloxacin and minocycline) have demonstrated good clinical and radiographical results for treatment of presented traumatized teeth with periapical lesion. Conclusion: It confirms that conservative treatment should be first option for treatment of periapical lesion. Triple antibiotic paste has benefical effects for traumatized teeth with periapical lesion.
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Correlation of mandibular ramus height and width with osteoporosis
Dur-e-Shahwar Rehman, Talat Yasmeen, Nabeel Qamar
May-August 2017, 5(2):40-45
Context: Osteoporosis is a disease of bone with distinctive decrease in bone mineral density and bone strength. It is important to diagnose it early before the patient presents to the emergency with a fracture hip or spine. Orthopantomogram (OPG) X-ray being cost effective and employed commonly can be used to demonstrate changes in mandibular morphology in osteoporotic patients. This can lead to early diagnosis of osteoporosis at the stage of osteopenia in a cost-effective manner. Aim: This study aims at establishing a correlation between morphological changes in mandible on OPG with dual-energy X-ray absorptiometry (DXA) scan of femoral neck and spine to see whether or not the OPG can be employed for the early detection and screening tool for osteoporosis. Settings and Design: Patients, attendants, and volunteers visiting Dow Radiology and Patel Hospital participated in this cross-sectional study. Materials and Methods: One hundred and seventy-four female participants, aged 25–85 years, were divided into premenopausal (Group I) and postmenopausal (Group II) groups. Each group was subdivided into normal (pre A, post A), osteopenic (pre B, post B), and osteoporotic (pre C, post C) groups by DXA scan. Mandibular morphological changes seen on OPG in subgroups of Group I were compared with each other and with subgroups of Group II. The parameters that were considered on OPG were mandibular ramus height (RH) and ramus width (RW). Statistical Analysis: Statistical analysis was performed by Statistical Package for Social Sciences version 16 using one-way analysis of variance to evaluate intragroup significance, and for intergroup significance, independent samples t-test was applied. Results: RH and RW showed no significant change on OPG. Conclusion: RH and RW on an OPG cannot be used as a screening tool or early detector of osteoporosis.
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Positron emission tomography/magnetic resonance imaging in head and neck carcinoma: A brief review of literature
Sonam Khurana, Dhruv Khurana
May-August 2017, 5(2):29-34
The carcinoma in head and neck region is the sixth most common worldwide cancer. Various advanced technologies are used for the diagnosis and staging of tumor and magnetic resonance imaging (MRI) and positron emission tomography (PET) scan are two such modalities. MRI provides information about anatomical and functional characteristics of tumor and PET scan provides metabolic and molecular information of tumor. The information obtained by PET/computed tomography (CT) and MRI is complementary to each other and hence gives accessory information for better diagnosis. It is difficult to combine both modalities, technically and clinically than it was expected. Different researches are still going on to evaluate the comparison of PET/MRI with PET/CT and diffusion-weighted MRI or their combination. This review article discusses the technical aspect as well as its clinical application in head and neck cancer cases.
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