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   2020| May-August  | Volume 8 | Issue 2  
    Online since October 5, 2020

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“CALCIFIC ISLANDS:” A cone-beam computed tomography review of soft-tissue calcifications in head-and-neck region
Ajay Parihar, Arushi Shastri, Arvind Jain, Ashish Saxena, Amit Rawat, Mamta Singh
May-August 2020, 8(2):30-35
Soft-tissue calcification of the head-and-neck region is now commonly seen because of the advent and increased usage of cone-beam computed tomography (CBCT) in dentistry. The purpose of this study is to construe the radiographic characteristics in CBCT of the soft-tissue calcifications in the head-and-neck region. The soft-tissue calcifications of the head-and-neck region may arise from pathological mineralization by deposition of calcium phosphate essentially in an unorganized manner known as “heterotopic calcification.” The three types of heterotopic calcifications are dystrophic calcifications, metastatic calcifications, and idiopathic calcifications (calcinosis). These calcifications can include sialoliths, calcified lymph nodes, carotid artery calcifications, and many more which present themselves with different radiographic presentations. These calcifications can be detected by different two-dimensional and three-dimensional imaging techniques, among which CBCT proves to be the best radiographic tool in most of the cases. The anatomic location, number, distribution, pattern, and size of calcifications are important interpretative criteria in radiographic evaluation of soft-tissue calcifications. Soft-tissue calcifications though usually asymptomatic are quite common in the head-and-neck region. An apt radiographic imaging aids in reaching up to the precise diagnosis which may enhance their approach and management by clinicians.
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Evaluation of mandibular incisive canal and its relationship to adjacent anatomical landmarks using cone-beam computed tomography
P Ramaswamy, Ch Sai Kiran, B Mrudula Raju, Myla Swathi, Goteti Elizabeth Sharanya
May-August 2020, 8(2):23-29
Introduction: One of the most common accidental complications that occur during surgical procedures in the mandibular interforaminal region is the numbness of the chin and lower lip. This happens when vital structures such as the mental foramen, the mandibular incisive canal (MIC) and the anterior loop of the inferior alveolar nerve are not properly identified and protected. orthopantomogram has the least accuracy in identifying this structure. Hence, a better image such as computed tomography or cone-beam computed tomography (CBCT) should be used in the inter-mental foramen area. Aim: The aim is to assess the presence, position, and dimensions of MIC and its relationship to adjacent anatomical landmarks using CBCT. Materials and Methods: A total of 50 patients with 100 MICs of age 20–70 years are studied, and the collected data were subjected to statistical analysis. Results: Statistically significant result was obtained with the MIC to root tip of canine, MIC to lower cortex, MIC to buccal cortical plate, and diameter of MIC with regard to gender, which is more in males. MIC is more toward the buccal plate, and there is no statistically significant difference between the right and left sides. The diameter of MIC is larger in males compared to females and larger on left side compared to right side. Conclusion: Analyzing MIC using CBCT scans can be a useful tool in avoiding implant surgical complications in the anterior mandible.
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“Face mask sign” on Tc-99m methylene diphosphonate bone scan
Prathamesh Vijay Joshi, Mukta Kulkarni, Kritik Kumar
May-August 2020, 8(2):41-43
Although bone scan is a sensitive imaging modality, it is nonspecific, and there are multiple potential causes of abnormal isotope uptake that can mimic metastatic disease. A 67-year-old male, a known case of prostate carcinoma, underwent bone scan for skeletal evaluation. His prostate biopsy had revealed adenocarcinoma of the prostate. His serum prostate-specific antigen level was 11.8 ng/ml. The scan showed increased tracer uptake in bilateral maxillary sinuses mimicking shape of the face mask. To characterize the abnormal tracer uptake in the bilateral maxillary sinuses and rule out the metastatic lesion, single-photon emission computed tomography–computed tomography (SPECT-CT) correlation was obtained. The SPECT-CT revealed mucosal thickening obliterating sinus space in the bilateral maxillary sinuses, suggesting the uptake secondary to maxillary sinusitis. On questioning, the patient admitted of having chronic history of pain along the sides of the nose and yellowish nasal mucus discharge. We concluded the uptake to be result of the bilateral maxillary sinusitis. We propose that such uptake pattern can be designated as 'face mask sign' on bone scan.
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Medication-related osteonecrosis of the jaw: Should cone-beam CT be considered as standard of care for diagnosis and treatment?
Deeba Kashtwari, Axel Ruprecht, Joseph Katz
May-August 2020, 8(2):36-40
Medication-related osteonecrosis of the jaw (MRONJ) is a major challenge faced in dental practice. Imaging plays a critical role in diagnosis and treatment planning of this condition. Conventional radiographs are commonly acquired as baseline imaging, but due to limitations such as being a two-dimensional modality and superimposition of adjacent anatomy, certain radiographic features may not be visualized like on a cone-beam computed tomography (CBCT) possibly resulting in either missing the lesion on radiographs or misinterpreting the severity of the disease. This case shows that CBCT could be a good initial choice along with clinical examination to avoid delay in proper diagnosis and management.
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Renewed focus in salivary diagnostics
Deepak Sharma, Nishant Negi
May-August 2020, 8(2):44-45
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