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Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a disease that presents as a hard trismus due to hyperplasia of the masseter and temporalis aponeurosis. Standard surgical methods for MMTAH include masseter resection, temporalis aponeurosis, and coronoidectomy. The operation of resecting the tendon aponeurosis attached to the posterior surface of the coronoid process carries the risk of bleeding and nerve damage because it cannot be observed directly. Therefore, the authors introduce a safer method by using an ultrasonic bone scalpel for this procedure. The authors used an ultrasonic bone scalpel with a long neck blade to scrape the posterior side of the coronoid process from the bottom to the top. The authors have treated 4 cases using this technique, and in all cases, the surgical procedure was performed safely and easily. In conclusion, ultrasonic bone scalpels are effective in MMTAH surgery for removing the attachment of the stiffened temporalis muscle tendon and aponeurosis., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.)

Background: Recent reports have shown that the Lymph node ratio (LNR) is useful for predicting the prognosis in some cancers, however there are few reports on the usefulness of LNR in predicting the prognosis of oral squamous cell carcinoma (OSCC). The predictive value of LNR for prognosis of OSCC was investigated., Materials and Methods: The study included 152 patients with OSCC and histologically confirmed cervical lymph node metastasis who underwent neck dissection. We analyzed the relationship between LNR and overall survival (OS) and recurrence-free survival (RFS) retrospectively in these cases, with the relationship between prognosis and clinicopathological findings also examined., Results: Using a receiver operating characteristics curve, the LNR cutoff value was set at 0.095, categorizing 64 and 88 cases into high LNR (≥ 0.095) and low LNR (< 0.095) groups, respectively. Regarding OS and RFS, the prognosis was significantly worse in the high LNR group compared with the low LNR group. In multivariate analysis, sex, postoperative nodal stage, and LNR merged as independent prognostic factors., Conclusion: This study's findings suggest that LNR may represent a prognostic indicator in OSCC with cervical lymph node metastasis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Since there are many differential diagnoses for cemento-osseous dysplasia (COD), it is very difficult for dentists to avoid misdiagnosis. In particular, if COD is related to an embedded tooth, differential diagnosis is difficult. However, there have been no reports on the characteristics of the imaging findings of COD associated with embedded teeth. The aim of the present study was to investigate the occurrence and imaging characteristics of cemento-osseous dysplasia (COD) associated with embedded teeth, in order to appropriately diagnose COD with embedded teeth., Methods: The radiographs with or without histological findings of 225 patients with COD were retrospectively analyzed. A retrospective search through the picture archiving and communication system (PACS) of the Division of Oral and Maxillofacial Radiology of Kyushu Dental University Hospital was performed to identify patients with COD between 2011 and 2022., Results: Fifteen COD-associated embedded mandibular third molars were identified in 13 patients. All 13 patients were asymptomatic. On imaging, COD associated with embedded mandibular third molars appeared as masses that included calcifications around the apex of the tooth. On panoramic tomography, COD showed inconspicuous internal calcification similar to that of odontogenic cysts or simple bone cysts, especially in patients with COD only around the mandibular third molar region. Those with prominent calcification resembled cemento-ossifying fibroma, calcifying epithelial odontogenic tumor, calcifying odontogenic cyst, adenomatoid odontogenic tumor, and so on, as categories of masses that include calcifications on panoramic tomography and computed tomography., Conclusions: The current investigation is the first to report and analyze the imaging characteristics of COD associated with embedded teeth. It is important to consider the differences between COD and other cystic lesions on panoramic tomography, and the differences between COD and masses that include calcifications on CT.

Background: Very recently, a significant relationship between tonsilloliths and dental plaque-related pathologies was reported using digital panoramic radiographs. Their dynamics over time suggest that tonsilloliths may be in a permanently active phase that functions to remove foreign matter. The aim of the study was to evaluate the relationship between the occurrence of tonsilloliths and the extent of periodontitis., Methods: A total of 608 patients who underwent both CT and panoramic radiographs were included in the study. Both of two imaging were retrospectively and independently assessed with respect to the presence of tonsilloliths detected on CT and panoramic radiographs, and bone defects caused by periodontitis detected on panoramic radiographs. The type of retrospective study is case-control. Then, the differences between age groups were evaluated with respect to the degree of bone resorption and its correlation with the presence of tonsilloliths. The relationships between categorical variables were assessed using Pearson's correlation coefficient or Spearman's correlation coefficient., Results: There was a significant relationship between tonsilloliths on CT and the extent of the bone defect on panoramic radiographs (Spearman's correlation coefficient, r = 0.648, p = 0.043). In addition, there was a significant difference in the extent of the bone defect caused by periodontitis between subjects with and without tonsilloliths in the 60 to 69-year-old group (Mann-Whitney U test, p = 0.025), 70 to 79-year-old group (Mann-Whitney U test, p = 0.002), and 80 to 89-year-old group (Mann-Whitney U test, p = 0.022), but not in other age groups (Mann-Whitney U test: under 9-year-old group, p = 1.000; 10 to 19-year-old group, p = 1.000; 20 to 29-year-old group, p = 0.854; 30 to 39-year-old group, p = 0.191, 40 to 49-year-old group, p = 0.749; 50 to 59-year-old group, p = 0.627; ≥90-year-old group, p = 1.000)., Conclusions: The presence of tonsilloliths was related to the extent of periodontitis because the structures were responding dynamically., (© 2023. The Author(s).)

Background: The distribution and drainage of the sublingual gland ducts have various patterns that might be related to sublingual gland-related diseases, including ranula. This study aimed to elucidate the characteristics of the distribution of Bartholin and/or Rivinus ducts in patients with ranula using magnetic resonance (MR) sialography., Methods: In this retrospective cross-sectional study, the distributions and drainage patterns of sublingual gland ducts on MR sialography were classified in 74 subjects without sublingual gland-related disease as confirmed by both medical history and clinical examination and 15 patients with ranula, respectively. All patients had visited Kyushu Dental University Hospital from July 2015 to June 2022 to undergo MR imaging. Data on the distributions and drainage patterns of the sublingual gland ducts, including the characteristics of the Bartholin and/or Rivinus ducts, were then statistically compared between subjects without sublingual gland-related disease and patients with ranula. The images were assessed by an experienced oral and maxillofacial radiology specialist certified by the Japanese Society for Oral and Maxillofacial Radiology. The distributions (five groups) and drainage patterns (three patterns) of the sublingual gland ducts on MR sialography were classified in reference to previous studies, with some modifications in all subjects without sublingual gland-related disease and patients with ranula., Results: A significant difference in the distribution of the ducts (P<0.001), with a low number of patients exposing an undetected canal or Rivinius duct, was found in the group of patients with ranula (P<0.05). Regarding drainage patterns, no patient with ranula presented a Rivinius duct only. A significant difference in the drainage patterns of the sublingual gland ducts on MR sialography was observed between subjects without sublingual gland-related disease and patients with ranula (P=0.001)., Conclusions: The present results suggest that the distribution of the sublingual gland ducts, mainly, the Bartholin duct, may be related to ranula formation. These findings also demonstrate that MR sialography contributes well to preoperative evaluation and is effective for assessing the complex excretory distribution of the sublingual gland ducts., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-948/coif). The authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)