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The aims of this pilot investigation were to calculate the levels of sensitivity and specificity of salivary glands ultrasonography (SGUS) in diagnosing Sjögren syndrome (SS) and to assess the ultrasonographic findings of parotid and submandibular glands.Patients diagnosed with SS or dry mouth and healthy controls were enrolled. Bilateral parotid and submandibular glands were assessed for (1) parenchymal inhomogeneity (PIH), (2) median size of the glands, (3) visibility of glandular posterior borders, and (4) size of sialolith, if present.This study included 34 female patients, of whom 12 had SS (35.3%), 12 had dry mouth (35.3%), and 10 were healthy controls (29.4%). Patients with SS showed higher PIH scores in all glands with the median differences being statistically higher in the right and left parotids and left submandibular glands (P.001, P = .012, and P.001, respectively). SGUS, with a PIH cutoff ≥2, showed a sensitivity of 100% and a specificity of 81.6% for detecting SS. The majority of SS had invisible glandular posterior borders (P.001). Median size of the glands and size of the sialolith did not show any statistically significant differences between groups.SGUS is a noninvasive imaging modality with good sensitivity and specificity that might be valuable as a diagnostic aid for SS.

Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign lesion exhibiting radiographic and histologic features that can be mistaken for malignancy. Most cases have been reported in the small tubular bones of the hands and feet, but involvement of the skull and jaws is extremely rare. Here, we present a case of BPOP involving the mandible in a 23-year-old male that, after initial excision, recurred within 18 months. To the best of our knowledge, this is only the third published case of BPOP arising in the mandible.

PURPOSE The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics™ (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students. MATERIALS AND METHODS The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations. RESULTS A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P

Aim To test whether the use of collagen matrix seal (CMS) results in similar hard and soft tissue remodelling to that with collagen sponge (CS) used as barriers 4 months following alveolar ridge preservation (ARP), in combination with freeze-dried bone allograft (FDBA). Materials and methods Twenty-eight patients were randomly assigned to the two groups. Clinical and radiographic measurements were recorded with the same stent at baseline and 4 months for standardization. The flapless technique following a traumatic extraction was used for the two types of barriers. Results All patients completed the study, 14 in the CMS group and 14 in the CS group. Reduction in coronal ridge width (1.21 mm-14.91% CMS and 1.47 mm-20.40% CS) and vertical buccal bone resorption (0.30 mm CMS and 0.79 mm CS) were not significantly different. A slight increase in buccal gingival thickness at the coronal part was observed in both groups (0.9 mm CMS and 0.5 mm CS). Conclusions Collagen matrix seal and CS, when combined with FDBA, significantly minimized ridge resorption in all dimensions and maintained buccal soft tissue thickness in sockets with a buccal plate loss of

Objectives Salivary glands ultrasonography (SGUS) is an emerging diagnostic aid for Sjogren syndrome (SS) with positive potentials because of its availability, noninvasiveness, and safety. The aim of this investigation was to assess and compare the ultrasonographic features of the parotid and submandibular salivary glands in patients with SS or dry mouth (DM) and in healthy controls and to evaluate the sensitivity and specificity of SGUS in the diagnosis of SS. Study Design This was a prospective observational 3-group comparison study. Patients diagnosed with SS (according to the 2016 American College of Rheumatology [ACR] and European League Against Rheumatism [EULAR] criteria, patients with DM (diagnosed on the basis of the subjective reporting of oral dryness and unstimulated salivary flow of Results Thirty-four female patients were enrolled in this investigation, of whom 76.5% were white. Twelve patients (35.3%) had definitive diagnosis of SS; 12 (35.3%) had DM; and 10 (29.4%) were healthy controls. The median age (interquartile range [IQR]) of patients in all 3 groups was 56.6 (± 14.2) years. Ninety-two percent of patients in both the SS and DM groups were on sialogogues, with the majority using cevimeline (83.3% and 41.6%, respectively). Overall, patients with SS showed significant SGUS features and had higher scores compared with patients with DM and controls. The median inhomogeneity score was significantly higher in the SS group compared with the DM and control groups in the right parotid gland (RPG), left submandibular gland (LSMG), and left parotid gland (LPG) (P = .000, .000, and .012, respectively), with no statistically significant differences detected between the SS and DM groups in the right submandibular gland (RSMG) only (P = .604). The median size of the hypoechogenic bands was statistically higher in all salivary glands (i.e., RSMG, RPG, LSMG, and LPG) in the SS group compared with the DM and healthy control groups (P =.000). When comparing the sizes of the glands, there were no statistically significant differences among the 3 groups in the median transvers dimension and height of the RPG (P = .846 and .137, respectively) and LPG (P = .382 and .538, respectively). Moreover, no statistically significant differences were observed in the median anteroposterior dimension and depth of the RSMG (P = .470 and .147, respectively) and LSMG (P = .495 and .695, respectively) among the 3 groups. Lack of visibility of the posterior borders of all glands was detected in the majority of patients in the SS group (RSMG = 66.6%; RPG = 83.3%; LSMG = 75%; LPG = 83.3%), whereas all patients in the DM and control groups had visible posterior borders (P = .000). The size of the sialolith, if present, did not show any statistically significant differences among the 3 groups in RSMG, RPG, LSMG, and LPG (P = .160, .136, .065, and .377, respectively). The SGUS, with a cutoff value of ≥ 2, showed sensitivity of 100% and specificity of 81.6% for detecting SS ultrasonographic features. Conclusions SGUS is a useful, noninvasive diagnostic modality with high sensitivity and specificity. Parenchymal inhomogeneity scores, sizes of the hypoechogenic bands, and visibility of the glands’ posterior borders may all have a good potential for detection of SS. We propose that the ACR and the EULAR take SGUS into consideration when reviewing/updating the diagnostic criteria for SS in the future.

Tooth extractions are followed by significant dimensional changes in the alveolar crest that may preclude implant placement. This randomized, controlled, prospective compares the preservation of soft and hard tissue dimensional changes after alveolar ridge preservation (ARP) using two membranes consisting of collagen matrix (CM) or extracellular matrix (ECM) as barriers over freeze-dried bone allograft (FDBA).Standardized clinical and radiographic measurements of soft and hard tissues were recorded by means of a stent before and 4 months after ARP. The surgery entailed sulcular incisions with minimal flap elevation and repositioning without advancement.Of 11 patients in the CM group and 12 in the ECM group who completed the study, gingival thickness (GT) increased from 0.1 to 0.2 mm for both groups along with a 0.5-mm decrease in the width of keratinized tissue after healing. Reductions in ridge width were most pronounced on the coronal aspect, 1.8 mm for CM and 2.0 mm for ECM, whereas vertical reduction was most pronounced on the buccal aspect, 0.7 to 1.0 mm. Differences between groups were not statistically significant. However, significant correlation for changes in GT (P = 0.001) and crestal bone width (P = 0.002) with preoperative buccal plate thickness (BPT) was observed.Both xenogeneic collagen matrices combined with FDBA were effective in maintaining soft tissues and minimizing ridge resorption in all dimensions after ARP. BPT was an important determinant for amount of change in crestal GT and ridge width.

Purpose The objective of this study was to investigate the effect of varying resolutions of cone-beam computed tomography images on the accuracy of linear measurements of edentulous areas in human cadaver heads. Intact cadaver heads were used to simulate a clinical situation. Materials and Methods Fiduciary markers were placed in the edentulous areas of 4 intact embalmed cadaver heads. The heads were scanned with two different CBCT units using a large field of view (13 cm×16 cm) and small field of view (5 cm×8 cm) at varying voxel sizes (0.3 mm, 0.2 mm, and 0.16 mm). The ground truth was established with digital caliper measurements. The imaging measurements were then compared with caliper measurements to determine accuracy. Results The Wilcoxon signed rank test revealed no statistically significant difference between the medians of the physical measurements obtained with calipers and the medians of the CBCT measurements. A comparison of accuracy among the different imaging protocols revealed no significant differences as determined by the Friedman test. The intraclass correlation coefficient was 0.961, indicating excellent reproducibility. Inter-observer variability was determined graphically with a Bland-Altman plot and by calculating the intraclass correlation coefficient. The Bland-Altman plot indicated very good reproducibility for smaller measurements but larger discrepancies with larger measurements. Conclusion The CBCT-based linear measurements in the edentulous sites using different voxel sizes and FOVs are accurate compared with the direct caliper measurements of these sites. Higher resolution CBCT images with smaller voxel size did not result in greater accuracy of the linear measurements.

Purpose: This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. Materials and Methods: One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. Results: There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value ⁄0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, “With CCAP” and “Without CCAP”, there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. Conclusion: This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health. (Imaging Sci Dent 2013; 43 : 235-43)