Biomedical subjects
Publications and source records attributed to A B Reiskin.
Imaging for the planning of implant placement, for surveillance of restored fixtures, and for the management of complications is confusing because of the large number of modalities available. Clinicians, however, must recognize that each technique has advantages and limitations. It is essential to consider treatment objectives and patient needs carefully before performing or ordering imaging tests.
Oral and maxillofacial radiology is a dynamic and multifaceted discipline that plays a critical role in patient care, the education of general dentists and dental specialists, and the academic health of the dental school. Diagnostic and treatment advances in temporomandibular joint disorders (TMD), implants trauma and orthognathic surgery, and craniofacial abnormalities depend heavily on conventional and advanced imaging techniques. Oral and maxillofacial radiology contributes to the education of pre- and post-doctoral dental students with respect to biomedical and clinical knowledge, cognitive and psychomotor skills, and the professional and ethical values necessary to properly prescribe, obtain, and interpret radiographs. The development of an active and successful oral and maxillofacial radiology department, division, or section requires the committment of institutional resources. This document may serve as a guide to dental schools committed to excellence in oral and maxillofacial radiology.
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Many technical factors and treatment philosophies affect the way dental radiology is practiced. Some, like minimum tube filtration, are legislated. Others, like proper darkroom techniques, are universally acknowledged as essential. Still others, like the selection of an image receptor and the selection of the type of examination, are the subject of much discussion and debate. This article addresses some of the more controversial options and choices facing dental practitioners by reviewing the standard assessment techniques available to help make appropriate decisions, by summarizing and analyzing available data, and by offering recommendations for practice.
Arthrograms of the temporomandibular joint were obtained in 20 symptomatic joints that had previous reconstructive arthroplasty with disk repositioning because of internal derangements. Preoperative arthrograms were available for comparison in 18 joints. Symptoms resulting in a postoperative arthrogram included pain, limited ability to open the mouth, and clicking of the joints. Postoperative arthrographic findings included limited anterior translation of the condyle (90%), irregularity in outline of the intraarticular contrast agent (60%), a conical configuration of the posterior recess (25%), decreased size of the joint (28%), anterior displacement of the meniscus (25%), and perforated meniscus (15%). Many of these findings may have resulted from fibrosis and scarring, which may be a response to intraarticular bleeding. The mechanism by which the fibrosis causes the postsurgical arthrographic features is discussed.
This article examines the efficacy of panoramic radiography alone and in combination with intraoral films as part of the "full-mouth" radiographic evaluation of asymptomatic dental patients in the diagnosis of dental caries and periodontal disease. Three full-mouth radiographic surveys--the panoramic alone, the panoramic plus posterior bitewing, and the periapical plus posterior bitewing--are compared. Two forms of measurement--comparative and incremental--were used to identify the radiographic survey with the highest single diagnostic yield when measured against the consensus standard. The findings show that the panoramic radiograph alone exhibits very low sensitivities to dental caries, ranging from 0.6% on anterior teeth to 25.6% on premolars. Even when posterior bitewing radiographs are added to the panoramic films, the sensitivities are significantly below those of the full-mouth periapical and bitewing survey. In contrast, the sensitivities of all three radiographic surveys in the diagnosis of periodontal disease are quite high, ranging from 87% to 96%, so that differences are not clinically significant. However, specificities tended to be low for periodontal disease and high for caries. Thus, for dental caries and (to a lesser extent) periodontal disease, the panoramic radiograph was inferior to the full-mouth intraoral series in its ability to correctly detect evidence of the disease.
This clinical study compares the diagnostic yield of Kodak Ektaspeed with the diagnostic yield of Kodak Ultraspeed using a split-mouth experimental design and proximal surface carious lesions as the test objects. Assuming that proximal surface carious lesions are distributed randomly in a given patient and in the population at large, then any difference in the diagnostic quality of either of the films should be disclosed as a difference in the frequency and distribution of lesions identified with either of the films. No statistical difference was observed, which suggests that the two films perform equally well for the diagnostic task of detecting proximal surface carious lesions. Considering that there is a 40% to 50% reduction in radiation exposure to the patient when the faster film is used, it appears that Kodak Ektaspeed should be the preferred film for the dental practitioner.
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Careful attention to technique is of utmost importance in instances in which clinical evidence indicates that the osteolytic or osteogenic margins of a lesion may extend beyond those visible on a conventional radiograph. Procedures such as radionuclide scans should be used to establish the appropriate boundaries for surgical resection in such instances. Although early surgical intervention will usually lead to a definitive histopathologic diagnosis, there is some risk that manipulation will either compromise the validity of later radiological procedure or extend the disease by local dissemination or blood-borne metastases. Appropriate radiologic evaluation of lytic lesions of the mandible can provide a maximum amount of information so that surgical resection of the lesion will be complete, and the possibility of recurrence will be reduced.
A case of a 14-year-old black girl with a lesion that appeared to be a dentigerous cyst is presented. Radiographic appearance, findings of a bone scan and biopsy by aspiration are discussed. Histologic findings showed that the lesion was an ameloblastoma that is believed to have arisen from the dentigerous cyst wall.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.