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At least 1,369 records · Page 76Linked to original sources
PubMed2006

Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs.

Panoramic radiographs, in combination with a clinical examination, are routinely used as an aid to orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the prevalence and location of incidental findings of pathology and abnormalities in pretreatment orthodontic panoramic radiographs. A total of 496 patients (232 girls and 264 boys; mean age 11.2 years, SD 2.33) were randomly selected from the Orthodontic Clinic at the Faculty of Odontology, University of Malmö, Sweden. All radiographic examinations were performed between 1999 and 2003 at the Department of Oral Radiology, Faculty of Odontology, University of Malmö, Sweden. Two independent examiners analyzed the radiographs for abnormalities and diagnoses of pathology. However, caries and findings related to the orthodontic treatment plan, such as eruption disturbances and missing or supernumerary teeth, were not recorded. All radiographs with positive findings were reexamined by a third examiner, a specialist registrar in oral radiology. A total of 56 findings in 43 patients (8.7%) were recorded, and significantly more findings were detected in girls (P = .007). The most common findings were radiopacities (idiopathic sclerosis) in alveolar bone (n = 22), thickening of mucosal lining in sinus maxillaris (n = 15), and periapical inflammatory lesions (n = 10). The majority of the periapical lesions and radiopacities were found in the mandible. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require medical or odontological management. However, the clinician should be aware of the potential to detect pathology and abnormality in pretreatment orthodontic panoramic radiographs.

Chi-Square Distribution↗
PubMed2004

Analyses of variable panoramic radiographic characteristics of maxillo-mandibular fibrous dysplasia in McCune-Albright syndrome.

OBJECTIVE: Fibrous dysplasia (FD) is a rare skeletal disease caused by activating GNAS1 gene mutations often found in association with the McCune-Albright syndrome (MAS). Multiple bones may be affected in FD, including maxilla and mandible. Patients with MAS have different endocrinopathies that can further influence bone metabolism. The purposes of this cross-sectional study are to characterize FD panoramic radiographic patterns, and to evaluate the effects of age, endocrinopathies and renal phosphate wasting on radiographic characteristics of maxillo-mandibular FD in MAS. SUBJECTS AND METHODS: Fifty-one consecutive MAS patients were screened and panoramic radiographs of 43 patients with craniofacial FD were evaluated and analyzed for FD involvement. Clinical chemistries were evaluated for associations between radiographic patterns and age, endocrinopathies or renal phosphate wasting using Fisher's Exact Test. RESULTS: Four types of radiographic changes were observed: ground glass (granular/condensed trabeculae), radiolucent (lytic), mixed radiolucent/radio-opaque (mixed density) or radio-opaque (sclerotic). Masking or displacement of the maxillary sinus (range: 77.8-86.4%) and mandibular canal (range: 55.6-75.0%) were prevalent in FD sites. Sixty-three percent of the MAS patients had multiple dysregulated endocrine/metabolic functions, the most common were hyperthyroidism, precocious puberty and renal phosphate wasting. There were no statistically significant associations between radiographic patterns and age, endocrinopathies or renal phosphate wasting. CONCLUSIONS: Maxillo-mandibular FD images in panoramic radiographs fall within a spectrum of four different patterns. Patients with facial asymmetry and any of these radiographic patterns should be promptly referred for further radiographic tests and endocrine evaluation if MAS is suspected.

Adolescent↗
PubMed2003

Angiotensin I-converting enzyme is expressed by erythropoietic cells of normal and myeloproliferative bone marrow.

It is proposed that a locally active, intrinsic renin-angiotensin system (RAS) exists in the bone marrow (BM) and plays a role in regulating haematopoiesis. Angiotensin II type I receptor has been detected on erythroid burst-forming unit-derived cells; its antagonist losartan and angiotensin I-converting enzyme (ACE) inhibitors can suppress erythropoiesis. The possible role of ACE/RAS in BM was investigated by evaluating ACE expression in normal BM, several myeloproliferative disorders and myelodysplasia. Immunohistochemical studies showed that erythroid elements expressed ACE protein in both normal and disturbed haematopoiesis. The presence of ACE in erythroid cells suggests another mechanism for direct ACE inhibitor activity in erythropoiesis.

Anemia, Refractory↗
PubMed2002

Dense bone island: clinical features and possible complications.

A case of dense bone island in a girl aged 10 years, 1 month old is presented. The lesion was asymptomatic and was an incidental finding on a radiograph taken for another purpose. Nine months after the patient's first visit, an obvious inclination of adjacent teeth was identified. The size and density of the lesion had increased by 10 and 7%, respectively. As the patient was still in adolescence, the lesion may increase in size and density, potentially resulting in further problems such as increased inclination of the adjacent teeth. In addition, the presence of the lesion may complicate any future orthodontic treatment. The lesion should be kept under observation until its growth ceases.

Bone Density↗
PubMed2001

Erdheim-chester disease.

Erdheim-Chester disease (ECD) is a rare histiocytic infiltrative disease, characterized by long bone sclerosis. We describe two confirmed cases of ECD, both of which demonstrate non-malignant retroperitoneal and peri-renal infiltration causing dilatation of the upper renal tracts. The cases are illustrated with contrast studies, computed tomography (CT) and magnetic resonance imaging (MRI). Typical sclerosis of the long bones was apparent on radiography. Both cases have been treated conservatively to date.A brief review of the literature regarding the manifestations of ECD is included. In cases of non-malignant retroperitoneal infiltration, ECD should be considered as a diagnosis and radiographs of the long bones performed.

Adult↗
PubMed1999

Use of bisphosphonates for the treatment of bone metastasis in experimental animal models.

Therapeutic effectiveness of bisphosphonates (BP) on bone metastases in patients with cancers including those of the breast and prostate has been well documented. However, there are still many important questions that remain unsolved or controversial. To obtain answers for these questions that are not readily addressed in a well-controlled manner in clinical studies, we have developed two animal models of bone metastasis (orthotopic and experimental). Using these models, we studied the effects of BP alone or in combination with anti-cancer agents on the metastasis of breast cancer to bone and visceral organs. In addition, we also determined the effects of BP on osteosclerotic metastases. We found that BP impaired the progression of bone metastases primarily through enhancing apoptosis in osteoclasts and breast cancer cells colonized in bone. In some situations, however, BP alone increased metastases in visceral organs including liver and adrenal glands. However, combination of BP with anti-cancer agents enhanced the suppression of tumour in both bone and visceral organs, leading to prolonged survival of tumour-bearing animals. Of potential importance, preventative administration of BP inhibited the development of eventual osteosclerotic bone metastases. These results suggest that BP exhibits diverse beneficial effects on osteolytic and osteoblastic bone metastasis and non-bone organ metastasis in breast cancer when administered appropriately. They also suggest that the animal models of bone metastasis described here allow us to produce clinically- relevant information that is useful for the design of optimal regimens of BP for the treatment of breast cancer patients with bone and visceral metastases.

Animals↗
PubMed2002

The relationship between proximal pole blood flow and the subjective assessment of increased density of the proximal pole in acute scaphoid fractures.

The cause and importance of increased density of the proximal pole of the scaphoid seen in radiographs after an acute fracture were investigated. Blood flow to the proximal poles of 32 nonsurgically treated scaphoid fractures were assessed 1 to 2 weeks after injury by measuring their uptake of gadopentetate dimeglumine with dynamic magnetic resonance imaging and calculating its steepest slope and percentage of enhancement values. Initial (week 0) and week 8 scaphoid series radiographs were independently assessed by 2 observers for increased proximal pole density; both agreed that the density had increased during treatment in 9 fractures. All 9 fractures united, suggesting that increased proximal pole density is not a major determinant of fracture outcome. Increased density of the proximal pole was associated with low proximal pole blood flow, but this relationship was not absolute, suggesting that other factors contribute to the appearance of increased density.

Adolescent↗
PubMed2001

Discectomy as an effective treatment for painful temporomandibular joint internal derangement: a 5-year clinical and radiographic follow-up.

PURPOSE: The purpose of this prospective study was to compare the preoperative and 5-year postoperative status of patients after unilateral discectomy for painful internal derangement of the temporomandibular joint. PATIENTS AND METHODS: The study was based on 64 patients. Fifty-six had disc displacement without reduction and 8 had disc displacement with reduction. The patients were examined clinically and radiographically before and 5 years after the operation according to a standardized protocol. RESULTS: Eighty-five percent of the patients (n = 52) had good results, 6% had acceptable results, and 9% had a poor outcome. Three patients (5%) were reoperated and 5 other patients (8%) needed a contralateral operation during the 5-year follow-up. The median increase in maximum mouth opening was 11 mm (range, -8 to +35 mm) and 83% of the patients had more than 40 mm maximal mouth opening postoperatively. Seventy-five percent of the patients had crepitation at 5-year follow-up compared with 27% before the operation. Postoperatively, the majority of the joints showed radiographic evidence of osteophytes, flattening, and sclerosis. The radiographic alterations did not correlate with the patients' symptoms. CONCLUSIONS: The results of this long-term follow-up after unilateral discectomy support the use of this operation in patients with painful internal derangement who show no improvement after prior nonsurgical treatment. The postoperative radiographic alterations should be interpreted as adaptive changes rather than progressive degenerative joint disease.

Adolescent↗
PubMed2001

Pycnodysostosis: clinical, radiologic, and endocrine evaluation and linear growth after growth hormone therapy.

Pycnodysostosis is a rare hereditary bone abnormality with an autosomal recessive mode of inheritance. We report the clinical, radiologic, and endocrine status of 8 children with this rare disease. All patients had the characteristic phenotype of the disorder including short stature (8 of 8), increased bone density (7 of 8), separated cranial sutures (8 of 8), large fontanel with delayed closure (8 of 8), obtuse mandibular angle (8 of 8), delayed teeth eruption (8 of 8), enamel hypoplasia (7 of 8), dysplastic acromial ends of the clavicles (6 of 8), frontal bossing (6 of 8), ocular proptosis (8 of 8), and dysplastic nails (8 of 8). Developmental evaluation according to the revised Denever developmental screening showed normal motor, fine motor-adaptive language, and personal social abilities in all the children. All had normal hepatic and renal functions. Serum calcium and phosphorus concentrations were normal. Two children had low serum alkaline phosphatase concentration. Short stature is a characteristic feature of pycnodysostosis. Seven of the 8 children were born short (length standard deviation score [SDS] = -3 to -1.5). Deceleration of linear growth was significant during the first 3 years of life. All the children had height SDS below -3 at the end of their third year of life. Although short stature is a feature of this genetic disorder, defective growth hormone (GH) secretion in response to provocation with clonidine and glucagon was found in 4 of the 8 patients. These 4 patients had pituitary hypoplasia on the magnetic resonance imaging (MRI) of their brain. In addition, 3 of these 4 patients had demyelination of the cerebrum. Patients with pycnodysostosis (n = 8) had low circulating concentrations of insulin-like growth factor-1 (IGF-1) compared with normal age-matched short children with constitutional short stature (CSS). IGF-I increased significantly after injecting GH for 3 days in these patients. Physiologic replacement with GH (18 U/m(2)/week) divided in daily evening doses subcutaneously increased IGF-1 concentration and improved linear growth velocity and height standard deviation scores (HtSDS) in the 4 children with GH deficiency. These data ruled out GH resistance and proved the usefulness of GH therapy in the management of short stature in these patients. In summary, some patients with pycnodysostosis have partial GH deficiency and low IGF-1 concentration. GH therapy markedly increases IGF-I secretion and improves their linear growth. MRI study of the brain including the hypothalamic-pituitary area is recommended in these children because of the high incidence of pituitary hypoplasia and cerebral demyelination.

Adolescent↗
PubMed2000

Effect of limited jaw motion on ankylosis of the temporomandibular joint in sheep.

The purpose of this study was to investigate the effect of limited movement of the jaw on ankylosis of the temporomandibular joint (TMJ). Eighteen adult sheep were divided into two groups. In Group 1, the temporal and condylar articular surfaces were removed together with the disc on the right. In Group 2, we did the same procedures but in addition the jaw movements were limited by a wire. One sheep was killed just after the operation, four at one month, and four at three months, in each group. The range of jaw movements preoperatively and at the time of death were recorded. The joints were examined radiologically, macroscopically, and histologically. We used a scoring system to assess the radiological changes and histological extent of ankylosis. At one month, the joint spaces were filled with fibrous tissue, but a small joint space existed in all four joints in Group 1. In Group 2, there was full ankylosis in two joints and partial ankylosis in two joints. At three months, similar ankylotic changes were seen in both groups. The histological score for ankylosis at one month showed that those in Group 2 were significantly more ankylosed than in Group 1 (P<0.01). The range of jaw movements was more limited at one month in Group 2, both vertically and to the left, and was significantly decreased in both groups (P<0.01) at three months. Limitation of jaw motion hastens the progress of TMJ ankylosis.

Analysis of Variance↗
PubMed2001

Mandibular reconstruction using a vascularised fibula osteocutaneous flap in a patient with pyknodysostosis.

We present the first successful report of mandibular reconstruction using a free fibula osteocutaneous flap in a patient with pyknodysostosis. The patient had recurrent refractory osteomyelitis of the mandible, which was initially treated with resection and reconstruction using an AO plate. Recurrent fistula formation with loosening of the plate was treated by radical re-excision and reconstruction with a free fibula flap. The postoperative course was uneventful; at 14 months the bony union was almost complete, without resorption or atrophy of the grafted fibula on radiography.

Adult↗
PubMed2001

MR grading of temporomandibular joint fluid: association with disk displacement categories, condyle marrow abnormalities and pain.

The purpose of this study was to investigate temporomandibular joint (TMJ) effusion on magnetic resonance (MR) images, and its association with specific categories of disk displacement, bone marrow abnormalities and pain. From a series of 523 consecutive TMJ MR imaging studies of patients referred to imaging because of pain and dysfunction, those with TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers, were analysed. The selected patients were reassessed and the amount of TMJ fluid was graded bilaterally according to a set of reference films. Other parameters recorded included disk displacement categories and condyle marrow abnormalities. Pain self-records were obtained from the patients immediately before MR imaging. The association between the recorded parameters and TMJ pain was analysed with t-tests and regression analysis. Of the 523 patients, 70 (13%) had TMJ effusion, which was unilateral in 61%. Only 9% of the 70 patients had effusion bilaterally, whereas bilateral disk displacement was found in 80%. In the 76 joints with effusion, 83% showed two specific categories of disk displacement at closed mouth. Condyle marrow abnormalities were found in 31% of the 70 patients, mostly on one side, and in 24% of the 76 joints. An in-patient regression analysis of the side difference in TMJ pain showed that effusion and condyle marrow abnormalities were significant pain-increasing factors. In conclusion, patients with TMJ effusion represent a subgroup with pain and dysfunction with more severe intra-articular pathology than those with disk displacement but no other joint abnormalities.

Adolescent↗