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PubMed1995

Diagnostic confidence and the accuracy of treatment decisions for radiopaque periapical lesions.

The periapical radiograph is a tool used in the diagnosis of periapical bone pathology. Radiographic diagnosis might therefore influence endodontic treatment planning and the quality and the cost of dental health care. The hypotheses were tested that (1) the subjective prevalence of a lesion would be associated with the accuracy with which it is diagnosed, (2) 'confident dentists' would be as accurate in their diagnosis as 'doubtful dentists' and (3) the diagnostic confidence of dentists for the diagnosis of periapical pathology would not influence their treatment planning. It was found that the probability of an appropriate treatment decision increased when dentists were relatively confident about a diagnosis. The results showed, furthermore, that the accuracy of diagnostic decisions increased when the dentist's confidence about a particular decision was high. Ways to increase diagnostic accuracy of radiopaque periapical pathology are proposed as a result of this study.

Clinical Competence↗
PubMed1993

Osteopathia striata--a case report.

Osteopathia striata is an unusual skeletal condition that can affect the bones of the skull quite markedly and result in dental problems that have rarely been discussed in the literature. The characteristic features exhibited by the patient in this case report were dense maxillary and mandibular bone, a high forehead with frontal bossing, a broad nasal bridge, prominent zygomatic arches and thickened angles of the mandible. The mouth opening was limited as a result of sclerosis of the mastoid process, and right lateral excursion of the mandible was reduced, probably because of a deformity of the left condyle.

Adolescent↗
PubMed2006

Periostitis ossificans (Garrè's osteomyelitis) radiographic study of two cases.

BACKGROUND: Periostitis Ossificans (PO) is a non-suppurative type of Osteomyelitis, commonly occurring in children and young adults, in mandible. The most common cause for PO is periapical infection of mandibular first molar. Radiographically PO is characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic appearance of "onion skin". CASE REPORTS: Two male children 11 years of age reported to the Department of Oral Medicine with a painless and persistent bony hard swelling in the mandible, with a short duration (Figs 1, 5). Both the patients had grossly decayed mandibular permanent first molar tooth with periapical infection and buccal cortical plate expansion (Figs 2, 6). The radiographic study revealed different appearances, the Orthopantomograph of case I showed a single radiopaque lamella outside the lower cortical border, without altering original mandibular contour (Fig. 3) and in case II showed a newly formed bony enlargement on the outer aspect of the lower cortical border without altering the original mandibular contour (Fig. 7). Occlusal radiograph of both the patients showed two distinct radiopaque lamellae of periosteal bone outside the buccal cortex (Figs 4, 8). Kawai et al. classified PO of mandible into type I and type II, based on whether the original contour of mandible is preserved or not. Each type is further classified into two sub types (Table 1). In case I, the orthopantomographic appearance is characteristic of type I-1 (Fig. 3), but the appearance in occlusal radiograph is characteristic of type I-2 (Fig. 4). In case II, the appearances in both the radiographs are characteristic of type I-2 (Figs 7, 8). CONCLUSIONS: Apart from the typical onion skin appearance, PO shows various other radiographic appearances. The radiographic appearance of Periostitis Ossificans may reflect the duration, progression and the mode of healing of the disease process. The radiographic classification of PO depends on the type of radiographs taken for evaluation.

Child↗
PubMed1996

Height of the residual ridge and radiographic appearance of bony structure in the jaws of clinically edentulous elderly people.

Alveolar atrophy and its relation to osteopenia of the mandible were studied in 124 edentulous 76-, and 81- and 86-year-old subjects (32 males and 92 females). Both variables were assessed visually from panoramic radiographs. Mandibular alveolar atrophy was found to be more severe in women (P < 0.001). No statistically significant differences were found between the three age-groups in mandibular alveolar atrophy, nor between the sexes or age-groups in maxillary alveolar atrophy. The structure of the mandibular bone was osteopenic in 38 patients (30.7%), a situation that was more frequent in women (P < 0.001). The relationship between the observed osteopenia and the severity of the mandibular alveolar atrophy in women was statistically significant (P < 0.05).

Age Factors↗
PubMed1978

Osteopathia striata with cranial sclerosis. An autosomal dominant entity.

The syndromic association of striae in the long bones and pelvis, together with sclerosis of the base of the skull, has been investigated in four families. Impairment of hearing and alteration in the shape of the head are the most important clinical manifestations. Spinal abnormalities are an inconsistent feature. The distribution of affected individuals in the kindreds is compatible with autosomal dominant inheritance.

Adult↗
PubMed1980

Osteopathia striata with cranial sclerosis: Highly variable expression within a family including cleft palate in two neonatal cases.

Cranial sclerosis with osteopathia striata was diagnosed in four members of a family in three generations. The expression of the gene varied from mild cranial enlargement to cranial abnormality associated with severe Pierre-Robin triad. The disorder was diagnosed prenatally in the most severely affected member of the family from the finding of an increased biparietal diameter of the fetal head on ultrasound examination.

Adult↗
PubMed1984

The syndromic status of sclerosteosis and van Buchem disease.

We have examined 50 persons with sclerosteosis in the Afrikaner community of South Africa and 15 individuals with van Buchem disease in Holland. The clinical and radiographic manifestations of these conditions are very similar, the only notable differences being greater severity and syndactyly in the majority of the patients with sclerosteosis. The Afrikaners have Dutch antecedants and it seems likely that these autosomal recessive disorders result from homozygosity of the same faulty genes. The phenotypic variation may be due to the epistatic effect of modifying genes in the Afrikaner population.

Adult↗
PubMed1990

Clinical considerations in Buschke-Ollendorff syndrome.

This brief report describes a mother and two daughters with the rare Buschke-Ollendorff syndrome. That the typical dermal connective tissue naevi lesions may become less obvious with time and that the condition is not always so "benign" are important clinical features not well recognised. Incorrect diagnosis may lead to embarkation upon hazardous management.

Adult↗
PubMed1994

Osteomesopycnosis.

The radiographic findings in two children with osteomesopycnosis are described. This is the first report in the Australian literature of this uncommon, recently described entity.

Adolescent↗
PubMed1996

Bone changes in tuberous sclerosis mimicking metastases.

Sclerotic and lytic bone changes of tuberous sclerosis (TS) can mimic bone metastases. We report a case of bone metastases from bronchogenic carcinoma in a patient with TS bone changes. Bone scintigraphy and magnetic resonance imaging are useful in distinguishing the TS bone lesions from bone metastases.

Adenocarcinoma↗