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A case of Gorham's disease in the maxilla of a 56-year-old male patient is described. The clinical presentation, radiographic and histopathological features and treatment are presented. A discussion of the current understanding of this rare disease, based on review of the literature, is offered. [ABSTRACT FROM AUTHOR]

Objectives: This retrospective study reviews the occurrence of keratocystic odontogenic tumours (KOTs) in nevoid basal cell carcinoma syndrome (NBCCS) patients seen in the Oral and Maxillofacial Radiology Special Procedures Clinic in the Faculty of Dentistry at the University of Toronto. Methods: This study examines the number and radiographic features of KOTs identified in 11 NBCCS patients who presented with 43 KOTs between January 1989 and 30 June 2007 on plain film radiographs and CT. Results: Regression analysis revealed a statistically significant (P < 0.01) relationship between the age at first KOT occurrence and the total number of lifetime KOTs (r= -0.78). Of the KOTs identified, 25 developed in the mandible and 18 developed in the maxillae. The majority of these were associated with a change in either the size or shape of the follicular space, and both plain film radiography and CT were equally effective at demonstrating these changes. CT was, however, more effective at demonstrating endosteal scalloping of cortical bone than plain film radiography (P < 0.001) while the opposite was true for showing tooth displacement (P < 0.01). For patients imaged with both plain radiography and CT (29 KOTs), 5 KOTs were detectable only by CT. Conclusions: Our results suggest that there should be early and frequent monitoring of NBCCS patients for the development of KOTs in youth and adolescence, and that CT imaging should play an important role in these investigations. [ABSTRACT FROM AUTHOR]

Many diseases and conditions can disrupt the normal function of the salivary glands, and imaging can be an important tool in the formulation of a diagnosis. With sialography being the imaging modality of choice for obstructive conditions of the major salivary glands, our group has previously demonstrated that cone beam computed tomography (CBCT) sialography offers enhanced visualization of inflammatory changes and obstructions, such as sialoliths and strictures, over plain film sialography.1 However, because ionizing radiation is a concern, optimizing imaging protocols is crucial in order to minimize the radiation dose to the patient while still producing images of high diagnostic quality. As a first step in the optimization of a new imaging protocol for CBCT sialography, this study aimed to determine effective dose (E) for a range of exposure parameters using 2 field of view (FOV) sizes for submandibular and parotid gland CBCT sialography. Using a RANDO male phantom, we determined site-specific radiation doses to 25 sites in the head and neck and calculated E across a range of operating kilovoltage peak and milliamperage settings of the J. Morita Veraview X800 (J. Morita Mfg. Corp., Kyoto, Japan). The E for the submandibular gland study using an 8 cm (diameter) × 5 cm (height) FOV size ranged from 22.7 to 171.1 µSv, when varied across the unit's allowable kilovoltage peak and milliamperage range. For the parotid gland study using an 8 cm (diameter) × 8 cm (height) FOV size, the E ranged from 21.5 to 160.4 µSv. The use of variable FOV sizes for the submandibular and parotid glands may allow reductions in E compared with our earlier work2 and allow us to further optimize sialography imaging protocols for future patients. [ABSTRACT FROM AUTHOR]

We report here an unusual case of a 67-year-old female who presented to the Faculty of Dentistry at the University of Toronto (Toronto, Canada) with a primary chief complaint of a 2-month history of dull pain in her left mandibular tooth. Clinical examination revealed percussion sensitivity and buccal palpation tenderness of the mandibular left first molar. Panoramic, intraoral, and cone beam computed tomography (CBCT) imaging showed a well-defined, irregularly shaped osteolytic lesion in the left mandibular body, with directional external root resorption of adjacent teeth. The radiologic differential diagnosis of a well-defined osteolytic lesion resulting in extensive, directional external root resorption includes benign neoplasms and cysts. Malignant neoplasms, such as multiple myeloma, would be an unlikely consideration. In this case, the radiologic impression was of a benign neoplasm, in particular, central giant cell granuloma. Ameloblastoma and odontogenic myxoma were also considered. A diagnosis of plasmacytoma was made through histopathologic examination. A subsequent systemic workup revealed multiple myeloma. Although the occurrence of root resorption in multiple myeloma is rare, it has been reported in a small number of cases in the literature. The radiologic features of this case are presented to highlight this uncommon presentation. [ABSTRACT FROM AUTHOR]