Search

To clarify the clinicopathological characteristics of primary hyper-IgE-related salivary gland disease (PHIESD), which is a newly proposed entity.Fifteen consecutive patients pathologically diagnosed with chronic sialadenitis were enrolled, and their clinicopathological features were comprehensively analyzed.(1) multiple salivary gland enlargement; (2) elevated serum IgE and/or IgE-positive cell infiltration in salivary gland tissues; (3) histology-confirmed lymphoplasmacytic infiltration; (4) exclusion of other known diseases.The male-to-female ratio was 5:10. The median age was 21 (range, 3-63) years. The average number of affected glands was 3.7 ± 1.4. Submandibular, parotid, and sublingual glands were involved in 15, 8, and 2 patients, respectively. Comorbid diseases included allergic diseases in seven patients and autoimmune diseases in two. Elevated serum IgE (median 175 kU/L) was seen in all patients. Serum IgG4 was slightly elevated in three patients. Histologically, most patients had mild lesions, including mild lymphocyte infiltration (60%) and focal fibrosis (66.7%). Lymphoid follicular formation (53.3%), moderate to severe lymphocytic inflammation (40%) and severe fibrosis (33.3%) were also observed. Immunohistochemically, IgE-positive cells infiltrated mainly around the ducts, with scattered infiltration of IgG4-positive, mast, and interleukin-4 positive cells. During follow-up (median, 46 months) of ten patients without intervention and two with immunosuppressive therapy, no significant changes in gland size or serum IgE level were noted.PHIESD manifests as homogeneous enlargement of multiple salivary glands and elevated serum IgE. Histopathology further verifies the diagnosis. It might be associated with anaphylaxis or autoimmune dysfunction. Conservative treatment is suggested.4 Laryngoscope, 132:2132-2138, 2022.

Tongue squamous cell carcinoma (TSCC) is the most frequent type of oral cancer associated with high malignancy. Circular RNAs (circRNAs) are a form of non-coding RNA with stable and conserved expression in mammalian cells. The aim of the present study was to investigate circRNAs expression profiles in TSCC, and examine the roles and potential mechanisms of circRNA-081069 (circ_081069). A high-throughput circRNA microarray analysis of tumor samples and adjacent normal tissues from four patients with TSCC was performed. Bioinformatic analysis was conducted to screen the differentially expressed circRNAs. Reverse transcription-quantitative PCR was performed to confirm the microarray results. A migration assay and proliferation assay were performed to detect the migratory and proliferative ability of TSCC cells. A luciferase assay was conducted to investigate the interaction between circ_081069 and microRNA (miRNA/miR)-665. In total, 335 circRNAs were found to be differentially expressed in tumor tissues. Among them, 59 were upregulated and 276 were downregulated (P

Objectives: The purpose of this study was to investigate the image quality of cone beam CT (CBCT) under different exposure parameters and the relationship between contrast-to-noise and visibility of eight anatomical structures. Methods: CBCT images for the evaluation of subjective image quality were acquired on an anthropopathic phantom containing a human skeleton embedded in soft tissue equivalent materials using 25 exposure protocols. Visibility of eight anatomical structures was evaluated by five independent observers. Using the SEDENTEXCT IQ Image Quality phantom, the contrast-to-noise ratio (CNR) was calculated by ImageJ software. Results: A reduction on the visibility of anatomical structures was seen under lower exposure parameters. However, for 84% of the protocols, visibility of anatomical structures remained acceptable even under some lower parameter settings. As CNR increased, the visibility of anatomical structures also increased correspondingly. A change point could be found in the CNR interval 29.42–36.51 after which the visibility of anatomical structures no longer increases with the increase of CNR. Conclusions: Although CNR decrease under a lower exposure parameter, the image quality often remained acceptable at exposure levels below the manufacture’s recommended settings. It is possible to standardize subjective image quality by physical factors. Currently, it is not possible to predetermine a change point CNR value due to different CBCT machine and variation of diagnostic tasks.

The application of assisted reproductive technology in animal production benefits the economy and conservation of biological resources. Single nucleotide polymorphism (SNPs) was used as predictive markers for breeding and reproduction. In the present study, we examined the association between a SNP of the grb10 gene and superovulation traits in cattle. Sequencing results indicated a point mutation and statistical analysis showed a significant association of the mutation with superovulation traits. The high number of embryos collected from the heterozygotes suggested that the mutation in the grb10 gene exerted a significant effect on the number of embryos recovered although the quality was not affected. The grb10 gene may serve as a useful biomarker for donor selection.

Objectives To explore the possibility of using 2-dimensional image assessments in combination with cone beam computed tomography (CBCT) in patients with temporomandibular joint osteoarthritis (TMJOA) to enhance the clinical significance and applicability of the CBCT findings on TMJOA changes. Study Design Fifty-two patients with unilateral TMJOA and 40 healthy adults who had undergone CBCT in preparation for orthodontic treatment were selected for this study. Temporomandibular joint images were acquired with CBCT. All images were classified into 4 phases (slight erosion, widespread erosion, appearance of bone maintenance, and partial loss of condylar head with a remodeled cortical surface) and 4 levels of severity (absent, slight, moderate, and extensive). Quantitative microstructural analysis, including bone value fraction (BV/TV), trabecular number (Tb.N), trabecular thickness, and trabecular separation (Tb.Sp) of each image, was performed by using a customized software. Results In patients with unilateral TMJOA, the affected side had significantly higher BV/TV and Tb.N and significantly lower Tb.Sp compared with the unaffected side. Compared with healthy individuals, the affected joints in patients with TMJOA had significantly higher BV/TV and trabecular thickness and significantly lower Tb.N and Tb.Sp. No significant difference was found among different phase groups or different severity levels. Conclusions CBCT combined with a software investigation protocol for microstructure measurement can be used to provide reliable trabecular parameters in assessing TMJOA.

Purpose To evaluate the diagnostic accuracy of computed tomography (CT) of the parotid gland for Sjogren's syndrome in comparison with conventional X-ray sialography. Methods CT scans and X-ray sialography were performed in 34 patients with confirmed Sjogren's syndrome and 22 symptomatic controls without the disease. CT data from 57 asymptomatic controls were included for quantitative analysis. The CT findings of heterogeneity, abnormal diffuse fat tissue deposition, diffuse punctate calcification, swelling or atrophy, nodularity or cystic changes of the parotid gland were analyzed by two independent blinded readers. The correlation between CT and X-ray sialography findings was evaluated. Diagnostic performance and receiver operating characteristics curves were calculated. Results On CT, heterogeneity of the parotid gland was seen in 30/31 (reader 1/reader 2) Sjogren's syndrome patients by the two readers (sensitivity 88.2%/91.2%; specificity 100%/90.9%). Abnormal diffuse fat tissue deposition was seen in 28/28 SS patients by the readers (sensitivity 82.3%/82.3%; specificity 100%/90.9%). Diffuse punctate calcification was seen in 10/12 Sjogren's syndrome patients (sensitivity 29.4%/35.2%; specificity 100%/100%). Stagings of CT findings correlate positively with sialography. The areas under the receiver operating characteristics curves were 0.887 (P = 0.000) and 0.908 (P = 0.000) for the maximum and standard deviation (SD) of the CT value. Conclusions Parotid CT is accurate and reliable in the diagnosis of Sjogren's syndrome. Heterogeneity, abnormal diffuse fat tissue deposition, and diffuse punctate calcification are specific for Sjogren's syndrome. CT attenuation analysis is helpful in diagnosis.

Objective The aim of this study was to evaluate and compare the measurement accuracy of the temporomandibular joint (TMJ) space in the Promax 3D cone-beam computerized tomography (CBCT) images scanned with 2 different dental protocols. Study Design TMJ space impression models were made according to the occlusion. Forty joints were scanned with the standard and the large view protocol of the Promax 3D CBCT scanner. Two observers measured the joint spaces 3 times on both radiographs and the photocopies of the impression models. Results A total of 120 CBCT images were measured. There were no significant differences among the actual joint spaces and the CBCT measurements performed with the 2 scanning protocols ( P = .305). The inter- and intraobserver variabilities were not significant. Conclusions The 2 scanning protocols provided by the Promax 3D CBCT scanner were reliable and similar for recording the TMJ space.

Objective The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. Study Design Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. Results Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. Conclusions CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail.

Objectives:We report two cases of congenital salivary fistula of an accessory parotid gland, and we discuss its occurrence in Goldenhar syndrome.Methods:Two teenagers complained of a congenital cheek fistula with constant salivary discharge. Computed tomography fistulography and sialography were performed. The diagnosis of Goldenhar syndrome was established based on clinical and imaging findings. Previously reported cases are reviewed and the clinical and radiological features summarised.Results:In these two patients, a salivary fistula of an accessory parotid gland was demonstrated on computed tomography fistulography, and did not communicate with Stensen's duct. Deformity of Stensen's duct and hypoplasia of the ipsilateral mandibular ramus were present. Tragal appendices have frequently been reported in such cases.Conclusion:A congenital cheek salivary fistula of an accessory parotid gland should be considered indicative of Goldenhar syndrome.

Aims To evaluate the diagnostic accuracy of approximal carious lesions among five CBCT systems and to assess the effect of detector types employed by different CBCT systems on the accuracy of approximal caries diagnosis. Materials and methods Thirty-nine extracted non-cavitated human permanent teeth were employed in the study. Seven observers evaluated 78 approximal surfaces of the teeth with respect to caries by the images from the following five CBCT systems: (1) NewTom 9000; (2) Accuitomo 3DX; (3) Kodak 9000 3D; (4) ProMax 3D; and (5) DCT PRO, respectively. The lesions were validated by histological examination. The area under receiver operating characteristic (ROC) curve ( A z ) was used to evaluate the diagnostic accuracy. Results Microscopy of approximal surfaces found 47.4% sound, 39.8% enamel and 12.8% dentin lesions. The differences of A z values among the five CBCT systems were not statistically significant ( p =0.348). No significant difference was found between the two detector types of CBCT systems ( p =0.47). Conclusions The five CBCT systems employed in the study showed no significant difference in the in vitro approximal caries detection. Neither the detector nor the FOV employed by the CBCT systems has an impact on the detection accuracy of approximal caries.

This study was carried out to assess whether the spatial resolution has an impact on the detection accuracy of proximal caries in flat panel CBCT (cone beam computerized tomography) images and if the detection accuracy can be improved by flat panel CBCT images scanned with high spatial resolution when compared to digital intraoral images. The CBCT test images of 45 non-restored human permanent teeth were respectively scanned with the ProMax 3D and the DCT Pro scanners at different resolutions. Digital images were obtained with a phosphor plate imaging system Digora Optime. Eight observers evaluated all the test images for carious lesion within the 90 proximal surfaces. With the histological examination serving as the reference standard, observer performances were evaluated by receiver operating characteristic (ROC) curves. The areas under the ROC curves were analyzed with two-way analysis of variance. No significant differences were found among the CBCT images and between CBCT and digital images when only proximal enamel caries was detected (p = 0.989). With respect to the detection of proximal dentinal caries, significant difference was found between CBCT and digital images (p < 0.001) but not among CBCT images. The spatial resolution did not have an impact on the detection accuracy of proximal caries in flat panel CBCT images. The flat panel CBCT images scanned with high spatial resolution did not improve the detection accuracy of proximal enamel caries compared to digital intraoral images. CBCT images scanned with high spatial resolutions could not be used for proximal caries detection.

Objective The objective of this study was to investigate the clinical and radiographic features of osteoarthrosis (OA) of the temporomandibular joints (TMJOA) in human adolescents and young adults. Study design Patients (n = 4883) with temporomandibular disorders (age, 11 to 30 years) underwent clinical and radiographic examinations. The radiographic findings were classified as erosive bony changes, proliferative changes mainly, including flattening with uneven sclerosis, and osteophytes of the condyle, and bilaterally short condylar processes. In addition, we interpreted the reassessment radiographs of 156 of the patients. Results Seven hundred eleven patients had radiographic signs of OA. The frequency of OA was higher in women (563/3360, 16.8%) than in men (148/1523, 9.7%). Most patients (541/711, 76.1%) with signs of OA showed proliferative changes of OA. Moreover, 56.4% of patients with TMJOA (88/156) remained stable. Conclusions These results suggest that although OA is an age-related disease, aging is not the crucial factor in the pathogenesis of OA.

Objective:There have been few previous reports of intraosseous schwannomas within the mandible with extension into the cranium. We report two such cases and discuss the relevant clinical features, radiological manifestations and treatment protocols.Method:Two case reports of trigeminal schwannoma of the mandible with intracranial extension, including analysis of clinical, radiological and pathological aspects.Results:Panoramic radiographs showed both tumours as multilocular radiolucencies. Solid and cystic components were seen on computed tomography and magnetic resonance imaging. The two tumours extended into the cranium through the pterygomandibular space and an obviously expanded foramen ovale.Conclusion:Trigeminal schwannoma of the mandible can develop to involve intracranial extension. Radiological identification of an expanded foramen ovale may facilitate pre-operative identification.

Objectives To evaluate the accuracy of cone-beam computerized tomography (CBCT) for the detection of noncavitated proximal caries and to compare the detection accuracies of 2 CBCT imaging systems with those based on plain-film radiographs and phosphor-plate images. Study design Test radiographs of 39 noncavitated unrestored human permanent teeth were obtained with film, phosphor-plate, ProMax 3D, and Kodak 9000 3D imaging systems. Seven observers used a 5-level scale to evaluate test images for the presence of proximal caries. With histologic examination serving as the reference standard, observer performances were assessed with receiver operating characteristic (ROC) curves, and the areas under the ROC curves (Az values) for the observers, and modalities were analyzed with a repeated-measures analysis of variance. Results The mean Az values for film, phosphor plates, ProMax 3D, and Kodak 9000 3D imaging systems were 0.541, 0.523, 0.528, and 0.525, respectively (P = .763). Conclusion For detecting subtle noncavitated proximal caries, the detection accuracy with the CBCT images was little better than chance performance and was similar to that with phosphor plate– and film-based intraoral images.

Objectives The aim of this study was to compare effective doses resulting from different scan protocols for cone-beam computerized tomography (CBCT) using International Commission on Radiological Protection (ICRP) 1990 and 2007 calculations of dose. Study design Average tissue-absorbed dose, equivalent dose, and effective dose for a ProMax 3D CBCT with different dental protocols were calculated using thermoluminescent dosimeter chips in a human equivalent phantom. Effective doses were derived using ICRP 1990 and the superseding 2007 recommendations. Results Effective doses (ICRP 2007) for default patient sizes from small to large ranged from 102 to 298 μSv. The coefficient of determination ( R 2 ) between tube current and effective dose (ICRP 2007) was 0.90. When scanning with lower resolution settings, the effective doses were reduced significantly ( P Conclusions ProMax 3D can provide a wide range of radiation dose levels. Reduction in radiation dose can be achieved when using lower settings of exposure parameters.

Objectives The aim of this study was to evaluate if the diagnostic accuracy of proximal dental caries in digital radiographs was similar when obtained in in vivo and in vitro conditions. Study design Thirty-nine noncavitated teeth were collected from 11 subjects who had part of upper or lower jaws excised owing to cyst or neoplasm. Before operation, radiographs of the teeth involved were taken with the digital imaging system Digora Optime (Soredex, Helsinki, Finland), and after operation, the same extracted teeth were mounted in plaster blocks and exposed with the same digital imaging system. The teeth were subsequently sectioned for histologic validation of the lesions. Six observers evaluated all of the radiographs according to a 5-category scale. Receiver operating characteristic analysis was performed. Repeated-measure analysis of variance was used for the statistical analysis. Results There were no significant differences between digital radiographs taken in in vivo and in vitro conditions for diagnosis of proximal dental caries (P = .286). Conclusion Detection accuracy of proximal dental caries obtained from an in vitro study can be considered to be representative of diagnostic accuracy of proximal dental caries obtained in the real clinical situation.

Objective The aim was to evaluate a semirigid endoscopic technique for diagnosis and management of sialolithiasis. Study design Diagnostic and interventional sialendoscopic procedures were performed in 90 patients with sialoliths (78 submandibular glands and 12 parotid glands). Results Owing to its extreme flexibility and rigidity, the endoscope can be introduced easily into the ductal system. Sialoliths with a round or irregular shape were detected by endoscopy in all cases, including 84 radiopaque and 6 radiolucent stone cases. Of the 78 cases with sialoliths in the submandibular (Wharton's) duct, 14 were present in the hilum of the main duct, 34 in the premolar region of the duct, 24 in the molar region of the duct, and 6 in both the premolar and the molar regions of the duct. Among these cases, we could remove the stones intraductally in 44 cases by endoscopy alone. Additionally, 6 cases were treated with basket retrieval and endoscopic-assisted surgery, and the remaining 27 were treated with endoscopic-assisted surgery. Of the 12 cases of sialoliths in the parotid (Stensen's) duct, 9 were treated with basket retrieval and 1 with basket-capturing and open surgery via a buccal incision. In total, 87 of 90 cases were successfully treated, with (n = 34) or without (n = 53) endoscopic-assisted surgery. These patients were stone free at their last follow-up (3 to 30 months). Conclusions The semirigid endoscope permits a better visualization of sialoliths and coexisting obstructive pathologies. With minimally invasive procedures, most stones in the main duct of the salivary gland can be removed using either an intraductal or an extraductal approach.

Objective The aim of this study was to investigate with cone-beam computed tomography (CBCT) the locations of impacted maxillary canines and resorption of neighboring incisors. Study design Two hundred ten impacted maxillary canines were analyzed using CBCT images. The locations of the impacted canines were assessed and angular and linear measurements were taken using NewTom proprietary software. In addition, root resorption of neighboring incisors was investigated. Results Among these impactions, 45.2% were impacted buccal-labially, 40.5% were impacted palatally, and 14.3% in the midalveolus. The locations varied: mesial-labial impaction (n = 67), mesial-palatal impaction (n = 74), in situ impaction (n = 31), distal impaction (n = 12), horizontal impaction (n = 18), and inverted impaction (n = 8). Quantitive measurements further depicted these variations. Root resorption was present in 27.2% of lateral and 23.4% of central incisors, and 94.3% of these resorptions occurred where the impacted canines were in close contact with the incisors. Conclusion The location of impacted maxillary canines varies greatly in 3 planes, and the resorption of neighboring permanent incisors is common.

To explore the clinical application of endoscope-assisted operative retrieval of large parotid stones as a minimally invasive alternative.From January 2010 to April 2013, 6 patients (male: 5, female: 1, age from 30-62 years, and median age: 49.5 years)suffering from recurred swelling of parotid gland due to sialoliths were treated by endoscope-assisted parotid surgery in Peking University School and Hospital of Stomatology. All of the patients underwent clinical, ultrasonographic and cone-beam CT (CBCT) examinations to get the detailed information of the number, location and size of stones, which was recorded in the medical records. endoscope-assisted parotid surgery was performed under general anesthesia in all the 6 cases after the failure of basket or forcep retrieval firstly. During the operation, sialoendoscope was used to locate the stone exactly and then the calculus was exposed through a pre-auricular approach and released by incising the duct. The postoperative complications were recorded and observed during the follow-up periods.Preoperative radiological examinations showed that all of the sialoliths were near the hilum of parotid gland ducts in the 6 cases, which were 5-9 mm in diameter. All of the stones were removed successfully by endoscope-assisted operative retrieval. The incisions healed smoothly in all the 6 cases. There were no cases of facial nerve weakness, infection or salivary fistula. After a mean follow-up of 19 months (ranging from 6-36 months), 5 patients remained asymptomatic and 1 patient had mild obstructed or infective symptoms. The final results were satisfied.It is suggested that endoscope-assisted operative retrieval is a viable minimally invasive alternative to remove the large or recalcitrant parotid stones with a high successful rate and low complications.

This study aimed to investigate the diagnosis and management of a distinct developmental deformity syndrome characterized by congenital cheek fistula, ectopic accessory parotid gland, and preauricular appendage.Retrospective study.We analyzed the medical records, radiologic and histopathologic findings, and follow-up data for seven patients (four males) with a congenital cheek salivary fistula. Computed tomography, fistulography, and sialography had been performed for diagnosis. Surgical treatment effect was evaluated.The mean age of the patients was 8.1 years (range, 2-16 years). The distinctive clinical feature was a congenital skin orifice lateral to the commissure with saliva discharge during eating. The cheek fistulae were accompanied by ipsilateral preauricular appendages in all seven patients. The skin orifice connected to an ectopic gland anterior to the masseter and inferior to Stensen's duct. Parotid sialography demonstrated an intact Stensen's duct in all cases. Hypoplasia of the ipsilateral mandible could be observed in five cases. Excision of the ectopic gland, skin orifice, and fistula was performed in five cases resulting in optimal treatment outcomes with no recurrent or adverse events.A congenital saliva-discharging fistula with an ectopic accessory parotid gland, ipsilateral preauricular appendage, and mandibular hypoplasia constitutes a rare developmental syndrome. Surgical excision can effectively treat congenital cheek salivary fistula.4.

To summarize and evaluate the utility of core needle biopsy in diagnosis of head neck tumors.Lesions were performed with core needle biopsy in 47 patients who were considered with tumors or other diseases in the head neck. According to the pathological diagnoses, their treating plans were made. If the pathological results could not give definite diagnoses and the lesions were considered tumors or other diseases, then operation or another biopsy was needed and, the other patients could be followed-up. The accurate rate was calculated.The biopsy tissue was enough for pathological diagnosis and immunohistochemical staining. Compared with the pathological results and follow-up, positive diagnosis was in 36 cases, negative diagnosis in 9 cases, false-negative in 2 cases, and the accurate rate was 95.7%. The pathological results had guided the treatment in 43 patients, accounting for 91.5%. No serious side effects were found.The core needle biopsy is significant for diagnosis and treatment of head neck tumors.

To evaluate the diagnostic accuracy of cone beam computed tomography (CBCT) and high resolution multi-slice computed tomography (MSCT) with eight-detector-rows in detecting the simulated external root resorption defects.External root resorption defects of different sizes and in different locations were simulated in 40 human single rooted teeth. Cavities simulating root resorption defects of 1 mm in diameter and 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm in depth were drilled in the cervical, middle and apical thirds of lingual surfaces of the teeth. The specimens were scanned with both CBCT (Accuitomo 3DX, Morita Co., Japan) and high resolution 8-slice CT (BrightSpeed Edge, GE Co., USA). The CBCT and MSCT images were read by two experienced observers. The data were analyzed with receiver operating characteristics (ROC) analysis. ROC curves were generated and the area under ROC curve (Az) was employed to express the diagnostic accuracy.The diagnostic accuracy (Az value) in detecting the simulated defects of all the locations and sizes were 0.921 for CBCT and 0.770 for MSCT. The Az values for CBCT in detecting defects located in the cervical, middle and apical thirds were 0.885, 0.991 and 0.873, while those for MSCT were 0.752, 0.844 and 0.709, respectively. The Az values for CBCT in detecting the defects of 0.1 mm, 0.2 mm, 0.3 mm and 0.4 mm in depth were 0.794, 0.934, 0.992 and 0.992, and those for MSCT were 0.592, 0.719, 0.920 and 0.990, respectively.The diagnostic ability for external root resorption of CBCT is better than that of MSCT. Smaller defects are better delineated with CBCT than with MSCT. The defects in the middle thirds of the roots are easier to be detected than those in the cervical and apical ones using both CBCT and MSCT.

To investigate the clinical effects of sialoendoscopically-assisted sialolithectomy for the sialolithiasis in the hilum of the submandibular glands.Between December 2005 and March 2011, treated 80 cases of radiography-verified sialiolithiasis in the hilum of the submandibular glands, The patients included 42 males and 38 females aged from 13 to 68 years. All these patients underwent sialoendoscopic observation and sialoendoscopically-assisted sialolithectomy and were followed up periodically for 3 - 6 months after operation. The success rate of stone removal, postoperative complications and clinical effects were analysed.The stones were completely removed in 71 cases, and almost completely removed in 5 cases, with a successful rate of 95% (76/80). Among 76 successful cases, 8 were treated by basket entrapment, 59 by intraoral open surgery and 9 by both of these two techniques. Within 3 - 6 months' follow-up, 1 case suffered temporary lingual nerve parenthesis and two suffered ranula formation.Sialoendoscopically-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with the hilum of the submandibular glands.

To compare the detection accuracy of occlusal caries in cone-beam computed tomography (CBCT) images scanned with different scanning parameters.Thirty-seven extracted human premolars and molars without restorations or obvious cavities were selected for this study. The teeth 3 or 4 as a group were mounted in 12 plaster blocks and scanned with DCT Pro (VATECH, Co., Ltd., Yongin-Si, S.Korea) at normal and high resolution settings and with ProMax 3D (Planmeca Oy, Helsinki, Finland) at low, normal and high resolution settings. In addition, the tooth blocks were imaged with the ProMax 3D at three different tube currents. Ten doctoral candidates of Peking University School and Hospital of Stomatology evaluated all the images of the tooth blocks using a five-level confident scale. Actual presence and the extent of caries were established by histological examinations. The areas under the ROC curves (Az value) were analyzed.Eleven (29.7%, 11/37) teeth were sound, 13 (35.1%, 13/37) had enamel caries and 13 (35.1%, 13/37) had dentine caries. There were no significant differences between normal resolution and high resolution for DCT Pro on the detection accuracy of occlusal (enamel+dentine) caries (0.698 ± 0.064 vs. 0.735 ± 0.044, P0.05).No significant differences were found for ProMax 3D among low, normal and high resolution (0.700 ± 0.031 vs. 0.700±0.054 vs. 0.701 ± 0.041, P0.05). For dentinal caries, there were no significant differences between CBCT images scanned with different resolutions for DCT Pro(0.776 ± 0.078 vs. 0.811 ± 0.047, P0.05) or ProMax 3D (0.713 ± 0.039 vs. 0.685 ± 0.063 vs. 0.713 ± 0.040, P0.05). No significant differences were found for enamel caries detection for DCT Pro (0.620 ± 0.068 vs. 0.659 ± 0.048, P0.05)or ProMax 3D (0.686 ± 0.050 vs. 0.685 ± 0.063 vs. 0.689 ± 0.063, P0.05). For ProMax 3D, there were no significant differences among different tube currents on the detection accuracy of occlusal caries (0.653 ± 0.065 vs. 0.700 ± 0.054 vs. 0.67 ± 0.062, P0.05).Different resolutions did not have an impact on the detection accuracy of occlusal caries. The tube currents for ProMax 3D did not show any effect on occlusal caries detection.

To compare the effective radiation dose levels of cone beam computed tomography (CBCT) with those of multi-slice computed tomography (MSCT) when scanning the same maxillofacial regions.The effective doses of 2 CBCT (NewTom 9000 and DCT Pro) and 1 MSCT (bright speed edge select 8 slice) scanners were calculated using thermoluminescent dosimeters (TLD) that were placed in a head and neck phantom, and expressed according to the International Commission on Radiation Protection (ICRP) 2007 guidelines.Effective dose values ranged from 41.8 to 249.1 µSv for CBCT. The doses of MSCT scanning for maxilla, mandible and maxilla + mandible were 506.7, 829.9 and 1066.1 µSv, respectively. Dose levels of scanning only for maxilla or mandible were significantly lower than those for maxilla + mandible.When scanning the same maxillofacial regions, the dose levels for NewTom 9000 and DCT Pro CBCT images were lower than those for Bright speed edge select 8 slice MSCT images. Dose levels reduction could be obtained when smaller regions were scanned.

Aims To evaluate the radiation dose level during cone beam computed tomography (CBCT) scanning for the different oral and maxillofacial regions with and without thyroid collar shielding. Materials and methods Average tissue-absorbed dose for a DCT PRO CBCT was measured using thermoluminescent dosimeter chips in a phantom with or without applying thyroid collars. Effective organ dose and total effective dose were derived using International Commission on Radiological Protection (ICRP) 2007 recommendations. Results The total effective doses for large, middle and small field of view (FOV) were 254.3 μSv, 249.0 μSv and 180.3 μSv, respectively, when no thyroid collar was used. Applying one thyroid collar around the front neck can reduce the total effective doses to 208.5 μSv (18.0% reduction), 149.1 μSv (40.1% reduction) and 110.5 μSv (38.7% reduction), respectively. When two thyroid collars were used around the front and back neck, the total effective doses were reduced to 219.1 μSv (13.8% reduction), 142.0 μSv (43.0% reduction) and 105.5 μSv (41.5% reduction), respectively. Conclusions Thyroid collar can reduce the radiation dose during CBCT scanning for the oral and maxillofacial regions. The dose reduction becomes more significant when middle or small FOV is chosen.

To evaluate the relative incidence of local control and toxicity in patients with head and neck cancers who underwent external beam radiotherapy (EBRT) plus (125)I seeds implantation.Ten patients diagnosed as head and neck cancers at the department of oral and maxillofacial surgery of Peking University School of Stomatology during the period of February 2008 to July 2010 were collected. The histologic types included squamous cell carcinoma in 8 patients, poorly differentiated adenocarcinoma of salivary gland in 2 patients. All patients could not receive surgical treatment due to poor medical status or unresectable advanced-stage tumors and underwent EBRT plus (125)I seeds implantation. Eight patients with squamous cell carcinoma had conventional fractionated EBRT with a total dose of 50 Gy; two patients with poorly differentiated adenocarcinoma had conventional fractionated EBRT with a total dose of 70 Gy. They all then had (125)I seeds implantation with matched peripheral dose of 60 Gy (TNM stage I-II) or 80 Gy (TNM stage III-IV ). The apparent activity per seed ranged from 25.9 to 29.6 MBq. follow-up of the patients was done to analyze acute and late toxicity, local control, and survival.After a median follow-up of 12 months (range 2-28 months), soft tissue necrosis was seen in one patient, dysphagia and hemorrhage in another. No other serious side effects were observed. All the tumor mass of 10 cases disappeared within 6 months, regional metastases was observed in one patient, and distant metastases was observed in another. Seven of 10 patients survived till the date of investigation.External beam radiotherapy plus (125)I seeds implantation is a safe and effective therapy regimen for patients with unrectable head and neck cancers.

to investigate the correlation between the expression of nerve growth factor (NGF) and tissue injury in irradiated rat submandibular gland.the salivary gland regions of the rats were irradiated with a single dose of 15 Gy X-ray. The histopathological changes in the submandibular gland were observed, while the expression of NGF was determined by immunohistochemistry and real-time PCR.the weight of the body and submandibular gland decreased in the irradiated rats 30 days after irradiation, compared with the control group. There were also significant histopathological changes in the submandibular gland of the irradiated rats compared with the non-irradiated rats. The acinar cells and ducts were degenerated obviously. Fibrosis appeared around the ducts. The mRNA and protein expression of NGF in the submandibular gland decreased in the irradiated rats compared with the control group. Protein expression of NGF was even observed in the striated duct in the irradiated rats. conclusion: NGF may play an important role in protection of the submandibular glands of rats from radiation.

to evaluate the value of the ultrasonographic features for differentiation between benign and malignant tumours of salivary glands.eighty-four cases of salivary gland tumours were analysed. Sixty-five cases were benign and 19 were malignant. All cases were confirmed by histopathological examination. The ultrasonographic features analysed included the shape of the tumour, the boundary echo, the internal echo and the posterior echo. Each feature was graded into three ranks. For statistical analysis, they were ranked respectively 1, 2 and 3. Another 28 cases of salivary gland tumours were analysed to verify the diagnostic accuracy of the ultrasonography. All data were analysed using SPSS 16.0 for windows. The Mann-Whitney U test, the receiver operating characteristic (ROC) curve and Fisher's discriminant test were performed.The differences between benign and malignant tumours were statistically significant in the shape of the tumour (P = 0.001), the boundary echo (P = 0.001) and the posterior echo (P = 0.000). However, the difference in the internal echo was not statistically significant (P0.05). The diagnostic accuracy, sensitivity and specificity were 82.1%, 63.2% and 87.7%, respectively, while the predicting diagnostic accuracy was 85.7%.the present study indicates that the shape of the tumour, the boundary echo and the posterior echo could be effective ultrasonographic criteria for differential diagnosis of benign tumours from malignant tumours in the salivary glands.

To evaluate the application of cone-beam computed tomography (CBCT) in the detection of dental root fractures and to analyse the demographic profile of these fractures.The study group comprised 398 teeth that were examined by CBCT for determining whether they had a root fracture. Patient characteristics were recorded, and the location, fractured roots, fracture types and three-dimensional images of the related skeletal structures were analysed. Two experienced oral radiologists independently analysed each case and reached a consensus, and the diagnosis was graded in one of the following three categories: fracture definitely present (FDP), fracture probably present (FPP) and no visible fracture (NVF).Among these teeth, 155 (39.0%) were diagnosed as FDP, 14 (3.5%) as FPP and 229 (57.5%) as NVF in the consensus reading. During follow-up, all teeth diagnosed as FDP and 4 of the 14 teeth diagnosed as FPP were intra-operatively demonstrated to be fractured. In FDP cases, 60.0% of the patients were aged from 50 to 69 years. In total, 107 FDP teeth were non-endodontically treated, and the remaining were endodontically treated with (n = 16) or without (n = 32) crown placement. The maxillary and mandibular molars were most frequently affected (81.9%). The fractured roots were mostly palatal (65.7%) in maxillary molars and mesial (84.2%) in mandibular molars. The fractures were characterised as vertical (n = 84), horizontal (n = 34), oblique (n = 5) and complicated (n = 32) fractures.The application of CBCT is valuable for the diagnosis of root fracture.

To investigate the value of endoscopy in the diagnosis and treatment of sialolithiasis.Diagnostic and interventional sialoendoscopic procedures were performed in 52 patients with sialolithiasis (43 submandibular glands and 9 parotid glands).Of the 34 sialoliths in the anterior and/or posterior part of the Wharton's duct, 24 were removed with basket retrieval; 2 removed with open surgery and basket retrieval, and 8 removed with open surgery under the guidance of endoscopy. Eight sialoliths in the hilum of the Wharton's duct were treated with open surgery. Of the 9 stone cases in the Stensen's duct, 3 was removed with basket retrieval, 3 was removed after opening-up of the ostium, 1 was treated with basket capturing and open surgery. The obstructive symptoms were improved in these cases during 1-24 months' follow-up.Sialoendoscopy is a minimal invasive and efficacious technique for the diagnosis and treatment of sialolithiasis.

To evaluate the feasibility of cone beam computed tomography (CBCT) for the evaluation of trabecular bone structure in mandibular condyle and to investigate the distribution of the trabecular bone structure within mandibular condyle.Eighty condyles from 40 healthy young volunteers (aged 20-32) were scanned by CBCT. A coronoid image was acquired of each condyle and divided into 8 regions where regions of interest were specified. After CBCT images were binarized, four morphological parameters including bone volume fraction, trabecular thickness, trabecular number and trabecular separation were computed.All parameters were significantly different between the superior zone and middle/inferior zone of the condyle (P0.05). Superior zone showed the largest bone volume fraction (52.2%), the highest trabecular number (1.33 mm(-1)), the thinnest trabecular thickness (393.48 microm), and the smallest trabecular separation (361.59 microm). Inferior zone showed the smallest bone volume fraction (49.64%). These results were not significantly different between bilateral sides of the condyles (P0.05).Trabecular bone structure was inhomogeneous within the condyle, but symmetrical between bilateral sides of the condyles. CBCT combined with image processing is a feasible tool in evaluating trabecular bone structure of human mandibular condyle.

Purpose The purpose of this article is to introduce the use of cone-beam computed tomography (CBCT) for evaluation of supernumerary teeth. Methods The study group comprised 487 patients with a total of 626 supernumerary teeth who were examined by CBCT. Patient characteristics were recorded, and the number, location, shape, and 3-dimensional position of the supernumeraries were analyzed. The ability of CBCT to visualize dental and skeletal structures relative to supernumerary teeth was also evaluated. Results Males were affected more than females in a ratio of 2.64:1. Seventy-two percent of the patients had 1 supernumerary tooth, 27.3% had 2, and 0.6% had 3 supernumeraries. Supernumerary teeth were most frequently located in the anterior maxilla (92%), and their sagittal location relative to the neighboring teeth could be used for classification purposes. Supernumeraries were most commonly conical in shape (83.5%). CBCT yielded accurate 3-dimensional pictures of the dental and bony structures. The sagittal positions of the 578 supernumerary teeth in the anterior maxilla were divided into 6 types, of which types I and III were most commonly associated with local malocclusions. Moreover, 43.4% of the premaxillary supernumeraries were inverted and 21.1% were transversely oriented. Conclusions CBCT imaging yields accurate 3-dimensional pictures of local dental and bony structures, which is helpful for pretreatment evaluation of supernumerary teeth.

Parosteal lipoma is an unusual kind of lipoma and occurs in intimate association with the underlying periostium of the bone. Parosteal lipomas mostly affect the long bones and involvement of the mandible is rare. We report a case of ossifying parosteal lipoma of the mandible in which CT was effective in diagnosis and showed a well-circumscribed mass of fat attenuation containing areas of ossification and branch-like bony protuberances from adjacent cortical bone. Microscopic examination revealed that the mass was composed of mature fat cells without nuclear hyperchromasia or atypia. Layers of bone and ossification were found inside. Although rare, it should be considered as a differential diagnosis of teratoma, osteochondroma and osteosarcoma.