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Radiology Case Reports Aug 2024Ectopic teeth, growing in abnormal locations like the maxillary sinus, are rare occurrences, with uncertain causes including trauma, infection, and developmental...
Ectopic teeth, growing in abnormal locations like the maxillary sinus, are rare occurrences, with uncertain causes including trauma, infection, and developmental abnormalities. They often appear in the second or third decade of life, sometimes without symptoms. They are often missed as symptoms can mimic chronic sinusitis but may include sinonasal issues like obstruction and facial pain. Complications ranging from recurrence to potential blindness or carcinoma have been reported. Diagnosis involves radiographic imaging, with CT scans providing precise localization. Following accurate diagnosis, treatment typically involves surgical removal, with endoscopic procedures gaining popularity due to reduced risks. Follow-up for asymptomatic cases can be conducted through periodic radiographs. We report a case of maxillary ectopic tooth as an incidental finding in an asymptomatic patient presenting to the emergency department with head trauma.
PubMed: 38872749
DOI: 10.1016/j.radcr.2024.04.083 -
Plastic and Reconstructive Surgery.... Jun 2024Reconstruction of extended total maxillectomy is challenging. This study aimed to isolate the skull base from the nasal cavity to avoid intracranial infection,...
Reconstruction of extended total maxillectomy is challenging. This study aimed to isolate the skull base from the nasal cavity to avoid intracranial infection, cerebrospinal fluid fistula, and palate closure to maintain feeding and conversation. However, facial appearance and symmetry are important for quality of life. We report primary multiple buttress reconstruction using a removed nonvascularized fibula that reduced the risk of infection and exposure. A 74-year-old woman experienced a local recurrence of right maxillary sinus cancer after subtotal maxillectomy and postoperative radiotherapy (60 Gy). We performed extended total maxillectomy, including the right eyeball, orbit, temporal bone, palate, and zygomatic arch. Primary reconstruction was performed using fibular and anterolateral thigh free flaps. The proximal fibula bone was resected to obtain the length of the peroneal vessels, and the distal 9 cm of the fibula was made into two pieces while keeping the peroneal vessels attached. The nonvascularized 5-cm fibula was split sagittally with an L-shaped section to maintain the strength of the fragments. An anterolateral thigh flap was elevated from the ipsilateral thigh attached to the partial vastus lateralis muscle, which was divided into proximal (to the cheek skin and prosthetic eye bed) and distal (to the nasal cavity and palate) skin islands. Two nonvascularized bone fragments were fixed at the lateral and infraorbital rims. The dead space around the built-up pillar made of transferred bone was filled with vastus lateralis muscle to prevent infection and depression. This approach allowed for one-stage multiple buttress reconstruction for extended total maxillectomy.
PubMed: 38868622
DOI: 10.1097/GOX.0000000000005901 -
International Journal of Paleopathology Jun 2024To determine which types of bone lesion (spicules, lobules, porous bone) in the maxillary sinus indicate sinusitis METHODS: Subadjacent dental disease is a cause of...
OBJECTIVES
To determine which types of bone lesion (spicules, lobules, porous bone) in the maxillary sinus indicate sinusitis METHODS: Subadjacent dental disease is a cause of maxillary sinusitis; if a lesion type indicates sinusitis it should be more common above diseased posterior maxillary teeth than a lesion type that is not indicative of sinusitis. The study sample is a British Mediaeval human skeletal collection.
RESULTS
Porous bone lesions (chiefly new bone deposits) in maxillary sinuses are associated with subadjacent dental disease; spicules/lobules of bone in the sinus are not.
CONCLUSIONS
The results support the idea that porous lesions indicate sinusitis but the spicules/lobules may not. Spicules, lobules and porous lesions within the maxillary sinus should be analysed separately in biocultural studies; it would be prudent to regard only the porous lesions as indicative of sinusitis.
SIGNIFICANCE
Maxillary sinusitis is commonly used as a health indicator in palaeopathology, and spicular deposits are generally the most common type of alterations. By assuming that they are indicative of sinusitis we may have been greatly overestimating the prevalence of bony sinusitis in the past.
LIMITATIONS
These conclusions are provisional. Further work on larger, more diverse samples, together with more detailed anatomical studies on lesion location and structure is ongoing.
PubMed: 38865933
DOI: 10.1016/j.ijpp.2024.05.003 -
OTO Open 2024
PubMed: 38863484
DOI: 10.1002/oto2.144 -
Maxillofacial Plastic and... Jun 2024Odontogenic maxillary sinusitis (OMS) is widely acknowledged in both the dentistry and otolaryngology fields. Recently, iatrogenic odontogenic maxillary sinusitis cases...
BACKGROUND
Odontogenic maxillary sinusitis (OMS) is widely acknowledged in both the dentistry and otolaryngology fields. Recently, iatrogenic odontogenic maxillary sinusitis cases can be encountered frequently. The purpose of this study was to evaluate the effect of intraoral sinus irrigation using the small lateral window approach in patients with odontogenic maxillary sinusitis by comparing pre- and postoperative volumetric measurement of CBCT and symptoms. We surveyed 21 patients who visited the Oral and Maxillofacial Surgery Department at PNUDH from 2016 to 2022. All the patients' information was extracted from an electronic database. The patients with a follow-up period of 2 months or more were included. The three-dimensional volumetric measurement was performed using the ImageJ program (National Institute of Health, University of Wisconsin).
RESULTS
Among 21 patients, 16 (76.1%) were male, and 5 (23%) were female. The most common type of surgery was general anesthesia (16 cases) in which oroantral fistula was present in 7 cases. In the causes of maxillary sinusitis, there were seven implant-related patients, five patients of tooth extraction, seven patients of bone grafting, and two patients in other groups. Radiographic opacity decreased by 40.15% after sinus irrigation especially in bone graft and tooth extraction cases. Clinically, symptoms improved in 17 patients (80.9%).
CONCLUSION
By this study, it can be concluded that maxillary sinus irrigation using the small lateral window approach is a clinically and radiologically effective treatment method for odontogenic maxillary sinusitis.
PubMed: 38861059
DOI: 10.1186/s40902-024-00429-6 -
BMC Medical Imaging Jun 2024To construct the deep learning convolution neural network (CNN) model and machine learning support vector machine (SVM) model of bone remodeling of chronic maxillary...
OBJECTIVE
To construct the deep learning convolution neural network (CNN) model and machine learning support vector machine (SVM) model of bone remodeling of chronic maxillary sinusitis (CMS) based on CT image data to improve the accuracy of image diagnosis.
METHODS
Maxillary sinus CT data of 1000 samples in 500 patients from January 2018 to December 2021 in our hospital was collected. The first part is the establishment and testing of chronic maxillary sinusitis detection model by 461 images. The second part is the establishment and testing of the detection model of chronic maxillary sinusitis with bone remodeling by 802 images. The sensitivity, specificity and accuracy and area under the curve (AUC) value of the test set were recorded, respectively.
RESULTS
Preliminary application results of CT based AI in the diagnosis of chronic maxillary sinusitis and bone remodeling. The sensitivity, specificity and accuracy of the test set of 93 samples of CMS, were 0.9796, 0.8636 and 0.9247, respectively. Simultaneously, the value of AUC was 0.94. And the sensitivity, specificity and accuracy of the test set of 161 samples of CMS with bone remodeling were 0.7353, 0.9685 and 0.9193, respectively. Simultaneously, the value of AUC was 0.89.
CONCLUSION
It is feasible to use artificial intelligence research methods such as deep learning and machine learning to automatically identify CMS and bone remodeling in MSCT images of paranasal sinuses, which is helpful to standardize imaging diagnosis and meet the needs of clinical application.
Topics: Humans; Maxillary Sinusitis; Tomography, X-Ray Computed; Chronic Disease; Female; Bone Remodeling; Male; Support Vector Machine; Deep Learning; Middle Aged; Sensitivity and Specificity; Adult; Neural Networks, Computer; Aged; Artificial Intelligence
PubMed: 38858631
DOI: 10.1186/s12880-024-01316-2 -
Nigerian Journal of Clinical Practice May 2024Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do...
Panoramic Radiography in the Evaluation of the Relationship of Maxillary Molar Teeth and Maxillary Sinuses on the Deep Learning Models Improved with the Findings Obtained by Cone Beam Computed Tomography.
BACKGROUND
Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used.
AIM
The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT).
METHODS
A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods.
RESULTS
DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively.
CONCLUSION
DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.
Topics: Humans; Cone-Beam Computed Tomography; Radiography, Panoramic; Deep Learning; Maxillary Sinus; Retrospective Studies; Female; Molar; Male; Adult; Maxilla; Middle Aged; Young Adult
PubMed: 38842718
DOI: 10.4103/njcp.njcp_220_24 -
Folia Morphologica Jun 2024This study aimed to determine maxillary sinus volume (MSV) in different skeletal malocclusion classes and the correlation between MSV and craniofacial morphology on Cone...
BACKGROUND
This study aimed to determine maxillary sinus volume (MSV) in different skeletal malocclusion classes and the correlation between MSV and craniofacial morphology on Cone Beam Computed Tomography (CBCT).
MATERIALS AND METHODS
The study was performed retrospectively on CBCT images of individuals aged 12-24 years. A total of 129 patients (70 females, 59 males) with a normal vertical growth pattern (27° ≤ SNGoMe ≤ 38°) were divided into three groups according to malocclusion. Group 1 consisted of Class I (1 ≤ ANB ≤ 4) (n = 46) patients, Group 2 consisted of Class II (ANB > 4) (n = 47) patients, and Group 3 consisted of Class III (ANB < 1) (n = 36) patients. Four angular (SNA, SNB, ANB, SNGoMe) and linear (S-N, ANS-PNS, S-Ar, N-ANS) parameters were measured to evaluate craniofacial morphology. Right and left MSV were measured using Dolphin 11.0 (Dolphin Imaging, Chatsworth, CA, USA) Imaging software. Pearson's correlation analysis was performed to assess statistical correlation.
RESULTS
MSV was larger in males than females (male AMSV = 14244.1 ± 4735.8, female AMSV = 12778.2 ± 4606.9 p = 0.011) in the general population, but just the Class II group showed this (male AMSV = 16089.6 ± 4330.4, female AMSV= 12705.9 ± 3210.2, p = 0.008). RMSV and LMSV were similar (female p = 0.181 male p = 0.097), and MSV showed no significant differences between the different malocclusion classes in both sex (female p = 0.315, male p = 0.118). In the Class III group, SNB was positively correlated with RMSV (r = 416, p = 0.012). MSV showed significant positive correlation with N-ANS in all groups (Class I r = 0.359, p = 0.014, Class II r = 0.336, p = 0.021, Cl III r = 0.387, p = 0.02). In the Class II and Cl III groups, there is a statistically significant correlation between MSV and the S-N parameter (Class II r = 0.304, p = 0.038, Class III r = 0.412, p = 0.013). ANS-PNS parameter was measured at the lowest statistically significant level (female 43.1 ± 3.9a, p < 0.001, male 43.1 ± 4.3a, p < 0.001) in the Class III group but no correlation was found with MSV. Only Class II group showed a weak positive correlation between MSV and ANS-PNS (r = 0.314, p = 0.032).
CONCLUSIONS
There was no difference regarding MSV between malocclusion classes. Class II males exhibit significantly larger MSV compared to females. There is a correlation between MSV and SNB, S-N, N-ANS and ANS-PNS parameters for various orthodontic skeletal patterns. Further studies are needed to understand the relationship between MSV and different skeletal structures.
PubMed: 38842076
DOI: 10.5603/fm.100054 -
Cureus Apr 2024Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection...
Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection following pulpal necrosis. This condition is typically asymptomatic and mostly affects the tooth's apices. It primarily affects non-vital teeth and is characterized by inflammation. Cyst development is the final stage of the inflammatory process after a periapical infection; hence, it often occurs later in life. A cyst in the maxilla can occasionally spread across the maxillary sinus. Radicular cysts can be treated with surgical endodontics, the removal of the problematic tooth, enucleation with primary closure, or marsupialization and enucleation. This case report discusses a successful surgical therapy for an infected radicular cyst.
PubMed: 38807828
DOI: 10.7759/cureus.59216 -
Cureus Apr 2024One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an...
One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an 11-year-old boy, who had a swelling over his left cheek, which was determined to be a dentigerous cyst by radiological imaging and clinical examination. Over the course of two months, the peanut-sized mass grew to 3x2 cm. A massive, well-defined cystic lesion connected to an unerupted premolar tooth was found on a CT scan of the left maxillary alveolar arch and sinus floor. Under general anesthesia, the patient had a Caldwell-Luc surgery to remove the cyst. In order to avoid difficulties related to cyst formation, which can invade surrounding tissues and even result in cancer if left untreated, early detection using radiological imaging is essential. Complete excision of the cyst is the treatment, particularly for big lesions, in order to limit morbidity and lower the likelihood of aggressive behavior. This case emphasizes the necessity of thorough examination and surgical intervention when necessary, underscoring the significance of early identification and adequate therapy to minimize potential problems related to dentigerous cysts. In cases of dentigerous cysts, early intervention, and appropriate surgical procedures are critical to reducing morbidity and improving patient outcomes.
PubMed: 38807792
DOI: 10.7759/cureus.59223