The present study was performed to investigate the relationship between the salivary flow rate and the interpretation results of salivary scan in the patients with dry mouth. Twenty-five patients with dry mouth who visited the Dept. of Oral Medicine & Oral Diagnosis, Seoul National University Dental Hospital, were included. The unstimulated whole salivary flow rate was determined by the spitting method and the stimulated whole salivary flow rate was measured with gum-base chewing. Salivary scan was performed after the infusion of $^{99m}technetium$ pertechnetate(Tc) and interpreted. The obtained results were as follows: 1. The unstimulated and stimulated whole salivary flow rate were significantly decreased compared to normal value, which reflected the extensive destruction of salivary gland function in the patients with dry mouth. 2. The unstimulated and stimulated whole salivary flow rate were decreased in the group with decreased function in salivary scan compared with the group with normal function in salivary scan. However, there was no statistical significance between groups. 3. The difference between the stimulated and unstimulated whole salivary flow rates was greater in the group with normal function in salivary scan compared with the group with decreased function in salivary scan. 4. There was significant positive correlation between the stimulated and unstimulated whole salivary flow rates. The level of correlation was higher in the group with decreased function in salivary scan than the group with normal function in salivary scan. Collectively, these data suggested that salivary scan had the limited value. The comprehensive evaluation including history taking, clinical examination, clinical laboratory as well as the measurement of salivary flow rate are need for patients with dry mouth.
Background/Objectives: The aim of this study was to investigate the diagnostic value of i-scan in the differential diagnosis of oral cavity leukoplakia based on visualization of abnormal vascular features. Materials & Methods: Thirty- one patients with oral cavity leukoplakia were enrolled in the study. Images of their oral cavity obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results: Among the 31 oral cavity leukoplakia patients, 8 (25.8%) patients revealed hyperkeratosis, 10 (31.2%) low-grade dysplasia, 5 (16.2%) high-grade dysplasia and 8 (25.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, we could found abnormal vascular change with neoplastic neoangiogenesis in most high-grade dysplasia or invasive cancer in oral cavity. (high-grade dysplasia: 4/5 [80.0%], and invasive squamous cell carcinoma: 7/8 [87.5%]). Conclusion: i-scan-enhanced endoscopy could be a useful optical technique for the diagnosis of oral cavity leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of suspected oral mucosal lesion.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.26
no.6
/
pp.658-665
/
2000
Purpose : The present study was carried out to determine the diagnostic usefulness of bone scan for evaluating jaw bone extension of oral cancer. Materials and Methods : Medical records, preoperative bone scans, computerized tomographic (CT) scans, conventional radiographs, and findings of histopathologic sections of twenty patients who had been treated for oral malignant tumors by a resection of mandible and soft tissue at Chonnam University Hospital from January, 1994 to September, 1999 were analyzed. Results : In 13 cases which showed histopathologically positive, preoperative bone scans were positive in 12 (92.3%) and false negative in 1 (7.7%). Preoperative CT scans were positive in 9 (69.2%) and false negative in 4 (30.8%) of the 13 cases. Preoperative conventional radiographs were positive in 8 (61.5%) and false negative in 5 (38.5%) of the 13 cases. In 7 cases showing negative histopathologic findings, 1 (14.3%) was in CT scans and 2 (28.6%) were false positive in preoperative conventional radiographs. Conclusion : These results suggest that bone scan is more sensitive and reliable method for evaluating jaw bone extension of oral cancer than conventional radiographs or CT scans.
Bone scan using radioactive isotope can be more effective than conventional X-ray radiograph for finding jaw lesion because it takes an image of the physiologic change of bone. This study is designed to show how available bone scan is able to diagnose jaw lesion better than simple X-ray and CT, as well as to determine a basis of diagnosis for jaw lesion using bone scan. The 77 patients, visiting the Oral & Maxillofacial Surgery, Department of Dankook University Hospital from January 2002. to August 2005. who were diagnosed histopathologically with postoperative malignant tumor, osteomyelitis, and bone infiltrative benign disease. Preoperative X-ray, CT, bone scan were taken and were compared with histopathologic finding. Also to compare specificty of each lesion in bone scan, bone density was measured to compare. The results were as follows. 1. Among the 25 cases of oral malignant tumor of bony invasion, a positive diagnosis associated with histopathologic evaluation, 22 cases(88%) in bone scan, 14 cases(56%) in CT image, and 10 cases40%) in simple X-ray. 2. Among the 31 cases of osteomyelitis, a positive diagnosis associated with histopathologic evaluation, 30 cases(97%) in bone scan, 23 cases(74%) in CT image, and 19 cases(61%) in simple X-ray. 3. Among the 11cases of bone infiltrative benign disease, a positive diagnosis associated with histopathologic evaluation, 11 cases(100%) in bone scan, 10 cases(91%) in CT image, and 6 cases(55%) in simple X-ray. 4. Measurement of bone density in each group showed no statistical significant difference between malignant tumor and osteomyelitis as well as benign bone disease. But, a statistical significance was seen between osteomyelitis and benign bone disease. From this results, bone scan are more sensitive than simple X-ray and CT image in jaw lesion diagnosis, but specificity shows no significant difference. Therefore, it should be suggested that evaluation of bone scan must be carrying out in reference to final histopathologic diagnosis.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.21
no.1
/
pp.19-29
/
1991
The purpose of this study was to evaluate the usefulness of Ga-67 scintigram in predicting the disappearance of inflammatory activity in mandibular lesions of dogs. Inflammatory bony lesions were produced artificially by the injection of sclerosing solution and bacterial suspension through the distal root canals of the lower 4th premolars in 10 dogs. The serial Ga-67 scintigrams and periapical radiograms were obtained. After 3 to 6 weeks duration of antibiotic therapy, the experimental animals were killed, and the mandibles were dissected. Bacteriologic culture and antibiotic sensitivity test were done. 1. The following results were obtained. The negative Ga-67 scan has 100% predictive value, and is a strong evidence of the resolution of inflammatory activity. In 2 animals of positive Ga-67 scan, I animal had negative culture. In 14 cases of positive Ga-67 scan, radiographically there was increase in the size of lesion in 9 cases, no change in 5 cases. In 8 cases of negative Ga-67 scan, radiographically there was increase in the size of lesion in I case, no change in 6 cases and decrease in 1 case.
Purpose: A fully digital approach to oral prosthodontic rehabilitation requires the possibility of combining (i.e., registering) digital documentation from different sources. This becomes more complex in an edentulous jaw, as fixed dental markers to perform reliable registration are lacking. This validation study aimed to evaluate the reproducibility of 1) intraoral scanning and 2) soft tissue-based registration of an intraoral scan with a cone-beam computed tomography (CBCT) scan for a fully edentulous upper jaw. Materials and Methods: Two observers independently performed intraoral scans of the upper jaw in 14 fully edentulous patients. The palatal vault of both surface models was aligned, and the inter-observer variability was assessed by calculating the mean inter-surface distance at the level of the alveolar crest. Additionally, a CBCT scan of all patients was obtained and a soft tissue surface model was generated using patient-specific gray values. This CBCT soft tissue model was registered with the intraoral scans of both observers, and the intraclass correlation coefficient(ICC) was calculated to evaluate the reproducibility of the registration method. Results: The mean inter-observer deviation when performing an intraoral scan of the fully edentulous upper jaw was 0.10±0.09 mm. The inter-observer agreement for the soft tissue-based registration method was excellent(ICC=0.94; 95% confidence interval, 0.81-0.98). Conclusion: Even when teeth are lacking, intraoral scanning of the jaw and soft tissue-based registration of an intraoral scan with a CBCT scan can be performed with a high degree of precision.
Temporomandibular disorders(TMD) is a collective term which is embracing a number of clinical problems that involve the masticatory musculature, the TMJ and associated structures, or both. Myofascial pain, which is a kind of masticatory muscle disorder of TMD, is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. There has been some controversies regarding etiologies of TMD and MFP. Especially the issue of occlusal conditions has been a critical issue for long time. Despite much efforts, the results of studies regarding occlusal conditions were contradictory. These controversies might be mostly due to various factors resulting from the complex nature of TMD, however, inaccurate and inappropriate study design, selection criteria, methodologies also play significant roles. Recently, a computerized occlusal analysis system, T-Scan II which made it possible to reveal quantifiable time data and relative force data for analyzing occlusion, was introduced. Some authorities suggested that the concept of disclusion time and prolonged disclusion time of posterior tooth and MFP are related using T-Scan II. But the previous studies which used T-SCAN II are not reliable for they did not provide accurate diagnostic criteria of MFP. Morever they did not compare with controls, and had many other problems. The purpose of this study was to evaluate the relationship between MFP and prolonged disclusion time of posterior tooth, which is one of the occlusal factors of TMD, by selecting 30 subjects as the study group through strict criteria and comparing them with 38 controls using T-SCAN II, computerized occlusal analysis system. The results, statistically analyzed, are summarized as follows: 1. Cronbach ${\alpha}$ coefficient of repeated measurements of disclusion time was 0.92. 2. There were no statistically significant differences at repeated measured disclusion time of both side between control and study group. 3. There was no statistically significant diffefence in the disclusion time between right and left side. From the results above, we can suggest that there was no relationship between MFP and disclusion time, so irreversible treatments leading to the reduction of disclusion time for treating MFP would not be appropriate. However more controlled, large scaled study, which consider various occlusal factors, and quantification of symptoms using Helkimo index would be necessary in the future.
The purpose of this study was to evaluate the effect of oral health education with Q-scan for preschool children. The 59 children were divided into two groups, one with Q-scan and the other with dentiform, and they were evaluated by interview questionnaire and measurement of dental plaque index using Quigley-Hein index. Using SPSS ver. 18.0 for statistical analysis, paired t-test and Independent t-test were carried out for dental plaque index change and chi-square independence test for change between before and after oral health education. The result of this study revealed that the dental plaque index of the children showed significant decrease of 12% more in the experimental group (p<0.001). Both groups showed significant difference in knowledge about fluorine (p<0.05) and the percentage of correct answers showed significant increase in questions about bad food for teeth (p<0.05). In attitude toward oral health, the experimental group showed significant difference in every variable (p<0.05), and the control group showed significant difference in regular oral examination and frequency of toothbrushing (p<0.05). The experimental group showed significant result (p<0.05) with increase in the percentage of correct answers for the question about how to hold a toothbrush and decrease in the percentage of correct answers for the question about how to apply toothpaste, while the control group did not show significant difference in any variable. Therefore, Q-scan as an appropriate tool for motivation, provides effective educational methods in oral health education.
Cystic lymphangioma is an uncommon benign developmental tumor of the lymphatic system, seen rarely in adults. A 23-year-old man visited DKUDH complaining of the painless swelling in the right submandibular area. It was reported that swelling had increased since 5 months ago. Clinically, fltriangle uctuant and mobile mass was palpated at the right submandibular area. CT scan showed a large, well-defined, homogenous low density mass, measuring 5.0 × 2.5 × 4.0 cm. T1W MRI scan demonstrated a large, multiseptated homogenous low signal mass with septum and rim enhancement. Proton-density and T2W MRI scan showed mass of high signal intensity. MRI scan was able to delineate better the enhanced multi septation and extent of the lesion. Histopathologically, a lobulated cystic mass lined by a layer of flattened endothelium was observed.
The increased use of cone-beam computed tomographic (CBCT) scans has made it increasingly necessary to evaluate incidental findings on CBCT scans. This report describes the case of a 66-year-old female patient who presented to the Department of Oral and Maxillofacial Pathology, Radiology and Medicine at the College of Dentistry of the author's institution and underwent a CBCT scan for maxillary alveolar process implant planning. Upon evaluation of the CBCT scan, a radiopaque (soft tissue attenuation) mass in the left superior aspect of the nasal cavity and left locule of the sphenoid sinus with opacification of the left locule of the sphenoid sinus was incidentally noted. These radiographic findings were suggestive of a space-occupying mass with a high possibility of malignancy. A further medical evaluation confirmed renal cell cancer metastasis to the sphenoid sinus. This study shows the significance of reviewing the entire CBCT scan for incidental findings.
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