Bernard radiology notes

1. Congenital teeth absence:Third molars are most commonly affected, followed by second
premolars,maxillary lateral incisors and mandibular central incisor.
2. Transposition: is where two adjacent teeth have exchanged positions, most commonly
involving the maxillary canines and first premolars
3. Microdontia : Most commonly affecting third molars and maxillary lateral
Incisors.
3. Concrescence: is The joining of roots of normally separate teeth with cementum.Most
commonly affects the maxillary molars.
4. Osteoradionecrosis of the jaws: Most commonly seen in the mandible, especially
posteriorly.
5. Osteonecrosis of the jaws Synonyms: ONJ, medication-related osteonecrosis of the jaws,
MRONJ, bisphosphonate-related ONJ, BRONJ. Related to antiresorptive and antiangiogenic
drugs. BRONJ is presently most common. Other potential causes include long-term steroid
therapy.Trauma is a significant contributing factor, including dentoalveolar surgical
procedures and irritation from dentures.Most commonly seen in the posterior mandible.
6. keratocystic odontogenic tumour : Most commonly seen in the posterior mandible.
7. Cementoblastoma: Most commonly seen at the mandibular first molar region,
centred apically.
8. Multiple myeloma most commonly affects posterior mandible.
9. Hemangioma most commonly affects posterior mandible.
10. Central giant cell granuloma most commonly affects posterior mandible.
11.Sialolisth Most commonly seen within the duct of the submandibular salivary gland,
often occurring proximally where the duct curves around the posterior border of the
mylohyoid muscle.
12. Most common sign of internal derrangment is noises.
13. Displacment of TMJ disc most commonly occurs in anterior direction.
When CBCT & MDCT&MRI
- There are two main differences between conventional spiral CT and MDCT. Firstly, MDCT has a
high acquisition speed (0.37 s rotation speed vs 1 s rotation speed for conventional CT);
secondly, and probably more importantly, MDCT acquires volume data instead of individual slice
data. These two factors together with thin section slices enable the new technique to provide
almost isotropic data that can be arranged in different planes without compromising the spatial
resolution of the original axial images
1.In osteomyelitis: usually demonstrates more features although CBCT
may be sufficient in some cases. MDCT is the imaging modality of choice if there is
clinically evident or suspected soft tissue involvement, and intravenous contrast
should be considered.
2. Where there is more than minor soft tissue involvement or if there is suspicion for
cellulitis or abscess collection related to a dentoalveolar infection or osteomyelitis,
MDCT with intravenous contrast is the first modality of choice. CBCT is insufficient.
While MRI may be useful in some cases, it is less sensitive in demonstrating the
dentoalveolar and jaw changes.
3. In osteoradionecrosis: (MDCT) may show relevant soft tissue changes but (CBCT) may be
sufficient.MDCT is recommended if there is secondary infection with soft tissue involvement.
4.In osteonecrosis: MDCT has the advantage of demonstrating relevant soft tissue changes
but CBCT may be sufficient. This is insufficiently examined with 2D radiography. MDCT is
recommended if there is secondary infection with soft tissue involvement.
5. In radicular cyst: Computed tomography (CT) is more sensitive in identifying the presence
of these lesions than 2D radiography. Multidetector CT (MDCT) may demonstrate more
features but cone beam CT .(CBCT) is likely to be sufficient for many, especially smaller
lesions.
6.In dentigerous cyst: These lesions are better demonstrated with CT than with 2D
radiography, although 2D radiography may be sufficient for small lesions which do not
impinge upon critical structures. MDCT may demonstrate more features but CBCT may be
sufficient for many cases.
7. In odontogenic keratocyst: A suspected KCOT requires evaluation with CT: MDCT may
demonstrate features which are not seen on CBCT. MRI may be useful.
8. In Calcifying epithelial odontogenic tumour:MDCT demonstrates more features than
CBCT.
9. In aneurysmal bone cyst: MDCT is the first imaging modality of choice.
10. In Stafne defect: When imaging is indicated, MDCT is preferred over CBCT as the soft
tissue content within the depression is poorly demonstrated with CBCT. However, CBCT may
suffice, especially if there is no access to MDCT.
11. MRI is best imagaing modality for TMJ
12. In coronoid hyperplasia: Best examined with MDCT, although CBCT may be sufficient if
there is no suspicion for soft tissue lesions.
13. In osteoarthritis: MDCT is the best
14.In symptomatic oroantral fistula: MDCT is the best radiograph.