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Biomedical subjects

D S MacDonald-Jankowski

Publications and source records attributed to D S MacDonald-Jankowski.

At least 19 recordsLinked to original sources
PubMed2004

Fibro-osseous lesions of the face and jaws.

Maxillofacial fibro-osseous lesions (FOL) consists of lesions that differ, with the exception of fibrous dysplasia, to those found in the rest of the skeleton. FOLs of the face and jaws are cemento-osseous [corrected] dysplasia, fibrous dysplasia and cemento-ossifying fibroma. Radiology is central to their diagnosis because the pathology for all FOLs is similar, although they range widely in behaviour, from dysplasia, hamartoma to benign neoplasia with occasional recurrence. Furthermore, once diagnosed the management of each is different. For cemento-ossifying dysplasia, this may mean doing nothing, simply because no treatment is generally appropriate. Almost all cemento-osseous [corrected] fibromas should be treated surgically, whereas cases of fibrous dysplasia are treated according to their clinical presentation, ranging from review and follow-up to surgery necessary to save the patient's sight or reduce deformity. The most important and frequent features of the FOLs differential diagnosis is discussed with assistance of a flow-chart.

Cementoma↗
PubMed2004

Computed tomography of odontogenic myxoma.

AIM: The aim of this study was to determine the computed tomography (CT) presentation of odontogenic myxoma (OM) in a Chinese population and to compare them with those observed on the accompanying conventional radiographs (CR). MATERIALS AND METHODS: The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for myxoma cases. RESULTS: Ten cases of OM were found of which eight had been investigated by CT. The formatted hard copy was found in seven cases, four in the maxilla and three in the mandible. Most of the OMs had a round shape but one was fusiform. CT was more likely to display a cortex and its perforation. All OMs had perforated cortices on CT with soft tissue appearing outside the bony contour in two cases. Contrast enhancement was apparent in six cases. Both CR and CT displayed septae, but the latter method revealed that most septae were situated at the periphery, presenting as "sunray" type spicules in one case. Tooth displacement and root resorption were more reliably observed on CR. CONCLUSION: The likelihood of perforation and pattern of septa of OM is better displayed by CT. CR should also allow a better assessment of the degree of definition of the lesion's margins with adjacent normal bone. Therefore, both CT and CR should be used in an investigation of an OM.

Adolescent↗
PubMed2004

Ameloblastoma in the Hong Kong Chinese. Part 1: systematic review and clinical presentation.

OBJECTIVES: The aim of Part 1 of this study was to determine the clinical presentation of central ameloblastomas in the Hong Kong Chinese and to compare them with other reported series by a systematic review (SR). METHODS: The study had two elements, that of a complete series of all ameloblastomas presenting at a major Chinese maxillofacial surgical unit as well as a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for ameloblastoma cases. The relevant literature was identified by electronic databases, review of citation lists and hand searching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS: Fifty-three published series of cases were included in the SR. They generally reported little more than sex, mean age and range, and affected jaw. Only 16 studies considered recurrence. Sixty-one cases of ameloblastoma were identified in the present study. There were 30 males and 31 females, contrary to the predilection for males in other reports. Eighty-four percent of cases were found in the mandible, agreeing with the SR. The mean age at first presentation was 30.5 years, lower than that of the SR; only a Korean report and a small Bangladeshi report showed younger presentation. The present report had the shortest period between first becoming aware of the lesion and seeking treatment; this period was significantly shorter for younger patients. Although the present study was in agreement with the SR with regard to swelling, this study reported a significantly higher proportion of patients presenting with pain. CONCLUSION: Although the presentation of ameloblastoma within this Chinese community was broadly similar to that observed in other populations, it differed in a number of important respects. It had a younger age at first presentation than many other communities, including other Orientals; it was associated with a shorter period between first becoming aware of the lesion and seeking treatment, particularly in the young; and it was more frequently associated with pain than in the SR.

Adolescent↗
PubMed2004

Ameloblastoma in the Hong Kong Chinese. Part 2: systematic review and radiological presentation.

OBJECTIVES: The aim of this part of the study was to determine the radiological presentation on conventional radiographs of central ameloblastomas in the Hong Kong Chinese and compare them with other reported series by a systematic review (SR). METHODS: The study had two elements, that of a complete series of all ameloblastomas presenting at a major Chinese maxillofacial surgical unit and a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for ameloblastoma cases. The relevant literature was identified by electronic databases, review of citation lists and handsearching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS: Only 13 reports gave any radiological details. The present study of the Hong Kong Chinese contained 61 cases. With the exception of radiodensity and shape of radiolucency, the majority of the 13 other reports did not record the other radiological features that could be important in the diagnosis. The present study agreed with the synthesis of the 13 reports with regards to complete radiolucency and cortication of ameloblastomas, but disagreed with regards to other important features. The present study had a significantly higher proportion of unilocular lesions, better marginal definition, and more frequent perforation of the cortex and buccolingual expansion. Nine of the ten maxillary lesions straddled both anterior and posterior sextants with four crossing the midline, whereas only 13 of the 51 mandibular cases affected both sextants, of which eight crossed the midline. The unicystic form, which was most prevalent, appeared significantly more frequently as unilocular radiolucencies in comparison with the non-unicystic forms. The frequencies of unicystic forms and unilocular presentations were significantly greater in the young. The lesions in the young were significantly sited solely in the posterior sextant. The lower border of the mandible was reached and affected by ameloblastoma in 36 cases in the present report. It was displaced and thinned in 15 cases whereas in just five it was at least partially undisplaced with the lesion expanding down past it either buccally or lingually to it. The unicystic form was significantly more associated with root resorption, tooth displacement and crowns of unerupted teeth. CONCLUSIONS: Radiologically, ameloblastomas in the Hong Kong Chinese differ significantly with regards to many features. This can be in part explained by the higher proportion of the unicystic form.

Age Factors↗
PubMed2004

Computed tomography of fibrous dysplasia.

OBJECTIVE: Fibrous dysplasia (FD) is an uncommon, but important lesion affecting the jaws. The aim of this study was to reveal its presentation on computed tomography (CT) in a consecutive series of cases. METHODS: The files of the Department of Oral and Maxillofacial Surgery of Hong Kong University between 1989 and 2000 were reviewed for cases of FD. RESULTS: Of the ten cases investigated by CT, two were rejected because of extensive biopsy or surgery before the CT investigation. Seven of the remaining eight cases were Chinese and one was Indian. The mandible and maxilla were equally affected. The cortex was generally intact, except when adjacent to the teeth in the maxilla. The margins were generally poorly-defined, but well-defined on at least some sections of each maxillary case. Five cases were extensive, affecting or nearly affecting the whole hemi-mandible or hemi-maxilla to the midline. All cases displayed expansion, which was fusiform in the mandible and an enlargement of the normal contour in the maxilla. The maxillary antrum was completely obturated in three maxillary cases; one displayed a rounded dome-shaped lesion more suggestive of a benign neoplasm. The orbital floor was displaced in three cases; one of those cases presented with proptosis. All maxillary cases extended back to the pterygoid process, but did not displace it. The "bone windows" of eight cases generally displayed a "ground-glass" pattern; one also displayed cyst-like radiolucencies. The soft tissue window, which depicts mineralized tissue as "white", showed that five cases were completely mineralized. CONCLUSION: CT can be used to determine the extent, specific dimensions and radiodensity of FD.

Adolescent↗
PubMed2003

Florid cemento-osseous dysplasia: a systematic review.

OBJECTIVES: To evaluate the principal features of florid cemento-osseous dysplasia (FCOD) by systematic review (SR), with particular regard to comparison of Oriental with non-Oriental populations, and of reports derived from pathology files with those from non-pathology sources. METHODS: All alternative names for FCOD were used as search terms for two electronic databases, namely Medline and "Web of Science". Only multiple forms of cemento-osseous dysplasia occurring in a series in the reporting authors' case load were considered. RESULTS: Medline produced more SR-identified reports. The search terms "Cementoma" and "Osseous Dysplasia" were the most effective for both databases. One hundred and fifty-eight cases of FCOD were observed in 17 series of patients reported in 16 SR-identified reports. Fifty-nine percent of cases were found in Blacks, 37% in Orientals and 3% in Caucasians. Ninety-seven percent were females. Fifty percent of cases in the SRs were observed incidentally. Pain was most frequent in those with presenting symptoms, and was significantly more frequent in the Oriental series. In two studies on the same Chinese community, those cases found incidentally on radiographs alone were significantly younger than those with symptoms in the pathology files. CONCLUSION: The nomenclature for FCOD is extensive, but older and more general terms were more effective in recalling SR-identified reports. Cases in a report based on pathology files appear to be older than those in a report based on radiology alone files. With the exception of a higher prevalence of pain in Orientals, mainly Chinese, there did not appear to be any differences in presentation compared with that observed in Black communities.

Asian People↗
PubMed2002

Odontogenic myxomas in the Hong Kong Chinese: clinico-radiological presentation and systematic review.

AIM: The aim of this study was to determine the clinical and radiological presentation on plain films of central odontogenic myxomas (OM) in the Hong Kong Chinese and compare them to other reported series by a systematic review (SR). METHODS: The study had two elements, that of a complete series of all OMs presenting at a major Chinese maxillofacial surgical unit and a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for OM cases. The relevant literature was identified by electronic databases, review of citation lists and handsearching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS: The SR revealed that only a quarter of the reports provided any quantitative radiological details. Just under half of the included reports provided the relative period prevalence of OMs compared to other odontogenic tumours, but these reports almost completely excluded consideration not only of the radiology but also specific clinical details. Furthermore, they did not report of recurrence data, an important feature of the OM. Most of the most recent reports were concerned with relative period prevalence. The relative period prevalence and 'number of OMs per hospital per year' of studies separated by two or more decades in Hong Kong and Nigeria indicate an increase in the number of lesions diagnosed as OMs. The 10 Hong Kong cases were broadly consistent with the predilections for females and the mandible of other reports. The mean age at first presentation in the present report is 36.9, older than the other reports. Most lesions are large, affecting both posterior and anterior quadrants. They appear to be larger than those in many other reports. Two of the OMs are accompanied by histories of recent rapid growth. Tooth displacement and root resorption are more frequently observed in OMs in the present study. Although all OMs in the present study are still being followed up after surgery, none have recurred. CONCLUSION: Although the presentation of larger lesions in the older Chinese could in part be explained by attitudes rooted in traditional medicine in spite of the widespread availability of modern medical care in Hong Kong, there is a history of recent rapid growth in at least two cases. An emphasis by recent reports on the OMs' relative period prevalence of concurrent odontogenic lesions, has omitted recording the radiology and the specific clinical details usually required for diagnosis.,

Adolescent↗
PubMed2001

Calcification of the stylohyoid complex in Londoners and Hong Kong Chinese.

AIM: To compare the prevalence and pattern of calcification of the stylohyoid complex in Hong Kong Chinese with that in London. METHODS: The panoramic radiographs of two consecutive series of patients attending the primary dental care departments were reviewed, 862 patients in Hong Kong and 800 in London. The morphology of the stylohyoid complex was allocated to one of 12 patterns. RESULTS: A normal styloid process is significantly more prevalent in Hong Kong (P<0.01). A calcified stylohyoid ligament is significantly more common in London (15.8%) than Hong Kong (3.9%, P<0.01), whereas there is no difference in the prevalence of an elongated styloid process (7.8% in London and 8.6% in Hong Kong). Segmentation was significantly more prevalent in London (P<0.01), whereas symmetry predominated in Hong Kong (P<0.01). Although the mean age of the Hong Kong patients was significantly older than those in London (P<0.001), those with a calcified stylohyoid ligament tended only to be older (0.025>P>0.01). There was no significant difference in age for an elongated styloid process. CONCLUSION: There are significant differences in the morphology of the stylohyoid complex between London and Hong Kong. A calcified stylohyoid ligament is more prevalent in Londoners.

Adult↗
PubMed2001

Systematic review in diagnostic radiology.

Systematic review (SR) already makes a major contribution to evidence-based healthcare by making the review process transparent and by reducing bias. SR has been successfully applied to observational studies. Radiologists have already begun to make an impact in dentistry by using SR as a decision-making tool. Central to SR is establishment of a research question, selection criteria, a search plan, a literature search, an appraisal of the identified literature by the selection criteria; an analysis and a formulation of recommendations. With regard to the literature search, electronic databases (Medline, Embase, Science Citation Index, Lilacs), controlled subject headings, exploding and free-text searching, handsearching and the gray literature are discussed.

Databases, Bibliographic↗
PubMed2000

The contribution by medical radiology departments to dental radiology in general dental practice in Scotland.

AIM: To determine the availability of the services of medical radiology departments to general dental practitioners in Scotland. METHODS: Fifty-seven hospitals were identified as likely to have services available to general dental practitioners; 41 were within central urbanised areas (the 'Central Belt') and 16 in the more remote rural areas, (the 'Borders, Highlands and Islands'). The available services were identified by questionnaire. RESULTS: All 57 questionnaires were returned. Although there were significantly fewer larger hospitals in the 'Borders, Highlands and Islands', there was no significant difference in availability of services to general dental practitioners between the two parts of Scotland. CONCLUSION: The services of medical radiology departments are generally available to general dental practitioners in both the 'Central Belt' and the 'Borders, Highlands and Islands'.

Dental Service, Hospital↗
PubMed1999

Idiopathic osteosclerosis in the jaws of Britons and of the Hong Kong Chinese: radiology and systematic review.

AIM: To compare the prevalence of idiopathic osteosclerosis in the jaws in Hong Kong and Britain. METHODS: The panoramic radiographs of consecutive patients who attended the primary care departments of the dental hospitals in Hong Kong in 1981 and 1990 and London in 1990 and of Edinburgh in 1993 were reviewed. The size of the Hong Kong lesions was measured. The literature was subjected to systematic review. RESULTS: The prevalence of idiopathic osteosclerosis in Hong Kong in 1981 and 1990, London and Edinburgh was 6.7, 5.5, 2.7 and 4.1% respectively. The prevalence of idiopathic osteosclerosis was greater in the Oriental (Chinese and Japanese) than in Western surveys. The lesions in the 1990 Hong Kong survey in the third decade were significantly smaller than those in the 1981 survey. The decrease in size in Hong Kong 1990 was also accompanied by a reduction in overall prevalence. The predilection for the mandible, especially in the premolar area, was observed in the Chinese and London series; this feature was also common to all other reports. CONCLUSION: The Chinese have a greater prevalence of idiopathic osteosclerosis than Western populations.

Adolescent↗
PubMed1998

Cemento-ossifying fibromas in the jaws of Hong Kong Chinese.

OBJECTIVE: To determine the clinical and radiological features of cemento-ossifying fibroma (COF) in a Chinese population. METHODS: Twenty cases of COF found in Chinese patients for whom the clinical notes, radiographs and histopathology reports were available, were reviewed to determine their clinical and radiological features. Overall size was measured digitally from the radiographs. RESULTS: All COFs occurred in females and most frequently in the third and fourth decades. Seventeen COFs were in the mandible and three in the maxilla. Eighteen COFs had well-defined margins and were round or avoid in shape. Four were radiolucent and 15 mixed density. COFs tended to be smaller in women in their early to middle-40s and larger in older women. CONCLUSIONS: The clinical and radiological features of this Chinese series were broadly consistent with those of non-Chinese populations reported previously. The principal difference was that all 20 patients were female.

Adult↗
PubMed1996

Florid osseous dysplasia in Hong Kong Chinese.

OBJECTIVES: To report the radiological features of florid osseous dysplasia (FOD) in a Chinese population. METHODS: Twenty-three cases of histologically confirmed FOD affecting middle-aged Hong Kong Chinese women were reviewed. RESULTS: Sixteen patients presented with symptoms arising from the lesions. Twelve cases exhibited bilateral lesions, five were in both the upper and lower right quadrants, and there were six cases of a solitary lesion; the mandible was affected twice as frequently as the maxilla. Whereas all bilateral and unilateral lesions were provisionally diagnosed as FOD, all six solitary (localized) cases were thought to be other entities. There was a significant association between edentuous areas and FOD lesions. CONCLUSIONS: While the radiological presentation of FOD in this series of Chinese women appeared similar to that reported in Western populations of Negroid origin, the greater prevalence of symptoms in the former may arise from secondary infection of the FOD lesions due, until recently, to the lack of availability of formal dental care.

Adult↗
PubMed1996

Odontomas in a Chinese population.

OBJECTIVE: To assess the pattern of distribution and age changes in odontomas in a Chinese population. METHODS: Forty cases of odontomas found in Chinese patients for which the clinical notes, radiographs and histopathology reports were available were classified as either compound or complex odontomas on the basis of their radiological appearance. Thirty-nine were wholly within the alveolus and one in the maxillary antrum. The overall size of the 39 alveolar odontomas and the size of their central opacities were measured digitally from periapical radiographs. RESULTS: Twenty-one of the 39 alveolar odontomas were complex (M/F = 8/13) and 18 compound (M/F = 10/8). The majority of cases presented in the second and third decades with an overall mean of 23 years. Thirty-eight per cent were found in the anterior maxilla. Complex odontomas had a predilection for the anterior maxilla and mandibular molar areas. The odontomas increased in size with increase in age. CONCLUSIONS: The pattern of presentation of this Chinese series is broadly in agreement with other series. Odontomas tend to increase in size with the age of the patient, suggesting continuing growth.

Adolescent↗
PubMed1995

Traumatic bone cysts in the jaws of a Hong Kong Chinese population.

The trabecular bone cyst (TBC) is the jaws' equivalent of the unicameral cyst of the long bones. A series of 20 TBCs were surgically treated in the jaws (19 in the mandible and one in the maxilla) of 14 Chinese patients (five males and nine females), who could broadly be divided into two age-sex groups; a young group of both sexes and an older, exclusively female group. Three patients in the older group had more than one TBC and the one with initially five separate TBCs (including one in the maxilla) exhibited six episodes of recurrence of the mandibular lesions which finally coalesced to affect the whole body of the mandible bilaterally.

Adolescent↗
PubMed1995

The effect of thin K-edge filters on the image quality of D- and E-speed dental film.

The use of K-edge filters and fast speed dental (non-screen) film have been separately shown to reduce the radiation dose imparted during dental radiography. The effect of these on image quality has been unclear. This study objectively examines the effect on image quality of eight film/filter systems: E- and D-speed film and four filter systems (the existing aluminium filter used alone or with erbium, niobium or yttrium). The components of the image quality parameters assessed were contrast, resolution, the minimum perceptible contrast (noise) and the square wave response function. No clinically significant difference in image quality was observed. This was confirmed by subjective assessment of images of an anatomical phantom. It is concluded that the use of faster speed film in addition to K-edge beam filtration has no major effect on the clinical image.

Filtration↗
PubMed1994

Mucosal antral cysts observed within a London inner-city population.

Mucosal antral cysts(MACs) appear as dome-shaped soft-tissue opacities and have prevalences of between 1.6% and 8.7% on otherwise normal panoramic radiographs. The aim of this survey was to define the prevalence in the inner-city population in London. A 14% prevalence for MACs was observed in the panoramic radiographs of 1000 consecutive patients attending King's College Hospital dental casualty department sited in inner London, which is higher than those reported for other populations. MACs were not significantly associated with the presence of signs and symptoms of periapical areas of bone loss. The differential diagnosis and management of these lesions are discussed.

Adolescent↗