Calcified carotid artery atheroma (CCAA) localization on panoramic radiographs.
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Biomedical subjects
Publications and source records attributed to Muralidhar Mupparapu.
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Wireless networking is not new to contemporary dental offices around the country. Wireless routers and network cards have made access to patient records within the office handy and, thereby, saving valuable chair side time and increasing productivity. As is the case with any rapidly developing technology, wireless technology also changes with the same rate. Unless, the users of the wireless networking understand the implications of these changes and keep themselves updated periodically, the office network will become obsolete very quickly. This update of the emerging security protocols and pertaining to ratified wireless 802.11 standards will be timely for the contemporary dentist whose office is wirelessly networked. This article brings the practicing dentist up-to-date on the newer versions and standards in wireless networking that are changing at a fast pace. The introduction of newer 802.11 standards like super G, Super AG, Multiple Input Multiple Output (MIMO), and pre-n are changing the pace of adaptation of this technology. Like any other rapidly transforming technology, information pertaining to wireless networking should be a priority for the contemporary dentist, an eventual end-user in order to be a well-informed and techno-savvy consumer.
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Cranium bifidum occultum is a rare skull ossification disorder referred to as the Catlin mark characterized by ossification defects in the parietal bones. Evidence suggests that this condition has a strong genetic heterogenicity. It is believed that, as calvarial growth continues, ossification in parietal bones fills these defects, and they can remain as parietal foramina on either side of the sagittal suture. During the conversion phase of cranium bifidum to the persistent parietal foramen, there will be periods when the brain is unprotected because of the delay in the ossification of the parietal bones. This report describes cranium bifidum occultum diagnosed as an incidental finding in a 14-year-old boy who initially had large bilateral unossified parietal bones and many congenital abnormalities. The patient underwent various surgical procedures over 6 years for the correction of cleft lip and palate. With craniofacial corrections and orthodontic treatment, the patient now has stable dentition and a firm palate with most of the parietal bones ossified. Cranioplasty was not recommended by his family physician after consultation with a neurosurgeon. Orthodontists should be familiar with this genetic abnormality because it causes delay in parietal bone ossification, and they should be able to distinguish between anatomic parietal foramina and enlarged parietal foramina (persistent unossified areas of cranium bifidum occultum), especially when craniofacial abnormalities are noticed.
An unusual presentation of dens invaginatus affecting a microdontic permanent lateral incisor in a 19-year-old female patient is reported and pertinent literature reviewed. The patient was referred to the oral and maxillofacial radiology clinic of the authors' institution for radiographic examination of her maxillary teeth. Dens invaginatus was identified on the maxillary right lateral incisor in the anterior periapical radiographs. The tooth was microdontic and clinically simulated a primary tooth. Dens invaginatus occurs rarely in primary dentition although it is fairly common in permanent teeth. Only 4 instances of dens invaginatus affecting the primary dentition have been reported in the literature. The etiology, pathophysiology, association with other dental anomalies, as well as management aspects of this common anomaly, are discussed.
Radiographic images and other patient records, including medical histories, demographics, and health insurance information, can now be stored digitally and accessed via patient management programs. However, digital image acquisition and diagnosis and treatment planning are independent tasks, and each is time consuming, especially when performed at different computer workstations. Networking or linking the computers in an office enhances access to imaging and treatment planning tools. Access can be further enhanced if the entire network is wireless. Thanks to wireless technology, stand-alone, desk-bound personal computers have been replaced with mobile, hand-held devices that can communicate with each other and the rest of the world via the Internet. As with any emerging technology, some issues should be kept in mind when adapting to the wireless environment. Foremost is network security. Second is the choice of mobile hardware devices that are used by the orthodontist, office staff, and patients. This article details the standards and choices in wireless technology that can be implemented in an orthodontic clinic and suggests how to select suitable mobile hardware for accessing or adding data to a preexisting network. The network security protocols discussed comply with HIPAA regulations and boost the efficiency of a modern orthodontic clinic.
This article summarizes the most recent (December 2003) dental x-ray guidelines from the National Council on Radiation Protection and Measurements report #145. The guidelines are intended for all dental health-care providers. They address radiation dose limits for occupational and nonoccupational exposure and radiation protection for operators, patients, and the public. Equipment design can play an important role in radiation protection, and recommendations from the guidelines are discussed.
This study was undertaken to identify the variations in the physiologic ossification of human laryngeal cartilages by evaluating the lateral cephalometric radiographs of healthy males and females referred to our facility. Lateral cephalometric radiographs of 359 patients (141 male and 218 female; ages 10 to 59 years) referred from various specialty clinics between April 1998 and March 2000 were used. Frequencies and confidence intervals were obtained and tabulated for both thyroid and cricoid ossifications as seen on these cephalometric radiographs. The interobserver agreement was strong for both thyroid (kappa = .986) and cricoid (kappa = .982) observations. Overall, thyroid cartilage was more frequently ossified compared with cricoid. Various degrees of thyroid and cricoid cartilage ossification were found in 186 patients (120 female and 66 male) in the third decade and beyond. Among 173 patients in the first 2 decades (98 females and 75 male), evidence of thyroid ossification was found in 2 male patients aged 14 and 18, and ossification was detected in the cricoid cartilage in 12 patients. There was a preponderance of laryngeal cartilage ossification in men compared with women. Radiographically detectable laryngeal ossification increased with age starting in the third decade. There is a general trend of increase in the ossification of laryngeal cartilages as the age advanced.
BACKGROUND: Infection, neoplasia and bone dysplasias cause alteration in bone architecture. Florid cemento-osseous dysplasia (FCOD) and chronic diffuse osteomyelitis (CDO) are two independent disease processes that may have overlapping clinical and radiographic characteristics. Differential diagnosis can be crucial, as the course of each process and its clinical management varies. CASE DESCRIPTION: A patient reported to the oral and maxillofacial radiology clinic at the University of Medicine and Dentistry of New Jersey's New Jersey Dental School with a complaint of chronic pain in the mandible. One of the authors (S.R.S.) obtained a panoramic radiograph. Later, the patient underwent computerized tomographic examination and biopsy. On the basis of the clinical, radiographic and histopathologic examinations, the authors made diagnoses of CDO and FCOD. The bilateral presentation of CDO along with the simultaneous presence of FCOD and these conditions' vivid radiographic appearances make this case highly unusual. CLINICAL IMPLICATIONS: Multiple, simultaneous processes can yield an atypical radiographic appearance seen on routine radiographic examinations. Characteristics unique to each process are used to make the differential diagnoses. FCOD can make the mandible more susceptible to osteomyelitis.
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Digital radiography has gained immense popularity in dentistry today in spite of the early difficulty for the profession to embrace the technology. The transition from film to digital has been happening at a faster pace in the fields of Orthodontics, Oral Surgery, Endodontics, Periodontics, and other specialties where the radiographic images (periapical, bitewing, panoramic, cephalometric, and skull radiographs) are being acquired digitally, stored within a server locally, and eventually accessed for diagnostic purposes, along with the rest of the patient data via the patient management software (PMS). A review of the literature shows the diagnostic performance of digital radiography is at least comparable to or even better than that of conventional radiography. Similarly, other digital diagnostic tools like caries detectors, cephalometric analysis software, and digital scanners were used for many years for the diagnosis and treatment planning purposes. The introduction of wireless charged-coupled device (CCD) sensors in early 2004 (Schick Technologies, Long Island City, NY) has moved digital radiography a step further into the wireless era. As with any emerging technology, there are concerns that should be looked into before adapting to the wireless environment. Foremost is the network security involved in the installation and usage of these wireless networks. This article deals with the existing standards and choices in wireless technologies that are available for implementation within a contemporary dental office. The network security protocols that protect the patient data and boost the efficiency of modern day dental clinics are enumerated.
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Dental implants have become part of routine treatment plans in many dental offices because of their increasing popularity and acceptance by patients. Appropriate preplacement planning, in which imaging plays a pivotal role, helps to ensure a satisfactory outcome. The development of precise presurgical imaging techniques and surgical templates allows the dentist to place these implants with relative ease and predictability. This article gives an overview of current practices in implant imaging for the practising dentist, with emphasis on selection criteria. Imaging protocols for site assessment and restorative evaluation are discussed. This information will enable the dentist to select and use appropriate radiographic images (digital or film) for implant treatment planning, restoration and postoperative follow-up. Modalities presented include intraoral and panoramic projections, linear and complex motion tomography and computed tomography (CT). The use of CT image reformatting software such as Dentascan and SimPlant with 3-dimensional reconstructions is discussed.
Chronic untreated fibrous dysplasia of the mandible in a 40-year-old man is described, with emphasis on the radiographic findings. To the authors' knowledge, this is the first such case to be reported in the literature. Within this mature mandibular lesion, a large radiolucency was noticed, with the appearance of a simple bone cyst. The patient did not have any symptoms directly related to the mandibular lesion. Various aspects of the diagnosis, radiographic appearance and differential diagnosis are discussed. The information presented here will be useful for all dentists, oral and maxillofacial surgeons, physicians and other health care providers in identifying the appearance of chronic fibro-osseous lesions.
An unusually large complex odontoma of the maxilla, occupying the entire maxillary sinus with expansion into the floor of the orbit and left nasal fossa, is reported. Although occurrences of complex odontomas are not considered rare, odontomas attaining extremely large sizes, especially involving the entire maxillary sinus with extension to the orbital floor and nasal fossae, are indeed, rare. In this article, the literature is reviewed to identify the common clinical, radiographic, and histologic characteristics of such lesions, and the outcome of treatment is discussed. Complex odontomas occasionally have significant growth potential, especially in the first two decades of life. Early recognition and consideration for surgical excision are key to successful management of this common odontogenic lesion. When odontomas extend beyond the alveolar process into the fascial planes, nasal fossae, paranasal sinuses, and orbits, computed tomography can readily demonstrate the extent and boundaries of the lesion.
A 53-year-old Caucasian female presented to the Oral Medicine Department at the hospital of the University of Pennsylvania for consultation regarding facial pain. A panoramic radiograph revealed multilocular radiolucencies in the right articular eminence. A CT scan was then performed, and the radiolucencies were determined to be pneumatization of the articular eminence.
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We report ossification of the thyroid cartilage detected on a routine lateral cephalometric film and discuss the clinical implications of this finding. The thyroid cartilage is a part of the laryngeal cartilaginous complex and may undergo calcification or endochondral ossification (or both), thereby becoming visible radiographically. Usually, ossification is visible only in individuals over the age of 20 years. It is unusual to see ossification in children or adolescents. We report here a case of thyroid ossification in a 14-year-old patient that is visible on a routine lateral cephalometric radiograph. An incidental limbus vertebra is also noticed situated anteroinferior to the fourth cervical vertebra.