Panoramic Radiograph and CBCT in Unilateral Mandibular Condylar Hyperplasia—A Case Report

Condylar hyperplasia (CH) of the mandible is a rare developmental disorder that results in enlargement of the condyle. It is predominant in females, mostly unilateral and self-limiting. This report presents a case of a 35-year-old female patient with unilateral condylar hyperplasia with an increase in vertical height of mandibular ramus of the affected side. After initial radiographic evaluation, the asymmetry index using a panoramic radiograph was determined and also analyzed using cone-beam computed tomography (CBCT). Condylar dimensions in all the planes were measured for both sides using CBCT. This case report emphasizes the importance of CBCT and its role in the diagnosis and assessment of mandibular condylar hyperplasia.

Correlation between the Mandibular Lingula Position and Some Anatomical Landmarks in Cone Beam CT

Background: the position of the mandibular lingula (Li) affects the success rate of the inferior alveolar nerve block (IANB) and ramus osteotomies. This study evaluated the position of the Li, to investigate the anatomical relationship between the Li and some anatomical measurements using cone beam computed tomography (CBCT). Methods: 201 hemimandibular CBCTs of 111 patients (43 males and 68 females; 18 to 88 years old) were retrospectively evaluated. The Li location was determined from the lingula tip to: the occlusal plane, the anterior and posterior borders of the mandibular ramus, the lower border of the mandible, the distal surface of the mandibular second molar, and the mandibular notch. We evaluated the correlations between the Li and the anteroposterior diameter of the mandibular ramus; the vertical distance between condyle and mandibular angle; the mesial–distal diameter of the first, second, and third mandibular molar, the intercanine distance, the intermolar distances among the first, second, and third mandibular molars; the distance between the intermolar line of the first molar and midline, and the length of the mandibular body. Results: the vertical distance of the Li from the occlusal plane was 11.22 ± 4.27 mm. Some parameters significantly correlated with the anatomical measurements taken into consideration. Conclusions: the present study provides new information concerning the Li and mandibular anatomy in the Italian population. Moreover, by correlating some anatomic measurements to the Li position, the localization of the Li is made possible, indirectly through the measurement of some distances between anatomical landmarks.

Age and sex estimation using fractal analysis in Brazilian adults: a discriminant analysis

This study assessed the accuracy of fractal analysis (FA) to estimate chronological age and sex in Brazilian adults for forensic investigations. The gender-balanced sample comprised lateral cephalometric radiographs of 120 individuals, stratified according to age (20-29, 30-39, 40-49, 50-59 years) and sex (female and male). A trained calibrated examiner measured the fractal dimension (FD) of the mandibular ramus and mandibular angle. Linear regression and multiple logistic discriminant analysis were carried out to explore the accuracy of FA. For all analyses, p-values < .05 indicated statistical significance. Overall, mean FD values were 1.49±0.10 for the mandibular ramus and 1.48±0.09 for mandibular angle. Results were more accurate in males than females for discriminating age and sex. The multiple discriminant analysis indicated that FA distinguished sex in 61.7% males and 58.3% females. In addition, the mean difference between actual and predicted value was 9.5 years and 10.1 years for men and women, respectively. Fractal analysis accurately identified sex- and age-related differences in the trabecular pattern of the mandible of Brazilian adults, confirming its utility for forensic investigations. Further studies investigating other populations are needed to assess the accuracy of FA for Forensic Dentistry.

Orthopantomography and use of Mandibular Indices for the Evaluation of Gender Distribution in Navi Mumbai Population - A Retrospective, Single Blind Study

Introduction: The study of forensic sciences often leaves the forensic expert to draw conclusions from any and every material available in determining the identity of the deceased. The initial step in identifying a person is to determine their gender based on their adult skeleton. The human skeleton displays sexual dimorphism, of which the skull is most dimorphic providing an accurateness of 92%. However, in certain situations where the skull may not be found intact, the mandible plays a vital role. The mandible's thick covering of compact bone helps keep it from exploding during a mass tragedy. Dimorphism in the mandible is gender specific and is mainly reflected in its shape and size. The mandible is also easily radiographed and specific linear measurements of the mandibular rami as seen on an OPG are useful indices for gender determination. Aims: To examine the efficacy of mandibular rami measures such as maximum ramus breadth, maximum ramus height, minimum ramus breadth, condylar height, coronoid height, mandibular body length and gonial angles on the right and left side of an OPG in determining gender. Materials and methods: 110 digital OPG’s (55 males, 55 females) of a Navi Mumbai population were obtained retrospectively from a reputed dental college and hospital. The OPG’s were taken using Xtropan 2000 OPG machine, 10x12 PSP plates, exposure parameters of 75 Kvp, 8 mas, 13 sec, and KODAK CR 7400 digitizer. Master View 3.0 software was used on the desktop computer to measure the mandibular ramus's width and thickness. Maximum ramus breadth, Maximum Ramus height and lowest ramus breadth of the mandibular rami, as well as the height of the condyle and the coronoid bone, and the length of the mandibular body and gonial angles on the right and left sides of the mouth, were all measured. Using a statistical formula, the measurements were substituted and gender was estimated. Result: We used the IBM SPSS v 21.0 statistical software for social sciences to do our statistical study. p0.05 was deemed statistically significant, with a 5% margin of error and a 20% margin of error, giving the study an 80 percent power. In the study group, 51 of the 55 men were expected to be males, while 49 of the 55 females were anticipated to be females, while 6 of the 55 females were predicted to be males. Conclusion: This research shows that the mandibular ramus is a useful tool for determining gender, and digital panoramic imaging yielded the best accurate linear measures. There was considerable sexual dimorphism in the mandibular ramus in the chosen Navi – Mumbai subpopulation, and the combination of 8 factors demonstrated an accuracy of 91.81 percent and was helpful for gender determination.

The diagnostic dilemma of Masticator space tumor

The masticator space is an anatomical and functional entity centered on the mandibular ramus, which divides it into medial and lateral compartments. The masticator spaces considered paired supra-hyoid cervical spaces on each side of the face that extend from the angle of the mandible to the parietal bone. The masticator space contains the mastication muscles, posterior mandible, and mandibular nerve. They are separated from the nasopharynx by the parapharyngeal spaces bilaterally. Primary malignancy of the masticator space is very uncommon.Here we report a diagnostic dilemma of primary masticator space malignancy mistaken by nasopharyngeal carcinoma as the patient 40-year old gentleman presented with left lateral rectus palsy and left nasopharynx fullness.

A Novel Animal Model for Three-Dimensional Horizontal and Vertical Bone Regeneration Using Osseous Shell Technique: A Pre-clinical In-Vivo Study in Rabbits

Background: Bone grafting is commonly used for reconstructing skeletal defects in the craniofacial region. Several bone augmentation models were developed to optimize bone regeneration in both vertical and horizontal dimesions. Aim: The aim of this study was to develop a surgical animal model for establishing a three-dimensional (3D) grafting environment in the animal's mandibular ramus for horizontal and vertical bone regeneration using osseous shell technique, as in human patients. Materials and methods: Initial osteological and imaging survey were performed on a postmortem skull of a New Zealand White (NZW) rabbit skull, Oryctolagus cuniculus, for feasibility assessment for performing the surgical procedure. 3D osseus defect was created in the mandibular ramus through a submandibular incision and the osseous shell plates were stabilized with osteosynthesis fixation screws and defect filled with particular bone grafting material. The in-vivo surgical procedures were conducted in four 8-week-old NZW rabbits utilising two osseous shell materials: xenogenic human cortical plates, and autogenous rabbit cortical plates, and the created 3D defects were filled using xenograft and allograft bone grafting materials. The healed defects were evaluated for bone regeneration after 12 weeks using histological and Cone Beam Computed Tomography (CBCT) imaging analysis. Results: Clinical analysis at 12 weeks after surgery revealed the stability of the 3D grafted bone augmentation defects using the osseous shell technique. Imaging and histological analyses confirmed the effectiveness of this model in assessing bone regeneration. Conclusion: The rabbit model is an efficient and reliable biological method for creating a seizable three-dimensional horizontal and vertical bone regeneration model in the mandibular ramus using osseous shell technique for testing various bone-substitute materials testing without compromising the health of the animal. The filled defects could be analyzed for osteogenesis, quantification of bone formation, and healing potential, using histomorphometric analysis, in addition to 3D morphologic evaluation using radiation imaging.