Interception of a Reverse Incisor Occlusion in Mixed Dentition

Introduction: This case report describes an orthodontic interception of a mixed dentition reverse incisor bite in a 12-year-old boy at the time of consultation. Case Report: After a careful clinical examination supported by routine radiological examinations, a skeletal class III diagnosis was made and an orthodontic interception was decided to restore the inverted incisor joint and the various orofacial functions disrupted by the malocclusion. After twenty months of interceptive treatment consisting of a joint jump and class III intermaxillary traction, we found satisfactory overhang and coverage allowing us to monitor the placement of the definitive canines with an improvement in the skin profile and smile. Conclusion: This simple gesture which made it possible to put the mandible back in a position restoring normal incisal coverage contributes to good orofacial muscle maturation closely linked to the various occlusal functions restored.

Diabetic Mastopathy. Review of Diagnostic Methods and Therapeutic Options

Diabetic mastopathy is a rare breast condition that may occur in insulin-treated men and women of any age. The etiology is still unclear; however, the autoimmunological background of the disease is highly suspected. The changes in diabetic mastopathy may mimic breast cancer; therefore, its diagnostic process is demanding, and treatment options are not clear and limited. Lesions in DM are usually multiple; therefore, surgical removal is not fully effective. A well-done anamnesis with core-needle biopsy is essential and definitive in most cases. In this review, we summarize up-to-date knowledge of diagnostic methods and therapeutic options for diabetic mastopathy treatment and present three cases of diabetic mastopathy-type lesions in ultrasound and radiological examinations.

Comparison of Surface Equivalent Dose in CBCT, Digital Panoramic and Intra-Oral X-Ray Generators Using InstadoseTM Device: An In-Vitro Study

Background: Radiation protection in the dental examination is often overlooked because the doses delivered are negligible. However, the volume of dental radiological examinations will constitute almost 15% of all the radiological examinations carried out in the medical field. Aim: This study aims to evaluate and compare the surface equivalent dose on various target organs from various radiology devices on the RINN phantom, and the effect of numerous scanning protocols on said dose using dosimetry badge (Instadose). Objectives: The main objective is to study surface equivalent doses delivered in various critical organ regions in the facial region with the help of an Instadose device and to compare the doses delivered between 2D programs against 3D programs. Materials and Methods: RINN phantom was mounted on a dental chair for use against Planmeca ProMax 3D Classic and Planmeca intraoral ProX. Models. An Instadose badge was placed on various anatomical landmarks, and radiographic exposure protocols were applied to vary the parameters. The equivalent dose was calculated by connecting the dosimeter to a laptop and performing an instant reading output on the Instadose software. Results: The Thyroid showed a mean of 0.350, 0.0000, 0.0133, and 0.0000 in response to exposure by intraoral machine ProX, Panoramic, CBCT, and CBCT in ULD mode respectively. The dose absorbed by the left salivary glands was found to be significantly lower than the right salivary glands in panoramic exposures. Conclusion: It was revealed that a significant reduction in the dose when applying the Ultra-Low Dose protocol was noticed, and it reached up to 100% in the thyroid. It was also noted that there is no need for a thyroid collar in CBCT and Panoramic exposures. Maintaining the KVp at a constant and the exposure time as a variant caused a change in the dose equivalent received by the floor of the mouth and the right salivary gland.

Paediatric diagnostic reference levels for common radiological examinations using the European guidelines

Objective: The purpose of this study was to explore the feasibility to determine regional diagnostic reference levels (RDRLs) for paediatric conventional and CT examinations using the European guidelines and to compare RDRLs derived from weight and age groups, respectively. Methods: Data were collected from 31 hospitals in 4 countries, for 7 examination types for a total of 2978 patients. RDRLs were derived for each weight and age group, respectively, when the total number of patients exceeded 15. Results: It was possible to derive RDRLs for most, but not all, weight-based and age-based groups for the seven examinations. The result using weight-based and age-based groups differed substantially. The RDRLs were lower than or equal to the European and recently published national DRLs. Conclusion: It is feasible to derive RDRLs. However, a thorough review of the clinical indications and methodologies has to be performed previous to data collection. This study does not support the notion that DRLs derived using age and weight groups are exchangeable. Advances in knowledge: Paediatric DRLs should be derived using weight-based groups with access to the actual weight of the patients. DRLs developed using weight differ markedly from those developed with the use of age. There is still a need to harmonize the method to derive solid DRLs for paediatric radiological examinations.

Proteus syndrome with sciatic nerve fibrolipomatous hamartoma: an uncommon finding in a rare disease: report of two cases with literature review

Proteus syndrome is an extremely rare condition, characterized by progressive asymmetric overgrowth of multiple body tissues. Here we present two cases of Proteus syndrome demonstrating typical clinical and radiological features of Proteus syndrome, in addition to an uncommon fibrolipomatous hamartoma of the sciatic nerve. The first case is a five-year-old girl who presented with seizures. The patient showed facial dysmorphic features, left head enlargement, kyphoscoliosis, asymmetric overgrowth of the right lower limb, right foot drop, and cribriform connective tissue nevi on the right palm and the right sole. Radiological examinations demonstrated left calvarial hyperostosis, dysplasia of the left cerebral hemisphere, dysregulation of the subcutaneous adipose fat of the body, kyphoscoliosis, and lipoma of the filum terminale. CT of both thighs showed asymmetric soft tissue overgrowth of the right thigh, associated with diffuse enlargement and fatty infiltration of the right sciatic nerve starting from the upper thigh, down to its bifurcation into the tibial and common peroneal nerves. The second case is an eighteen-year-old girl who presented with left conductive deafness. The patient showed facial dysmorphic features, right head enlargement, asymmetric overgrowth of the right upper limb, kyphoscoliosis, left foot drop, and cribriform connective tissue nevi on the nose and the left foot. Radiological examinations demonstrated right calvarial hyperostosis, left external auditory canal hyperostosis and stenosis, and kyphoscoliosis. CT and MRI of both thighs showed diffuse enlargement of the left sciatic nerve starting from the upper thigh down to the mid-thigh and showing inter fascicular adipose tissue proliferation, giving the typical features of nerve lipomatosis.

Bilateral subdiaphragmatic kidneys with right-sided renal malrotation

Background The subdiaphragmatic kidney is a positional variant of the uncommon cephalad renal ectopia, whereas renal malrotation refers to the anomalous renal hilar position. Both anomalies are rare, possibly under-reported, discovered incidentally on radiological examinations since patients are often asymptomatic. Case presentation This case report presents a unique renal anatomical variation in a 71-year-old female patient. A bilateral subdiaphragmatic renal ectopia coupled with right-sided renal malrotation, discovered accidentally on abdominal ultrasound (US), and confirmed by abdominal magnetic resonance imaging (MRI). Conclusions The presented case of bilateral subdiaphragmatic kidneys associated with right-sided renal malrotation is rare and not previously described in the literature. Radiologists must be familiar with these renal anomalies that can be discovered on imaging performed for other indications. MRI can provide more anatomical data compared to US.

Infected Facial Tissue Fillers Caused by Dental Infection

Injectable dermal fillers are widely used for facial rejuvenation; they help reshape the facial contours by treating volume loss due to aging changes. Facial fillers may become infected following a dental infection. In this report, we present a case of a 44-year-old female patient who presented with a swelling in her upper right buccal region following dental treatment of her second maxillary right premolar. After a thorough history, clinical, and radiological examinations, the diagnosis of infected dermal filler was made. The lesion was treated by association of two antibiotics (ciprofloxacin IM and clindamycin tablets 300 mg), and a complete healing was observed two months after the end of the dental treatments.

What can we learn from the SARS-COV-2 pandemic about the value of specific radiological examinations?

Background The SARS-COV-2 pandemic provides a natural intervention to assess practical priority setting and internal evaluation of specific health services, such as radiological services. Norway makes an excellent case as it had a very low infection rate and very few cases of COVID-19. Accordingly, the objective of this study is to use the changes in performed outpatient radiological examinations during the first stages of the SARS-COV-2 pandemic to assess the practical evaluation of specific radiological examinations in Norway. Methods Data was collected retrospectively from the Norwegian Health Economics Administration (HELFO) in the years 2015–2020. Data included the number of performed outpatient imaging examinations at public hospitals and private imaging centers in Norway and was divided in to three periods based on the level of restrictions on elective health services. Results were analyzed with descriptive statistics. Results In the first period there was a 45% reduction in outpatient radiology compared to the same time period in 2015–2019 while in period 2 and 3 there was a 25 and 6% reduction respectively. The study identified a list of specific potential low-value radiological examinations. While some of these are covered by the Choosing Wisely campaign, others are not. Conclusion By studying the priority setting practice during the initial phases of the pandemic this study identifies a set of potential low value radiological examinations during the initial phases of the SARS-COV-2 pandemic. These examinations are candidates for closer assessments for health services quality improvement.