Incidental Finding of an Extensive Oropharyngeal Mass in Magnetic Resonance Imaging of a Patient With Temporomandibular Disorder: A Case Report

In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain

Jaw pain secondary to atypical maxillary torus near the incisive canal: A cone beam computed tomography study

Pain in the anterior maxilla can be odontogenic or nonodontogenic. If it is not related to the teeth, then the differential diagnosis is based on a clinical exam, radiographic exam, and often, on advanced imaging. This case report is based on a 58-year-old male with a chief complaint of chronic pain with acute exacerbations in the region of the rugae of the maxillary central incisors. Clinical examination and planar radiography led to the suspicion of a cyst in the region of the incisive foramen. The patient was referred for advanced imaging. Cone beam computed tomography imaging confirmed the presence of an unusual tori in the region of the incisive foramen that led to periodic inflammation in the region. A differential diagnosis of the pain included pain secondary to a localized inflammation of the incisive canal and nasopalatine duct, and an inflammation of the soft tissue interdental col in the region of the central incisors as well as the benign and malignant minor salivary gland tumors. Because the rugae is attached to the palate, any expansion of the soft tissues in this region causes pain that must be diagnosed accurately to treat the cause

Diagnosis and management of late onset osteoradionecrosis of the mandible

Osteoradionecrosis (ORN) is frequently encountered in clinical dental practice. The identification and management of such a lesion is often challenging. This clinical report is based on a patient who had radiation therapy to the head and neck region for a salivary gland malignancy. The patient developed ORN of the mandible 12 years later. This demonstrates the need to understand the pathophysiology of this condition better than we currently know

Florid expansile cemento-osseous dysplasia of the jaws: Cone beam computed tomography study and review of the literature

An interesting case of florid expansile cemento-osseous dysplasia (FECOD) of the maxilla and mandible in a 36-year-old female is being presented. The patient presented for consultation for orthognathic surgery and was unaware of these lesions. Upon clinical and radiographic examination, including cone beam computed tomography, massive cemento-osseous lesions in all quadrants were observed. The radiographic appearance of the lesions was consistent with cemento-osseous dysplasia (COD), the key difference being extreme expansion. Expansion, although not a new phenomenon, is present in all quadrants. These radiographic features suggest a variation of florid cemento-osseous dysplasia and is more aptly termed FECOD. This name is proposed for its diagnostic relevance based on the radiographic features. As with similar CODs, unless the lesions are disfiguring, conservative management is the preferred approach. Biopsy was not indicated unless there are additional associated complications. A detailed review of the pertinent literature was undertaken

Vaccination induced complacency in adherence to COVID-19 precautionary measures among oral health care professionals in India and the United States: a retrospective pretest-posttest design

In the context of the COVID-19 pandemic, vaccination-induced behavioral complacency in adherence to COVID-19 appropriate behavior emerged as a significant concern. This study was conducted among a convenience sample of 540 oral health care professionals in India and the United States. This was a retrospective pretest-post-test design, a choice to eliminate response-shift bias, where the participants responded online on their adherence or otherwise to COVID-19 precautionary measures before and after vaccination. The difference between post-test and retrospective pretest scores was used in assessing the magnitude of complacency demonstrated by the individual as a function of getting vaccinated, and the process was validated using exploratory factor analysis (EFA) with principal axis factoring and confirmatory factor analysis (CFA) on two randomly split subsets of the overall sample. It was observed that there had been a decline in the adherence to all the considered COVID-19 precautionary measures from the time before vaccination to the time of achievement of the fully vaccinated status. EFA performed on the randomly split sub sample of 240 subjects returned a two factor solution with five items in factor 1 and seven items in factor 2. Items in both the factors demonstrated adequate internal consistency in reliability analysis (Cronbach’s alpha 0.84 and 0.82, respectively). The two factor solution obtained in EFA demonstrated good model fit in CFA [RMSEA (90%CI) – 0.077 (0.063–0.092); TLI – 0.872; CFI – 0.897; SRMR – 0.056]. These results highlight the vaccination-induced complacency in observing COVID-19 appropriate behavior among oral health professionals in India and the United States

Presentation of cysticercosis of the lateral pterygoid muscle as temporomandibular disorder: A diagnostic and therapeutic challenge

Orofacial pain can often be the chief complaint of many systemic disorders. Cysticercosis involving the lateral pterygoids may cause limitation of mouth opening and may mimic clinical symptoms of a temporomandibular disorder. A 37-year-old female presented with 1-month-old complaint of limited mandibular range of motion. She reported a similar episode a year earlier and was diagnosed with a temporomandibular joint disorder by her primary dentist. Comprehensive intra- and extra-oral examinations were performed, which revealed a limitation of mouth opening accompanied by mild limitation of contralateral excursion. A magnetic resonance imaging revealed a ring-enhancing lesion within the left pterygoid muscle suggestive of cysticercosis. The patient was referred to her primary care physician for further treatment and given physical therapy (stretching exercises) to improve mouth opening. One week later, she developed lesions in the arm and trunk. Further ultrasound imaging of the abdomen and the forearms confirmed the diagnosis of cysticercosis. She was treated with albendazole, physiotherapy, joint stabilization appliance, and had eventual complete recovery. This case emphasizes the importance of diagnosis of a systemic condition that may have serious implications, if untreated, and the importance of a comprehensive evaluation, workup, and multidisciplinary management