Stomatitis migrans. Manifestation der Lingua geographica an untypischen Stellen der Mundschleimhaut

Die stomatitis migrans ist eine oft beobachtete benigne Normvariante der Mundschleimhaut mit einer Prävalenz von 1.0–2.5%, wobei sie bei jungen Erwachsenen deutlich höher ist. Frauen sind häufiger betroffen. Die Ätiologie ist unbekannt, kommt aber in gleichen Familien gehäuft vor. Klinisch zeigen sich demarkierte, erythematöse Areale, die teilweise von einem gelblichen Saum umrandet sind

Incidental findings in cone beam computed tomography (CBCT) scans for implant treatment planning: a retrospective study of 404 CBCT scans.

OBJECTIVES To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning. METHODS 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age ( 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated. RESULTS In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p  60 years (OR = 5.37 patient's age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805). CONCLUSIONS A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings

Localization of impacted maxillary canines and root resorption of neighbouring teeth: a study assessing the diagnostic value of panoramic radiographs in two groups of observers

SUMMARYOBJECTIVES: To assess the diagnostic value of panoramic views (2D) of patients with impacted maxillary canines by a group of trained orthodontists and oral surgeons, and to quantify the subjective need and reasons for further three-dimensional (3D) imaging. MATERIALS AND METHODS: The study comprises 60 patients with panoramic radiographs (2D) and cone beam computed tomography (CBCT) scans (3D), and a total of 72 impacted canines. Data from a standardized questionnaire were compared within (intragroup) and between (intergroup) a group of orthodontists and oral surgeons to assess possible correlations and differences. Furthermore, the questionnaire data were compared with the findings from the CBCT scans to estimate the correlation within and between the two specialties. Finally, the need and reasons for further 3D imaging was analysed for both groups. RESULTS: When comparing questionnaire data with the analysis of the respective CBCT scans, orthodontists showed probability (Pr) values ranging from 0.443 to 0.943. Oral surgeons exhibited Pr values from 0.191 to 0.946. Statistically significant differences were found for the labiopalatal location of the impacted maxillary canine (P = 0.04), indicating a higher correlation in the orthodontist group. The most frequent reason mentioned for the further need of 3D analysis was the labiopalatal location of the impacted canines. Oral surgeons were more in favour of performing further 3D imaging (P = 0.04). CONCLUSIONS: Orthodontists were more likely to diagnose the exact labiopalatal position of impacted maxillary canines when using panoramic views only. Generally, oral surgeons more often indicated the need for further 3D imagin

Morphologic characteristics, location, and associated complications of maxillary and mandibular supernumerary teeth as evaluated using cone beam computed tomography

SUMMARYOBJECTIVES: To evaluate the location and morphologic characteristics of supernumerary teeth and to assess the frequency and extent of root resorption of adjacent teeth using cone beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT scans of 82 patients with supernumerary teeth in the maxilla and mandible were evaluated by two orthodontists independently. Data regarding the type, shape, and three-dimensional (3D) location of the supernumeraries including the frequency and extent of root resorption of adjacent teeth were recorded and evaluated for possible associations. RESULTS: The study comprised a total of 101 supernumerary teeth. Most of the patients (80.5 per cent) exhibited one single supernumerary tooth, while 15.8 per cent had two and 3.7 per cent had three supernumeraries. Males were affected more than females with a ratio of 1.65:1. Mesiodentes were the most frequently diagnosed type of supernumerary teeth (48.52 per cent), followed by supernumerary premolars (23.76 per cent) and lateral incisors (18.81 per cent). Supernumeraries were most commonly conical in shape (42.6 per cent) with a normal or inclined vertical position (61.4 per cent). Root resorption of adjacent teeth was detected for 22.8 per cent of the supernumerary teeth, most frequently for supernumerary premolars. There was a significant association between root resorption of adjacent teeth and type and shape of tooth. Interrater agreement for the measurements performed showed kappa values ranging from 0.55 to 1 with a kappa value of 1 for type and shape of the supernumerary teeth. CONCLUSIONS: CBCT provides 3D information about location and shape of supernumerary teeth as well as prevalence and degree of root resorption of neighbouring teeth with moderate to high interrater correlatio

Significant benefits of AIP testing and clinical screening in familial isolated and young-onset pituitary tumors

Context Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs). Objective To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients. Design 12-year prospective, observational study. Participants & Setting We studied probands and family members of FIPA kindreds and sporadic patients with disease onset ≤18 years or macroadenomas with onset ≤30 years (n = 1477). This was a collaborative study conducted at referral centers for pituitary diseases. Interventions & Outcome AIP testing and clinical screening for pituitary disease. Comparison of characteristics of prospectively diagnosed (n = 22) vs clinically presenting AIPmut PitNET patients (n = 145), and AIPmut (n = 167) vs AIPneg PitNET patients (n = 1310). Results Prospectively diagnosed AIPmut PitNET patients had smaller lesions with less suprasellar extension or cavernous sinus invasion and required fewer treatments with fewer operations and no radiotherapy compared with clinically presenting cases; there were fewer cases with active disease and hypopituitarism at last follow-up. When comparing AIPmut and AIPneg cases, AIPmut patients were more often males, younger, more often had GH excess, pituitary apoplexy, suprasellar extension, and more patients required multimodal therapy, including radiotherapy. AIPmut patients (n = 136) with GH excess were taller than AIPneg counterparts (n = 650). Conclusions Prospectively diagnosed AIPmut patients show better outcomes than clinically presenting cases, demonstrating the benefits of genetic and clinical screening. AIP-related pituitary disease has a wide spectrum ranging from aggressively growing lesions to stable or indolent disease course

L’érythème exsudatif multiforme (ou érythème polymorphe)

L’érythème exsudatif multiforme (EEM) ou érythème polymorphe (EP) est une inflammation de la peau et/ou des muqueuses (forme mineure ou majeure), d’apparition soudaine. Typiquement, elle atteint de jeunes adultes de sexe masculin et en bonne santé.L’érythème exsudatif multiforme (EEM) ou érythème polymorphe (EP) est une inflammation de la peau et/ou des muqueuses (forme mineure ou majeure), d’apparition soudaine. Typiquement, elle atteint de jeunes adultes de sexe masculin et en bonne santé. Tout d’abord, et parfois exclusivement, les lèvres sont affectées. Les muqueuses de la joue, de la gencive et de la langue peuvent également être atteintes. Plus rarement, les lésions intraorales se situent également sur le palais dur et mou et le plancher buccal. Les patients rapportent des douleurs intenses en mangeant, à la déglutition et en parlant. En général, le tableau clinique est suffisamment caractéristique pour poser le diagnostic et l’examen histopathologique n’est pas nécessaire

Non‐infective Swellings: Cysts, Tumours and Ranulas

Introduction Swellings can appear extraorally, intraorally or in combination. If infectious origins have been excluded, non‐infectious swellings can be caused by either benign or malign processes. Benign processes are far more common in children, but it is important to identify the rare malignant entities without delay. Besides a structured clinical examination, further diagnostic tools can be applied, and clinicians have to decide which are the most appropriate for the situation at hand. Radiographic imaging representing hard or soft tissues can help identify the origin and nature of a swelling. Probe aspiration may help identify the fluid content and differentiate a swelling from a solid tumour. Incisional or excisional biopsies are further options for diagnosis and treatment planning, and may even be performed simultaneously with therapy

Dysplasie osseuse: présentation d’une découverte radiologique fortuite

Les dysplasies osseuses (DO, anciennement appelées dysplasies cémento-osseuses) sont des altérations idiopathiques dans la région de la crête alvéolaire portant les dents. La structure osseuse normale est remplacée par des fibroblastes et des fibres de collagène, et plus tard par du tissu minéralisé et de l’os. Selon la classification actuelle de l’OMS, les DO font partie des lésions associées à l’os, respective- ment des lésions fibro-osseuses non néopla- siques de la région de la tête et du cou.Les dysplasies osseuses (DO, anciennement appelées dysplasies cémento-osseuses) sont des altérations idiopathiques dans la région de la crête alvéolaire portant les dents. La structure osseuse normale est remplacée par des fibroblastes et des fibres de collagène, et plus tard par du tissu minéralisé et de l’os. Selon la classification actuelle de l’OMS, les DO font partie des lésions associées à l’os, respective- ment des lésions fibro-osseuses non néoplasiques de la région de la tête et du cou

Osseous dysplasia: an incidental radiological finding

Ossäre Dysplasien (OD; frühere Bezeichnung: zemento-ossäre Dysplasien) sind idiopathische Veränderungen im Bereich des zahntragenden Alveolarfortsatzes. Die normale Knochenstruktur wird dabei durch Fibroblasten und Kollagenfasern und später wieder durch mineralisiertes Gewebe und Knochen ersetzt. OD werden in der aktuellen WHO- Klassifikation bei den Knochen-assoziierten Läsionen, respektive bei den nicht neoplastischen, fibro-ossären Läsionen des Kopf-Hals- Bereichs eingeteilt.Osseous dysplasias (OD; formerly known as cemento-osseous dysplasias) are idiopathic changes in the area of the tooth-bearing alveolar process. The normal bone structure is replaced by fibroblasts and collagen fibres and later by mineralized tissue and bone. In the current WHO classification, ODs are categorized as bone-associated lesions or non-neoplastic, fibro-osseous lesions of the head and neck region

Prominent osteolysis in the maxilla: case report of an odontogenic fibroma mimicking a cyst

Abstract Background Odontogenic fibroma (OF) is a rare benign odontogenic tumor of ectomesenchymal origin, mostly affecting the tooth-bearing portions of the jaws in middle-aged patients. Whilst small lesions tend to be clinically asymptomatic, varying unspecific clinical symptoms occur with an increase in size and may mimic odontogenic or other maxillofacial bone tumors, cysts, or fibro-osseous lesions of the jaws. Case presentation A 31-year-old female patient presented with a hard, non-fluctuating protrusion in the vestibule of the upper right maxilla. It was visualized on cone beam computed tomography (CBCT) as space-occupying osteolysis with the displacement of the floor and facial wall of the maxillary sinus, mimicking a cyst-like lesion. The tissue was surgically removed and identified as an OF in the histopathological examination. One year after the surgery, restitution of regular sinus anatomy and physiological intraoral findings were observed. Conclusions This case report emphasizes that rare entities, like the maxillary OF presented, often demonstrate nonspecific clinical and radiological findings. Nevertheless, clinicians need to consider rare entities as possible differential diagnoses and plan the treatment accordingly. Histopathological examination is essential to conclude the diagnosis. OF rarely recur after proper enucleation