Proteus syndrome is a rare disorder with progressive asymmetrical and disproportionate overgrowth of various tissues of the body. The syndrome is characterized by a wide range of malformations, including craniofacial deformities. Extraoral examination revealed several of the classical craniofacial features of Proteus syndrome: pronounced hemifacial hypertrophy, macrodactyly and hyperostosis. Intraoral examination revealed a high arched palate and gingival hyperplasia. Other findings were unilateral enlargement of the tongue, alveolar growth and dilaceration of the roots of the teeth. There were severe degenerative changes and deformities in the left temporomandibular joint but the oversized condyle was asymptomatic; there was no pain, limitation and deviation at mouth opening. Treatment was not necessary owing to the asymptomatic situation but periodic follow-up with clinical and radiographic examination was considered. The aim of this article is to describe the radiographic manifestations of an asymptomatic condyle malformation and other craniofacial, oral and dental findings in a 33-year-old female patient with known Proteus syndrome.
PurposeDetecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard.Materials and MethodsA total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance.ResultsEighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively.ConclusionIn most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.
Eagle's syndrome (ES), also known as the stylohyoid syndrome, is defined as the elongation of a styloid process by more than 30 mm and the mineralization of the stylohyoid-stylomandibular ligament. Two types of ES are described in the literature: classical stylohyoid syndrome and vascular stylocarotid syndrome. While bilateral ES is commonly seen in women, the symptoms are usually unilateral. This case report describes the surgical treatment of a 45-year-old female patient with bilaterally-elongated styloid processes who presented with vascular ES symptoms. A literature review is also included.
ÖZETEagle Sendromu (ES) veya Stilohyoid Sendromu, stiloid prosesin 30 mm'den fazla uzaması ve stilohyoid-stilomandibular ligamentin mineralizasyonu olarak tanımlanmaktadır. Literatürde iki ES formu tanımlanmaktadır. Bunlar klasik tip stilohyoid sendrom ve vasküler tip stilokarotid sendromudur. ES sıklıkla kadınlarda ve bilateral olarak görülürken, belirtiler genellikle tek taraflıdır. Bu olguda bilateral olarak uzamış stiloid prosesi olan ve Eagle tipi sendromun vasküler tipini destekleyen semptomlarla başvuran 45 yaşında bir kadın hasta ele alınmış ve ilgili literatür sunulmuştur.
[Abstract in English is at the end of the manuscript]
GİRİŞDiş kaybı prevalansı son 50 yılda pek çok endüstri ül-kesinde azalma göstermiş olmakla birlikte, 1 gelişmek-te olan ülkelerde özellikle 65 yaş ve üstünde bu oran hala yüksektir.2,3 Ülkemizde ise dişsizlik oranı 65-74 yaş grubunda %48 olarak bildirilmiştir. 4 Tam dişsizlik geçmişteki kadar sık görülmese de, hareketli protez ihtiyacı nedeniyle diş hekimine başvuran hasta sayısında azalma olmadığı belirtilmektedir.5 Bu durum, modern toplumda yaşam süresinin uzaması nedeniyle yaşlı popülasyonunun artmasına bağlanmaktadır.6,7 Bu veriler doğrultusunda günümüzde olduğu kadar gelecekte de hareketli protez uygulamalarına olan gereksinimin devam edeceği düşünülebilir.Hareketli protezler ile fonksiyonların rehabilitasyonu yaşam kalitesini artırmakta, ancak protezler ağız ortamını oral mukoza lezyonlarının gelişimine yatkın hale getirmektedir. 7,8 Buna bağlı olarak, oral mukoza lezyonlarının sıklığının hareketli protez kullanan hastalarda, kullanmayanlardan fazla olduğu çeşitli çalışmalarda bildirilmiştir.9-12 Hareketli protezle ilişkili oral mukoza lezyonları (POML), protez materyalinin yüzeyinde oluşan biyofilme veya protezin yapıldığı materyale reaksiyon olarak ya da hatalı/uyumsuz protezlerin dokuda oluşturduğu travmaya bağlı olarak oluşur. Protezlerin oral mukozayı örtmesi, travma, protezlerin uyumsuzluğu, hijyen yetersizliği, yıpranmış protezler, protezlerin devamlı kullanılması, protezlerin kullanım süresi POML için risk faktörlerini oluşturmaktadır. [13][14][15][16][17][18][19] Daha önce yapılmış çalışmalar hastaların büyük bir kısmının hijyen ve doku uyumu bakımından uygun olmayan protezleri
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