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Objective: Radiotherapy may alter the normal morphology of salivary glands located in the radiation field. These changes could be evaluated safely by sonography; however, there have been few studies in this regard. This study is aimed at evaluating the sonographic changes of the parotid and submandibular glands in patients undergoing radiotherapy for head and neck malignancies. Methods: 20 patients (16 males and 4 females) with head and neck malignancies who had been referred for radiotherapy to the Qaem Hospital in Mashhad, Iran, entered the study. Length, height, depth, echotexture, echogenicity and margins of parotid and submandibular glands were evaluated in three stages (I, before radiotherapy; II, 2 weeks after radiotherapy; and III, 6-7 weeks after radiotherapy) using sonography. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) were also evaluated by Doppler sonography. Results: Significant differences in length, height and depth (p 5 0.000, p 5 0.000, and p 5 0.39, respectively) and also echotexture, echogenicity and gland margins (p 5 0.000) were observed before and after radiotherapy. Doppler sonography results showed no significant differences regarding PSV, EDV and RI between sonographic stages. Echotexture and echogenicity were the only independent parameters that showed significant differences in sonographic stages I and II (p 5 0.000). Length in stage I and II (p 5 0.000) and echogenicity in stage III (p 5 0.038) were the only parameters that showed significant differences between the two glands. Conclusion: Radiotherapy may change the echotexture, echogenicity and margins of the salivary glands from homogenic to heterogenic, hyperechoic to hypoechoic and regular to irregular, respectively, and may reduce their size.

PurposeThis study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT).Materials and MethodsIn the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined.ResultsThe mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group.ConclusionThe average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.

Aim:The purpose of this laboratory research was to compare the accuracy of digital and conventional bitewing radiographs in the diagnosis of recurrent caries under class II amalgam restorations. Methods and Materials:This study involved 82 posterior intact teeth in which class II amalgam boxes were prepared. Carious lesions were simulated in half of the proximal boxes in the intersection between the facial or lingual wall and the gingival floor or midway between the facial and lingual walls. The other half of each tooth specimen served as a control. The prepared boxes were then restored with a Tytin FC (Kerr, USA) amalgam. The teeth were radiographed in the bucco-lingual direction to obtain images comparable to bitewing. Digital radiographs made with an intraoral CCD sensor and conventional radiography with dental E film were used. Three expert observers evaluated both types of images for the diagnosis of recurrent caries.Results: Sensitivity and specificity values for direct digital radiography were 73 and 95 percent at the buccal and lingual line angles, respectively, and 29 and 90 percent at the mid-gingival floor, respectively. These corresponding values for conventional radiography were respectively 63 and 93 percent at the buccal line angle, 61 and 93 percent at the lingual line angle, and 44 and 95 percent at the mid-gingival floor. The total sensitivity and specificity values were 58 and 93 percent for digital radiography and 56 and 93 percent for conventional radiography. The overall accuracy was 76 percent for digital and 75 percent for conventional radiography. No significant difference in specificity or sensitivity was found between the digital and conventional radiography (p=0.104). Separately, no significant difference was seen between the buccal line angle and the mid-gingival floor, but a significant difference was seen between the two methods in the lingual line angle (p=0.004). Conclusion:The digital and conventional bitewing radiographs had similar diagnostic accuracy for the diagnosis of recurrent caries. Lesions located at the buccal or lingual line angle were more easily detected than those at the mid-gingival region.Clinical Significance: Although there was no significant difference between digital and conventional radiography in the diagnosis of recurrent caries, digital radiography requires less ionizing radiation, making this method of imaging suggested for routine dental practice.

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