BackgroundThe study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain.MethodsFifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test.ResultsThere was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy.ConclusionsIn the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain.

AIM: The present study aimed at evaluating the role of mental foramen and mandibular canal in gender determination using CBCT.METHODOLOGY: A total number of 73 volumes of CBCT of the mandible was evaluated. Four measurements were used to assess the bucco-lingual and supero-inferior location of mandibular canal and the supero-inferior location of mental foramen was determined using two measurements on both right and left sides of the mandible. Inter and intra-observer variability was analyzed with help of t-test.RESULTS: Good intra-observer and inter-observer agreement was noted with regard to all the six measurements. The mean of all the measurements of mental nerve foramen and mandibular canal was found to be higher in males than females, however, significant difference was noted with regard to Superior Mental foramen (SMeF) and Superior Inferior Alveolar Canal (SMC) (p=0.037, p<0.001 respectively) on the right side and SIAC and Inferior Inferior Alveolar Canal (IIAC), (p=0.015, p=0.046 respectively) on the left side.CONCLUSION: The results of the present study suggest that SMeF, SIAC and IIAC may be used for gender determination. Further, either side of mandible can be used for this purpose. CBCT was found to be a useful modality in this study for sexual dimorphism.

The term paradental cysts (PC) was first introduced by Craig in 1976 and is described as "A cyst of uncertain origin found primarily on the distal or facial aspect of a vital mandibular third molar, consisting of intensely inflamed connective tissue and epithelial lining." It is included in the group of rare lesions constituting 1-5% of all odontogenic cysts. PC is often associated with mandibular third molars and less frequently, with the second and first molars and rarely with premolars or canines/incisors. Not many cases of PC have been reported in maxillary teeth. The PC has been misdiagnosed as dentigerous cyst, lateral radicular cyst, pericoronal abscess, or some other entity related to the inflammatory conditions of the dental follicle. Lesions like dentigerous cyst may transform to an ameloblastoma, squamous cell carcinoma, or mucoepidermoid carcinoma which requires moderate to extensive surgical interventions with varied prognosis. Lateral radicular cyst and pericoronal abscess require minimal intervention. On the other hand, the topography, behavior, and clinical management are different with a better prognosis for PC. Therefore, it is important to diagnose PC by correlating the radiographic and histologic findings from other entities.

Vascular malformations (VMs) are congenital anomalies of the capillary, venous, lymphatic, and arterial system. They may be distinguished from vasoproliferative tumors (hemangiomas) which present with increased endothelial cell turnover, whereas VMs are structural anomalies of vessels without endothelial cell proliferation. VMs, in general, occur in superficial areas such as lips, tongue, and buccal mucosa, and an intramuscular location is quite rare. An intra-massetric location may be mistaken for a parotid swelling and may also pose problems in terms of proximity to facial nerve. One such rare case of intra-massetric VM occurring in a 23-year-old female with an unusual clinical presentation is being presented in this case report. The patient complained of a swelling associated with pain on her right cheek since 9 months. The swelling develops only when her head and torso is bent to 90° or more for at least 5-10 min and gradually disappears on attaining an upright posture (turkey wattle sign). Color Doppler ultrasonographic findings were suggestive of a VM. The lesion was excised under general anesthesia and was sent for histopathologic evaluation which was suggestive of an intramuscular hemangioma/ malformation. The patient did not develop any post-operative complications and had recovered well after the surgery.