Oral & Maxillofacial Imaging Techniques Shivlal M Rawlani, Shobha S Rawlani
INDEX
Page numbers followed by f to figure respectively
A
Angiography 89, 172
Angle of mandible 18f
Anterior
body of mandible 26
displacement of disk
with reduction 99
without reduction 99
Arthrography 4, 91, 124
Arthroscopy 4, 101
Articular disk 192f
Autoimmune disease 117
B
Bartholin's duct 82
Basic rules of scanning 158
Bisecting line angle technique 11, 19
Body of mandible 18f
Bone scanning 110, 115
Bowman's or Liebreich's graduated lacrimal probe 80
Bridge of nose 18f
Buccal object rules 22
C
Caldwell projection 29, 31f
Capsule penetration instrument 103
Cardiovascular imaging 110
CBCT image production 73
Charge-coupled devices 59, 136, 142
Chronic sialadenitis 87f
Cieszynski rule 11
Clerks rule 22
Color Doppler 168, 169f
ultrasound 166, 168
Component of MR system 180f
Computed
radiography 2
system 142
tomography 2, 3, 59, 64, 68, 77, 120, 122, 139, 148
Cone beam
computed tomography 72, 120, 122
imaging 74, 76
Continuous
infusion pressure-monitored technique 81
wave Doppler unit 168
Contrast media in arteriography 90
Conventional radiographic techniques 3
Corner of mouth 18f
CT guided biopsy techniques 71
D
Darkroom techniques 57
Denoptix processing unit 150f
Dental
applications of ultrasonography 165
X-ray machine with specific timer 131
Digital subtraction radiography 126, 127, 172
Digora FMX system 133f, 150f
Direction of central beam 2629, 31, 32, 34, 36, 37, 3943, 4549
Display processing units 132
Doppler ultrasound 166, 167f
Double contrast
arthrography 97, 98f
arthrotomography 96
Duplex Doppler US 166, 169, 169f
E
Echocardiography 172
Elastography 166, 173
Electromagnets 182f
Encapsulated air bubbles 170
Evaluation of facial trauma 75
Extraoral
radiography 23
source of radiation 51
F
Fetal heart 157f
First generation CT scanner 66f
Fitzgerald technique 7
Flash-Dent system 142
Focus of transducer 161f
G
Geometry of cone beam 72f
Gradient
coils 183, 184f
recalled sequences 188
Granger projection 29
H
Head coil 183f
Hybrid arrays 166, 173
Hydrostatic technique 81
Hyperparathyroidism 47, 48
I
Inclined posteroanterior projection 29, 30
Installation of drainage catheter 171
Integrated systems digital networks 143
Intraoral
localization techniques 21
radiographic technique 5
sensor 132, 132f
source of radiation 49
Ionizing imaging techniques 3
L
Lateral cephalogram 44
Long cone technique 10
M
Magnetic resonance imaging 2, 4, 59, 120, 125, 148, 174
Mandibular
anterior region 14f
projection 17, 19
teeth 18f
Maxillary
molar region 14f, 15f
teeth 18f
McQueen dell technique 38
Midpoint of infraorbital margin 18f
Modified
occipitomental projection 33f
submentovertex projection 43f
MR
imaging 179
signal intensities 188
machines 186
technique 190
Multiple myeloma 47, 48
N
Nonencapsulated air bubbles 170
Nonionizing imaging techniques 4
Normal
bone scanning image 116f
MRI anatomy of TMJ 188
sialographic appearance of
parotid gland 84f
submandibular gland 84f
TMJ arthrogram 98
Nuclear medicine 4, 110
imaging 59
O
Occipitofrontal projection of nasal sinuses 29
Outer canthus of eye 18f
P
Paget's disease 47, 48
Paralleling technique 7
Periapical, occlusal and panoramic techniques 135
Permanent
magnets 181, 182f
recording of image 162
Photostimulable phosphor radiography 4, 148, 153
Placement of X-ray film 8
Position of transducer 159f
Positron emission tomography 110, 112, 118, 148
Posterior body of mandible 27, 28f
Posteroanterior
cephalogram 47
mandible 35
projection 29
of mandibular body and ramus 35
skull 47
Power Doppler 166, 170
Presurgical radiographic evaluation 135
Principles of
panoramic image formation 53
photostimulable phosphor radiography 148
Provide spatial localization of sign 183
Pulsed wave Doppler unit 168
R
Radiography of
base of skull 41
mandible 35
maxillary sinuses 31
temporomandibular joint 37
zygomatic arches 41
Radiovisiography 4, 131
system 142
Ramus of mandible 18, 28f
Resistive magnets 182f
Reverse Towne's projection 44f
Right angle technique 22
Rod lens system 102
Roentgenographic facsimile 141
Role of cone beam computed tomography 72, 122
Rule of isometry 11f
S
Sagittal plane of head perpendicular to floor 10f
Salivary gland 118
scanning 110, 117
Selfoscope lens system 102
Shoulder coil 183f
Sialoendoscopy 88, 89
Sialogram 85f, 86f
of normal submandibular gland 84f
Sialographic appearance of
calculi 84
intrinsic tumors 86
normal parotid gland 83
sialadenitis 85, 86
Sialography 4, 77, 78, 88
appearance of normal submandibular gland 84
Sialoscopy 4
Simple injection technique 80
Single
contrast arthrogram 93f
photon emission computed tomography 110
Sjögren's syndrome 86, 87f, 117
Snowstorm appearance of punctate sialectasis 87f
Soft tissue imaging 69
Solid instrument 103
Sonographic system and technique 155
Standard occipitomental projection 31, 32f
Submandibular gland 87f
Submentovertex projection 41
Superconducting magnets 181, 182f
Superimposition of structures 68
Superparamagnetic iron oxide 90
T
Technical staff monitoring transmission system 146f
Technique of
arthroscopy 107
sialography 79
Temporomandibular joint 24, 37, 75f, 101, 113f, 120
complex 61
diseases 91
imaging 4, 120
Therapeutic US 166, 173
TMJ articulation 18f
Tomographic techniques 139
Tomography 3, 59, 60, 121
Tomorex-panoramic unit 53f
Towne's projection 24, 48, 49f
Traditional lens system 102
Tragus of ear 18f
True lateral projection 46f
Types of
channels 143f
movement for pluridirectional tomography 61f
U
Ultrasonography 4
US
biomicroscopy 166, 173
guided
intervention 166
tumor ablation 171
U
Use of intraoral source of radiation 49
USG guided
core biopsy 171
FNAC 171
Using extraoral X-ray machine 40
V
Venous Doppler signal 170
Vertical angulation of X-ray tube head 15
W
Water soluble contrast media 79
X
X-ray beam limitation 76
Z
Zimmer projection 39
Zygomatic bone 18f
×
Chapter Notes

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1ORAL AND MAXILLOFACIAL IMAGING TECHNIQUES2
3ORAL AND MAXILLOFACIAL IMAGING TECHNIQUES
SHIVLAL M RAWLANI BDS MDS (Oral Medicine and Radiology) Associate Professor and Head Department of Dentistry Mahatma Gandhi Institute of Medical Sciences Sevagram, Wardha, Maharashtra, India Co-author SHOBHA S RAWLANI MBBS MS (Anatomy) Professor and Head Department of Anatomy Dr Panjabrao Deshmukh Memorial Medical College Amravati, Maharashtra, India Forewords VEDPRAKASH MISHRA P NARANG
4
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Oral and Maxillofacial Imaging Techniques
First Edition: 2014
9789350908464
Printed at
5Dedicated to
Our Beloved Parents
Mihomal H Rawlani
Smt Krishnabai M Rawlani
and
Our Children
Sudhir Rawlani
Sujata Rawlani
6
7Foreword
The initiative and the effort diligently articulated by Dr Shivlal M Rawlani, an Ex-Senior Faculty Member in the Department of Oral Medicine and Radiology at Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India, a constituent unit of Datta Meghe Institute of Medical Sciences (Deemed University), Nagpur, Maharashtra in bringing out a book titled Oral and Maxillofacial Imaging Techniques is exemplary at one end and genuinely praiseworthy at the other.
It is indeed an effort to compile all the relevant intellectual inputs on a significantly vital area and render them in such a free flowing manner, so that it is easy to understand, decipher, and assimilate by the learner, teacher, a professional and otherwise a reader as well.
This has been singularly achieved by the author by virtue of his writings, which are in easy textual format and are appropriately syntaxed, so as to render the desired grasp and sought after understanding of the subject in a handy but yet in an immaculate manner, which turns out to be the unique feature of this authorship, which makes it look and feel different from the other available reading material on the subject as of now.
It is, indeed, a fact that maxillofacial region is not only anatomically complex region of the human body, in as much as it has several elements and organs from the different systems that get affected by several pathological processes. The anatomical complexity makes it all the more difficult to diagnose the affecting pathologies exclusively on the basis of clinical skills. It is for this very reason, the aiding diagnostic tools turn out to be of huge significance and relevance of which ‘Diagnostic Imaging’ has earned a central place in evaluation of this region. Radiography per se has turned out to be one of the most significant diagnostic tools over a period of time, and now it is in routine usage for more than one reason if relevant.
It is an evident reality that for a very long time, the radiography film was the long and yet a very pertinent modality in the domain of diagnostic imaging. But the advent of technology at a very rapid pace in the context of electronic era has made a sea change, whereby several specialized techniques and instrumentations stand incorporated in the operational arena, which has now made it multifaceted.
The author has brought out all the imaging techniques in usage in a very deserving, appropriate, and chronologically lucid manner. The chapters' sequence vividly brings out the continuum from conventional radiography of yesteryears to the present-day magnetic imaging techniques with 8due incorporation of tomogrophy, computed tomography, sialography, sialoscopy, arthrography, arthroscopy, temporomandibular junction (TMJ) imaging, subtraction radiography, radiovisiography, implant radiology, teleradiography, photostimulable phosphor radiography collectively grouped under the ionizing imaging techniques and digital radiography, and ultrasonography as nonionizing imaging techniques in between.
Each of the radioimaging techniques has been dealt with in all the need-based relevant details that include description of the technique, their indications, contraindications, advantages, and limitations as well. As a matter of fact, the extent of coverage worked out by the author is indeed very vast but has been so well capsulated that it makes it poignantly a very interesting reading and learning material, as well.
I am sure that this elegant piece of scientific literature embodied in the book format by the author will make every user feel that he/she could avail all that he/she desired, needed, and expected out of it. I have no hesitation in putting on record my appreciation for the effort undertaken by the author in terms of a loud statement that he has generated a ‘satiety center’ for quenching the inquisitional thirst' in the domain of radioimaging techniques in dentistry.
Vedprakash Mishra md
Pro-Chancellor
Datta Meghe Institute of Medical Sciences
(Deemed University)
Nagpur, Maharashtra, India
9Foreword
Roentgen Wilhelm Conard was experimenting with the conduction of electricity in a vacuum tube when he noticed a strange fluorescence on a barium screen lying nearby. Further experiments indicated that the fluorescence was created by some invisible rays from the tube. These rays could also pass through substances that ordinary light could not penetrate and they could also affect the photographic film. Roentgen named these rays as X-rays, and they are also often called after the name of the discoverer. This occurred in 1895, and Roentgen received the world's first Nobel Prize in Physics in 1901.
Roentgen even in his remotest dream could not have ever imagined the revolution that his discovery was likely to bring about in the next hundred years not only in its fundamental application of physics but also in medical science. If any discovery has actually promoted the path of disease diagnosis in medicine by affecting the majority patients, it is the discovery of X-rays. Today, the explosive knowledge accumulated over the years has become so intricate and technically complex that it is almost beyond complete comprehension. Conventional radiography has given way to more sensitive modalities, such as the sonography, tomography, and electromagnetic radiography. These advances have also paved the way for intervention radiology, and unlike the statement made by Abraham Verghese quoted above; the radiologists are also now getting a chance to talk to the patients. However, there is a need to present these complexities in a more simple and comprehendible manner particularly for the uninitiated students. The authors, by bringing out this book have addressed these complexities in a simple intelligent manner without compromising with the essence and accuracy. They have stuck to their belief that any radiologists, whether in dentistry or in medicine, can only be good in interpreting the images if he/she understands the fundamental physics and basic principles of the equipment that he/she is using. Moreover, the 10basic principle of any diagnostic laboratory or unit is that the medical person venturing to interpret the results must first himself be a good technician. A medical radiologist must, along with other things, have full knowledge of technical details, such as positioning of the patient, amount and time of exposure, developing of films, nature of the dyes and contrasts used, and then only will he/she be able to photograph the correct target site. With the advent of nuclear medicine, radiology has entered into yet another arena of diagnosis giving the relevant definitions and the uses of positron emission tomography (PET), single-photon emission computed tomography (SPECT), and other techniques. The very fact that the authors have restricted to a small portion, i.e. maxillofacial imaging, is in itself an indicator that radioimaging and interpretation of every part has become a science in itself. Writing a story book or a novel depends on author's ability to imagine and fantasize. Authoring a technical and a professional volume requires knowledge, experience, and expertise.
Dr Shivlal M Rawlani with his vast experience as a teacher and community worker, along with Dr Shobha S Rawlani, has understood the difficulties of the budding radiologists and has, therefore, brought out this book that would be useful not only to students of dentistry but also to aspiring radiologists in medical schools.
The book is clinically relevant and practical to use. The chapters are straightforward, well illustrated, and the basics have been simplified, making the text easily understandable. I am sure that every individual who reads the book would like to possess it.
P Narang md
Dr BC Roy Awardee
Secretary
Kasturba Health Society
Director Professor
Department of Microbiology
Mahatma Gandhi Institute of Medical Sciences
Sevagram, Wardha, Maharashtra, India
11Preface
The book provides the basic knowledge of oral and maxillofacial imaging techniques used in dentistry, which is important for every student of dental and medical faculty and also preparing for entrance examination. The student undergoing postgraduation in Oral Medicine and Radiology, and Oral and Maxillofacial Surgery will also find this book very beneficial.
In this book, attempt has been made to introduce most of imaging techniques being used in dentistry under one platform in simple language, which include brief history, clinical implication, indications, contraindications, advantages, disadvantages, and complications of every technique.
As this is the first edition of the book, there may be few mistakes/errors in text, we will be very thankful to the teachers and the students for sending suggestions and drawing attention towards the errors.
Shivlal M Rawlani
Shobha S Rawlani
12
13Acknowledgments
I would like to thank:
Shivlal M Rawlani