Diagnostic Imaging in Dentistry

Mel Mupparapu, DMD, MDS, Editor

For every technological innovation in Oral and Maxillofacial Radiology, we have hailed the change as stunning and revolutionary. Better visualization of anatomy has led to better diagnosis. We are now able to image an anatomical region of interest with some sense of understanding thanks to the technological innovations in the field of radiology, including computed tomography (CT), MRI, and radionuclide imaging, followed by PET, PET/CT, and PET/MR, and cone-beam computed tomography (CBCT). CBCT is a game changer for all dental practitioners as they are able to finally look at teeth, their supporting structures, and jaws three-dimensionally. Since the discovery of radiographs in 1895 by Wilhelm Conrad Röntgen, what we have been able to accomplish in this short 120-year period is amazing. We have been able to better understand the effects of radiation on the human body at every level, selectively use radiation for diagnostic as well as therapeutic purposes, and recognize the concepts of radiation safety in order to introduce better radiation hygiene measures. We are certainly in a safer world than our predecessors; thanks to them, we are more prudent in our methods as we have learned the lessons of radiation injury from each and every amputation that the early radiologists went through. Father of modern dentistry and early radiology in the United States, Dr Charles Edmund Kells (1856-1928) of New Orleans, Louisiana, paid with his life trying to understand the biological effects of radiation. Selective and prescriptive radiology based on the selection criteria, guidelines, dose reduction strategies, and awareness campaigns like Image Gently changed radiology for the better.

Diagnostic radiology is both challenging and rewarding. When I approached the associate publisher for Elsevier Clinical Solutions, John Vassallo, I had only one concern in my mind: How can I make the topics in diagnostic dental radiology more interesting for students, residents, and practicing dentists? What insights can I provide the readers to make a topic more interesting? My mentor and former chair of Radiology at Penn Dental Medicine, the late Dr Bob Beideman, taught me the philosophy of being a good educator. His knowledge and love for radiology and his kindness always inspired me. For this issue, I knew that the study of diagnostic imaging should have an overview with current developments in the field of oral and maxillofacial imaging. I hope that my colleague, Dr Christine Nadeau from the Université Laval, and I were able to present a comprehensive treatise. The issue would not be complete without an article on the developmental disturbances. Dr Ghada AlZamel from the King Abdulaziz Medical City-Dental Center, Riyadh and Dr Scott Odell from Penn Dental Medicine aided me in authoring an extensive review on the anomalies related to teeth and jaws. We also hope that the tables come in handy for a quick look-up for syndromes of the head and neck. Learning radiology of periodontal diseases is an integral component in becoming an astute diagnostician. I teamed up with Drs Jon Korostoff, Ali Aratsu, and Brian Kasten from the Department of Periodontology at Penn Dental Medicine to present the readers with a comprehensive review of the radiology of periodontal diseases. I could not have gone to better experts than my colleagues, Drs Mansur Ahmad and Eric Schiffman from the University of Minnesota, for an article on temporomandibular disorders (TMD) and orofacial pain. They spearheaded and published the Research Diagnostic Criteria for TMD and the development of image analysis criteria that led to better understanding of TMD diagnosis. The article on benign lesions was written by my esteemed colleague from Boston University, Dr Anita Gohel, and her associates, Drs Osamu Sakai and Alessandro Villa. My colleagues from the Rutgers School of Dental Medicine, Drs Steven Singer and Adriana Creanga, undertook the arduous task of writing an article on cancerous lesions of jaws, a topic that is very difficult to condense due to the wealth of information available on the subject. They did a marvelous job in presenting the relevant material to the readers. There is one topic that most dental practitioners and specialists alike have a hard time understanding due to the ambiguous nature of the disease process and its variations—the benign fibro-osseous lesions of the jaws. My colleagues from Loma Linda University, Drs Ken Abramovitch and Dwight Rice, did a phenomenal job in comprehensively presenting the pathognomonic radiographic features to the audience by using pertinent radiographic images. My frequent trips to India as a visiting professor to the Sibar Institute of Dental Sciences fostered a valued friendship with my colleagues, Drs Baddam Venkat Ramana Reddy, Kiran Kuruba, and Samatha Yalamanchili, who helped me report the material on granulomatous lesions affecting the jaws. Drs Art Kuperstein and Tom Berardi from Penn Dental Medicine assisted me with writing the article on systemic diseases affecting jaws; a large majority of the lesions in this article were observed firsthand in the admissions clinic of Penn Dental Medicine. Finally, the issue would not be complete without the masterful writing skills of my colleagues from Penn Dental Medicine, Drs Sunday Akintoye and Temitope Omolehinwa, who presented the material on chemical and radiation-associated jaw lesions. I would like to thank the many contributors who readily shared their images for this publication, especially Dr Mansur Ahmad from Minnesota, Dr Elena Kurtz from Philadelphia, Dr Maano Milles from Newark, Drs Carl Bouchard and Joanne Ethier from Canada, and Dr Adrian Creanga from Romania.

This issue would not have been possible without the help and support from the associate publisher, John Vassallo, developmental editor, Kristen Helm, and journal manager, Joseph Daniel, along with several other members of the Elsevier staff. My sincere appreciation goes to the Department of Oral Medicine administrative staff, Hazel Dean and Umme Jahani, and my Radiology clinic staff, Carol Walsh, Karen McAdoo Wong, and Roseanne Butts, for accommodating my scheduling conflicts while I was authoring this issue.

I would like to thank my wife, Anitha, and my children, Vamsee and Archana, for putting up with me when I was burning the midnight oil or denying them a promised road trip so that I could catch up with writing my articles. I can say with certainty that this would not have been possible without their patience, understanding, and appreciation of my love to teach and share.

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Oct 28, 2016 | Posted by in General Dentistry | Comments Off on Diagnostic Imaging in Dentistry
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