Evaluation of Dimensional Accuracy of Panoramic Cross‐Sectional Tomography,Its Ability to Identify the Inferior Alveolar Canal,and Its Impact on Estimation of Appropriate Implant Dimensions in the Mandibular Posterior Region

Objectives: To evaluate the dimensional accuracy of panoramic cross‐sectional tomography, its impact on implant size estimation and its ability in identifying the inferior alveolar canal in the mandibular posterior region. Material and Methods: Eight partially edentulous mandibles with 18 edentulous sites were obtained. Orthopantomograms and tomograms were made and the mandible's outline and the position of mandibular canals on tomograms were traced on a clear acetate paper. Horizontal and vertical magnification factors were calculated. The mandibular height, distance between mandibular canal and alveolar crest, maximum bucco‐lingual width, distance between buccal cortex and mandibular canal, and cortical thickness at the inferior border of the mandible were measured. Potential implant sites were identified and implant sizes were estimated. Location and visibility of mandibular canals were also evaluated. The mandibles were sectioned at each site and all the above mentioned parameters were assessed which served as gold standard. Results: Mean horizontal and vertical magnification factors were 1.47 ± 0.048 and 1.53 ± 0.038. Total height and maximum bucco‐lingual width were underestimated by 1.88% and 1.59%. Crest to canal distance, cortical thickness at the inferior border of the mandible and buccal cortex to mandibular canal were overestimated by 0.59%, 5.16%, and 3.64%. Implant sizes were estimated for 11 sites and changes were recorded at 2 sites between record 1 and record 2. However, there was no disagreement between record 2 and record 3. Of the canals, 61.11% were located lingually and the visibility of mandibular canals was poor in 44.44% of cases. Conclusions: The tomograms were found to be accurate for the measurements in both horizontal and vertical planes and reliable for implant size estimation, taking into consideration proper magnification factors. They were also found to be useful in assessing the location of mandibular canal but were not very effective in discerning it.     

Le-fort I access osteotomy to nasopharyngeal tumor – A case-report

Removal of extensive central skull base and paranasal sinus tumors is a significant challenge that is often hampered by limited access and exposure. The safety and efficacy of the Le Fort I osteotomy approach to the skull base have been well established. The purpose of this article is to describe the use of Le fort-1I osteotomy as an access procedure to reach tumors in the nasopharyngeal region in a young patient. The large mass which he presented within the nasopharyngeal region, later diagnosed to be juvenile nasopharyngeal angiofibroma, posed a challenge for surgical access.     

Mycobacterium fortuitum skin infection as a complication of anabolic steroids: a rare case report

Mycobacterium fortuitum is a rare cause of recurrent skin abscesses in an immunocompetent person. We report the case of a 37-year-old man presenting with multiple recurrent non-healing skin abscesses. Culture of the abscess wall yielded growth of M fortuitum. In our case, we highlight the association of anabolic steroids with non-tuberculous mycobacterial skin abscesses that fail to resolve despite repeated drainage.