Chairs:
bence tamás szabó

212: RADIOGRAPHIC FEATURES OF ARTERIOVENOUS MALFORMATION

C. Baltera Zuloaga1, B. Martinez2

1Universidad Mayor, Servicio de Radiologia Oral, Santiago, Chile, 2Universidad Mayor, Servicio de Diagnostico y Urgencia, Santiago, Chile

Female patient, 8 years old. Consultation for evaluation and study of zone 3.6 and 3.7.

The panoramic radiograph shows a radiolucent area of diffuse limits, multilocular that extends from the distal area of tooth 3.5, to the area near the mandibular incisure, in a caudal cranial direction it extends from the area of the marginal bone ridge to the basilar edge. Distal displacement of tooth 3.7, bulging of the marginal bone ridge, alteration of the trabecular pattern adjacent to the lesion. Entrance foramen and mandibular canal with increased caliber. Partial mesial and distal root resorption of tooth 3.6.

Cone beam computed tomography shows an oval hypodense lesion in the distal area of tooth 3.5 and caudal to tooth 3.7, of approximately 26.5 and 13.9 mm, with partially defined limits. Thinned lingual cortex.

During the biopsy the lesion presents abundant bleeding in the surgical site.

Computed tomography with contrast medium. A highly vascularized lesion is observed in areas adjacent to the medial margin of the mandibular angle, with vascular nidus dependent on the external carotid artery. The lesion extends to the masticatory and parapharyngeal space. Lesion compatible with arterio-venous malformation (AVM).

Radiologically, vascular malformations of the jaws are known as „large radiological mimics“ and can mimic another lesion, from a cyst to a malignant pathology. In the mandible, the vascular malformation produces an ill-defined radiolucent image, often with a honeycomb or soap bubble appearance, with multiple rounded areas, dilated mandibular canal and widening of the medullary spaces.

73: RADIOLOGICAL FINDINGS OF PRIMARY NON-HODGKIN‘S LYMPHOMAS OF THE JAWS. A REVIEW OF 8 CASES

E. Chatzipetros1, K.-E. Alexiou1, C. Angelopoulos1, K. Tsiklakis1

1National and Kapodistrian University of Athens, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Athens, Greece

Aima: The purpose of this study was to analyze the radiological findings of 8 patients, ignorant of their disease, who were referred for Cone Beam CT (CBCT), exhibiting common dental signs and symptoms and their histological diagnosis was Non-Hodgkin’s Lymphoma (NHL).

Material and methods: In this study, 8 patients with a final diagnosis of malignant NHL were included. They were referred for CBCT of either maxilla or mandible and their medical history and chief complaints were recorded. In all patients biopsy of the tumors was performed and histopathological or immunohistochemical examinations lead to the final diagnosis of NHL.

Results: Most of the patients had a free medical history and their main chief complaints were: Hypoesthesia, teeth mobility and facial swelling. Maxilla was involved in 3 cases and mandible in 5. All lesions were osteolytic with ill-defined or moth-eaten borders and cortical erosion, infiltration or destruction was observed in all patients. In two patients, 2 small lesions were observed in the same area of the mandible, while a single larger lesion was detected in the other cases. Involvement of inferior dental canal was found in all patients with mandibular lesions and maxillary sinus or nasal cavity was involved in all cases of the maxilla.

Conclusions: Primary NHLs of the jaws are rare, but when they occur, they exhibit common dental signs and symptoms. The radiological findings are much similar of those of malignancy and the clinician should be aware in order to formulate a correct differential diagnosis.

177: COMPARISON OF ORAL SQUAMOUS CELL CANCER PATIENTS ACCORDING TO HPV+ AND HPV- STATUS IN TERMS OF CLINICAL, GENOMIC AND MUTATIONS

A. Pınarbaşı1, K.S. Yücel1, E.M. Canger1

1Erciyes University, Department of Oral and Maxillofacial Radiology, Kayseri, Turkey

Aim: In integrated studies conducted in the form of comprehensive genomic analysis of oral squamous cell carcinoma (OSCC), there are significant differences according to HPV+ and HPV- status. The aim of this study is to determine differences in overall survival, genomic alterations and mutations in OSCC patients.

Material and Methods: Data from 487 samples were downloaded from the Cancer Genome Atlas data portal. Fisher Test was applied to compare the differences between mutations occurring in the form of missense, truncating, inframe and splice. The Benjamini-Hochberg procedure, automatically applied by CBioportal, was followed in the study for content and scope validity.

Results: 14.8% of the participants showed HPV+ status and 85.2% showed HPV- status. The overall survival rate was higher in HPV+ patients and a significant difference was found. Mutations occurred more frequently in HPV- patients in 85% of the 20 genes with the most frequent mutations in patients, and a significant difference was found. In the TP53 gene, where the most frequent mutation was observed, missense and truncating mutations were observed in HPV+ patients, and missense, truncating, inframe and splice mutations were observed in HPV- patients.

Conclusion: These results emphasize that both TP53 and CDKN2A driver pathways, cancer-related functional pathways in OSCC, vary depending on HPV status, and it has also been stated in studies in the literature that they may be associated with radiomic features. Therefore, this study is important in terms of forming the basic assumption of radiogenomic studies that can be planned in the future.

233: EVALUATION OF THE DENT PERIODONTAL STATUS BY USING CT BEFORE AND AFTER RADIO AND/ OR CHEMOTHERAPY IN PATIENTS WITH ONCOLOGICAL PATHOLOGY IN THE ENT

A. Cristina1, H. Danisia2, M. Anca1, S. Mihaela1, C. Corina1, H. Tudor1, G. Cristian1, D. Yllka1, P. Roxana2, C. Radu Eduard3, M. Eugen3

1UMF GR T POPA, Endodontology, Iasi, Romania, 2UMF GR T POPA, Radiology, Iasi, Romania, 3UMF GR T POPA, Surgery, Iasi, Romania

Aim: Comparasion of the dental-periodontal status in the patient with oncological pathology in the ENT sphere in relation to the healthy one by CT examination before and after radio and/or chemotherapy.

Material and methods: Our study included 35 patients aged between 32 and 81 years who were being treated at Iasi Regional Oncology Institute with ENT cancer. Imaging exploration was performed with CT Aqullion Lightening 16- row 32 slice helical .Acquisition CT spiral nativ saggital, coronal, axial, reconstructions in the soft tissue be acquisition with 3 mm reconstructed volume 1 mm.

Results: In principle the number and size of the periapical lesions before and after radio and/ or chemotherapy was the same with small variations.

Conclusion: It is good to clean up the oral cavity of the patients with cancer in ENT sphere before radio and/ or chemotherapy to avoid osteoradionecrosis.

108: FRONTAL SINUS OSTEOMA IN A YOUNG PATIENT – CASE REPORT

A. Reis Durao1, F. Barros dos Santos2, A. Morosolli3, A. Arcanjo1

1University Fernando Pessoa, Health Sciences, Porto, Portugal, 2Private pratice, Porto, Portugal, 3Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, discipline of Radiology – Dentistry Course – School of Health and Life Science, Rio Grande do Sul, Brazil

Paranasal sinus osteomas are slow-growing benign bone tumors that can present a variety of clinical symptoms depending on their size and location. Most osteomas are asymptomatic and occur in the frontal sinus. In rare circumstances, they might develop and expand into the cranial or orbital cavities, resulting in abnormal imaging characteristics.

Aim: To describe a clinical case of osteoma in the frontal sinus with the presence of an inflammatory sinus polyp in a 16-year-old female patient, referred to the radiology service due to a finding in a lateral teleradiography examination performed for orthodontic treatment.

Material and methods: A 16-year-old female patient was referred to the radiology unit following a lateral cephalometric radiograph performed for orthodontic treatment purposes. During a visit with the orthodontist at the same time, a tomographic examination of the facial sinuses was requested for a more thorough evaluation and better understanding of the lesion. The patient had no symptoms, a family history, or any other comorbidities. The tomographic sections revealed a well-defined hyperdense pedunculated lesion within the left frontal sinus, on the posterior wall, with dimensions are approximately 7.9 × 7.6 mm, in anteroposterior and transverse orientations. The left frontal sinus, showed mucosal thickening and polypoid development. There was no evidence of obstruction of the sinus or erosion through either the outer or inner wall of the sinus. Being referred to the otorhinolaryngologist.

Conclusion: The importance of early diagnosis is highlighted, which can be justified by the progressive and sudden nature of the injury.

230: A RARE CASE REPORT: MULTİPLE ENDOCRİNE NEOPLASİA TYPE 2B SYNDROME

S. Uzun1, I.B. Yuksel1, F.B. Deniz2

1Necmettin Erbakan University Faculty of Dentistry, Dentomaxillofacial Radiology, Konya, Turkey, 2Necmettin Erbakan University Faculty of Dentistry, Dentomaxillofacial Surgery, Konya, Turkey

Aim: Multiple endocrine neoplasia type 2B (MEN 2B) is a very rare syndrome characterized by a very peculiar phenotype with mucosal neuromas, marfanoid habitus, and bumpy lips associated with medullary thyroid cancer (MTC) and pheochromocytoma (PHEO). It is still diagnosed too late when the MTC is metastatic, and frequently when the PHEO has already developed. This case report describes a 35-year-old patient diagnosed with Men2b syndrome.

Case Report: A 35-year-old male patient with Men2b syndrome applied to our hospital with bleeding gums and a request for a prosthesis. It was learned from the anamnesis that the patient, who has congenital Men2b syndrome, is treated and followed up regularly. In the extraoral examination, hypertrophy in the lower and upper lips, marfanoid hands, and hypertelorism were observed. Intraoral examination revealed bilateral papules in the right and left corners of the mouth, gingival hyperplasia in the upper anterior region, also hypertrophy, and multiple neuromas in the tongue. The patient was first consulted with the surgeon so that prosthetic restorations could be made. However, the patient did not agree to continue treatment due to the risk of neuroma recurrence and follow-up was recommended to the patient.

Conclusion: This case shows that knowledge of this syndrome is still insufficient and that the lack of knowledge impairs the ability to obtain an early diagnosis and cure. Because most patients with MEN 2B have no familial history, the only way to ensure a timely diagnosis is to recognize the MEN 2B phenotype on a clinical basis.

250: MULTIPLE ODONTOGENIC KERATOCYSTS IN A NON-SYNDROMIC PAITENT: AN 8-YEAR FOLLOW-UP

A. Üzel1, U. Seki1, A. Kuran1, E.A. Sinanoğlu1

1Kocaeli University, Kocaeli, Turkey

Aim: Although odontogenic keratocysts (OKC) are common in the jaws, multiple occurrences are rare and are often associated with syndromes such as nevoid basal cell carcinoma syndrome (NBCCS). In this case report, an 8-year follow-up of a patient with multiple OKCs recurring in a patient who did not show any syndromic features is presented.

Material and Methods: Upon referral, a male patient aged 15 years presented with unicystic lesions localized in the bilateral mandibular and maxillary molar regions, later diagnosed as OKCs. Recurrences were observed four years later in the right mandibular molar region and eight years later in the right maxillary sinus, alongside emerging lesions in the pericoronal regions of the mandibular third molars. Following the excision of all recurrent lesions, a diagnosis of OKC was affirmed. Given the significant risk of recurrence, mutational analysis of the PTCH1 gene was carried out.

Results: The patient was examined through any possible link of inheritence and clinical features of NBCCS. No relevant findings were identified, and genetic testing for PTCH1 revealed no mutations associated with NBCCS. The patient is being followed up for possible new recurrent lesions.

Conclusion: This case presents multiple OKCs with frequent recurrences, which is an indicative feature of NBCCS. Consequently, it is important to conduct a thorough histopathological examination to identify any other existing lesions. Furthermore, a comprehensive clinical evaluation should be undertaken, followed by long-term monitoring.

68: GLANDULAR ODONTOGENIC CYST OF THE MANDIBLE: CASE SERIES

H. Sabban1, N. Abdel-Wahed1

1King Abdulaziz University Faculty of Dentistry, Oral Diagnostic Sciences, Jeddah, Saudi Arabia

Aim: Glandular odontogenic cysts (GOC) are rare developmental odontogenic cysts. They are aggressive and predominately a radiographic finding, with a relatively high recurrence rate. The objective of this study is to document the radiographic features of five cases diagnosed histopathologically as GOC, and correlate them to common features reported in previous studies.

Materials and Methods: Five patients, of those imaged with cone beam CT (CBCT) in the Oral Radiology department at King Abdulaziz University Dental Hospital (from 2022 to 2023), were reported to have GOC.

Results: The reported five cases were all male patients with age range between (32-50) years old. All lesions were located in the mandible; three located anteriorly and two posteriorly. Two lesions crossed the midline. Two of the lesions were unilocular and three were multilocular. The septa were straight, long and at right angles to the outer border. The borders were well defined, corticated, with scalloping between the roots. The effects on the surroundings included, thinning of the buccal/lingual cortical plates, expansion, inferior displacement of the mandibular canal, displacement of the teeth, and one lesion also showed loss of the lamina dura and root resorption. Only one lesion showed perforation of the cortical borders.

Conclusion: GOC shows similar radiographic features with odontogenic keratocyst, ameloblastoma, lateral periodontal cyst, residual cyst and central giant cell granuloma. Therefore a careful histopathological examination and a long-term follow-up are required to confirm the diagnosis and rule out recurrences.

17: RADIOLOGICAL EVALUATION OF PERMANENT TEETH OF CHILDREN FOR TREATMENT PLANNING

D. Ivanauskaite1, A. Vasauskiene1, V. Brukiene1, R. Zaliuniene1, E. Nedzinskiene1

1Vilnius University, Institute of Dentistry, Vilnius, Lithuania

Aim: To propose the protocol for following step-by step for the right choice of the treatment method for the permanent teeth with open or closed root apex after the clinical and radiological examination.

Material and Methods: Basic knowledge about the root development stage due to the age, radiographs in dentistry, the radiological appearances of the permanent teeth in children, caries, periapical bone and the treatment methods for pulp and root canal system were discussed with dentist working in field of oral radiology, specialists in pediatric dentistry, endodontist, and general dental practitioner. The clinical expertise and attitudes with regards to different treatment methods of pulp and root canal system in permanent tooth were discussed among specialists. During the protocol development several meetings were held to clarify the structure of the protocol.

Results: Protocol was structured in main steps/sections: Patient complaints, Clinical examination, Radiographic examination, Radiological evaluation of Dental anatomy, Radiological evaluation of Dental pathology and Treatment planning. The sections of Radiological evaluation of Dental anatomy and Treatment planning were split to the subsections: Teeth with open apices and Teeth with closed apices. Treatment methods for the teeth with open or closed apices are listed and linked.

Conclusion: Protocol is designed as a scheme that can be easily used by the general dental practitioner, pediatric dentist or endodontist to follow it step-by-step to evaluate the permanent teeth with open or closed root apex and to choose the treatment method for the children in daily practice.