Review of Normal Anatomy and Common Pathologies in Dental Imaging
JHM Cheng, SY Luk, DCW Tang, JAWK Tang, DTF Lee, ACW Tam, WKW Leung, WK Kan, JLS Khoo
Hong Kong J Radiol 2018;21:196-212
DOI: 10.12809/hkjr1816853
In imaging of the head and neck regions, the dental space is an area which many radiologists are less familiar with and which often does not receive adequate attention. Dental and periodontal pathologies are hence often overlooked and underreported in daily practice. This article reviews the normal anatomy and imaging findings of the common pathologies in the dental region. Dental infection and inflammation are commonly encountered and have a variety of manifestations with different degrees of severity, ranging from asymptomatic incidental findings, local infection confined within the dental space, and inflammation of the adjacent paranasal sinuses (i.e. odontogenic sinusitis), to severe and extensive deep neck infection. Odontogenic cysts and neoplasms are occasionally seen, most of which are benign. The challenge in the imaging of these lesions is to distinguish them from other mandibular lesions that demonstrate similar radiological appearances. A detailed clinical history and careful imaging interpretation are very helpful in narrowing the differential diagnosis and guiding management. Developmental anomalies (eg, supernumerary teeth, ectopic tooth) of the dentition are usually isolated incidental findings or a manifestation of a syndromal disease such as Gorlin-Goltz syndrome and cleidocranial dysostosis. Finally, dental injury should be carefully evaluated in the context of head and neck trauma, including injury to the tooth itself, the periodontal structures and the associated complications (eg, aspiration of fractured tooth). Learning and becoming familiar with the basic dental anatomy and common pathologies are essential in identifying diseases and making accurate diagnoses.
Author affiliation(s):
JHM Cheng, SY Luk, DCW Tang, JAWK Tang, DTF Lee, ACW Tam, WKW Leung, WK Kan, JLS Khoo: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
中文摘要
牙科成像中正常解剖學和常見病理學回顧
鄭希敏、陸嬈、鄧峻樺、鄧永健、李騰飛、譚枝慧、梁錦榮、簡偉權、邱麗珊
在頭部和頸部成像中，牙齒區域是不少放射科醫生不太熟悉且沒有充份關注的範疇。因此，牙科和牙周病變經常在日常診症中被忽視和低估。本文回顧牙齒區域常見病理的正常解剖學和影像學表現。牙齒感染和炎症是常見病症且具有不同重度的各種表現，包括無症狀的偶然發現、牙齒內的局部感染和鄰近鼻旁竇的炎症（即牙源性鼻竇炎），及至嚴重和廣泛深頸部感染。牙源性囊腫和腫瘤偶發大多屬良性。在成像學角度將上述病變與表現類似的下頜骨病變區分是一項挑戰。詳盡的臨床病史和仔細的成像詮釋有助鑑別診斷和指導治療。牙齒發育異常（如多生牙、異位牙）通常是個別偶然發現或如Gorlin-Goltz綜合徵和鎖骨顱骨發育不全等綜合症的表現。此外，在頭頸部創傷時應仔細評估牙齒損傷，包括牙齒本身的損傷、牙周結構和相關併發症（如吸入斷牙）。學習並熟悉基本牙科解剖學和常見病理對於識別疾病和作出準確診斷至關重要。