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Presurgical evaluation of malignant neck nodes by assessment it’s Intranodal vascularity using the color Doppler ultra sound

Author: Dr. Nazhat M. AbdlKareem, B.D.S., M.Sc. د.نزهت عبد الكريم
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2011 Volume: 8 Issue: 3 Pages: 293-303
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractColor Doppler ultra sound is an ideal imaging tool for initial assessment ofintranodular vascularity which may reflect some pathological behaviors of tumorsand lymph nodes in patients with cervical lymphadenopathy. The aim of this studywas to evaluate the usefulness of Color Doppler ultra sound in differentiatingbenign from malignant cervical lymph nodes by the assessment of Nodalvascularity. In a prospective study of 24 untreated patient with 65 cervical lymphnodes clinically including enlarged hard and soft palpable and non palpable lymphnodes . All these lymph nodes were evaluated with Color Doppler ultra sound as apre-surgical diagnostic tool, the findings were compared with histo-pathalogicalresults.Fine needle Aspiration cytology was used for 15 palpable enlarged cervicallymph nodes, most of these lymph nodes 12 lymph nodes were associated withreactive lymph nodes and not operated on, just follow up with antibiotic treatmentand performed only 3 lymph nodes were associated with malignant lymph nodeswhich removed surgically and assessed histopathologically.Upon Color Doppler ultra sound examination pre-operatively of 65 cervicallymph nodes were found 20 lymph nodes as a reactive lymph nodes and 45 asmalignant lymph nodes.After neck dissection, all lymph nodes histo-pathologically examined whichshowed 22 benign lymph nodes and 43 lymph nodes containing metastases. Nodalvasculature were classified into:· Hilar· Capsular· Hilar with capsular vascularityResults: most of the malignant nodes showed the presence of capsular vascularity andcapsular with hilar vascularity, 37.2% and 48.8% respectively, where as themajority of the reactive nodes showed hilar vascularity 77.3% and the different washighly significant P<0.01 when chi-square was used.Conclusion: the distribution of intra nodal vascularity appears to be useful indifferentiating benign from malignant cervical lymph nodes by means ColorDoppler ultra sound which consider as a routine pre-surgical tool to provide thesurgeons with a valuable information that aids them to modify their surgicalmanagement.

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Article
Comparison of Three Dimensional Dental Software Computed Tomography Findings with Real Time Surgical Approaches for Impacted Teeth

Authors: Nazhat M. Abdlkareem --- Shefaa H. AL-Nuome --- Haider A. Rassul --- Taha Y.Hamad
Journal: Tikrit Journal for Dental Sciences مجلة تكريت لعلوم طب الاسنان ISSN: 20731213 Year: 2014 Volume: 3 Issue: 1 Pages: 113-122
Publisher: Tikrit University جامعة تكريت

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Abstract

An exact localization of impacted teeth is often difficult to assume by using two dimensional conventional radiological techniques like OPG or dental films. In contrast to these two dimensional imaging method, the Dental slice Software Computed Tomography offers a three-dimensional imaging of maxilla-facial region, providing the opportunity to study objectives in all standard plans with three-dimension, reconstructed and multisection views. The aim of this study is to prove the effectiveness of the Dental slice Software Computed Tomography in evaluating the position of impacted teeth as a presurgical diagnostic aid. 25 patients with total of 40 impacted teeth were classified and evaluated by three sets .The first set of radiographs consist of traditional two dimensional images(per apical , occlusal films and OPG).The second set comprised three-dimensional views obtained from a Dental slice Soft ware Computed Tomography and a third set which was surgical interventions results. Teeth crowns were classified into: type I (buccal or labial), type II (palatal or lingual), type III (half distance of the labio-palatal or bucco-palatal ,labio-lingual or bucco-lingual) according to their position within dental arches. The dental soft ware Computed Tomography succeeded to identify the exact situations of whole 40(100%) impacted teeth crowns that were confirmed surgically in the same anatomical locations. On the other hand there was a Failure of 33(82.5%) crowns that could not be determine their positions by two dimensional images and proved surgically in opposite sides. Three dimensional Computed Tomography is a helpful and stimulating tools by providing the surgeons a perfect mulitislices: axial, coronal, sagital, two dimensional and three dimensional images in one visit and once exposure and permits the oral surgeons to visualize the position and surgical anatomy of the tooth as it will be in the operating theatre, thus establishing sufficient patterns for adequate surgical planning ,reduce of need for exploratory procedures with less morbidity to the osseous structure and time saving.

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