رائد ابراهيم عبدالله السدحان

This is the second course of oral radiology which is comprehensive course in radiographic interpretation and differential diagnosis of developmental, pathological lesions and fractures of the jaws and associated structures.
The course is covered by the lectures in the first half of the year and practical and tutorials in the second half.
The lectures in the first half will encourage the student to present and participate in case discussion sessions in the second half.

Overall learning objectives:
By the end of this course students should be able to:
1- Describe the advanced imaging modalities, their uses in the head and neck including CT, MRI, US and nuclear medicine.
2- Know different types of inflammatory lesions of jaws and their clinical and radiographic features.
3- Know different types of odontogenic and non odontogenic cysts and to describe the radiographic appearance of each one.
4- Know the most common benign odontogenic and non odontogenic tumors. Know the most characteristic radiographic features of benign lesions. Know the clinical and radiographic appearance of each one.
5- Know different malignant lesions, stressing on the clinical and radiographic features. Be able to refer patients for advanced imaging to complete the differential diagnosis of tumors.
6- Know different types of bone diseases that have jaw manifestations, stressing on the clinical features and radiographic appearance.
7- Be familiar with soft tissue calcifications seen on oral and maxillofacial radiographs.
8- Identify and diagnose fractures of the jaws and facial bones, their clinical features and different imaging technique used for diagnosis.
9- Know the systemic disease and some of syndromes that can be manifested in the jaws.
10- Know TMJ anatomy, different radiographic technique used to examine TMJ. To know the radiographic appearance of the most common disorders affecting the TMJ.
11- Know maxillary sinus anatomy, different radiographic technique used to examine sinus. To knows the radiographic appearance of the most common diseases affecting the maxillary sinus.
12- Know salivary gland anatomy different radiographic technique used to examine salivary gland. To know the radiographic appearance of the most common diseases affecting them.

Content of the Lectures:
(Chapter and page numbers in: Oral Radiology principles and Interpretation, 6th edition 2009 By: White and Pharoah)
  1- Advanced Imaging Modalities (Ch. 13, pp 207)
Computed Tomography (CT) and Cone beam CT( Ch 14 pp 225): definition, production of CT image, digitization, functions of the CT system, sections of the head, direct and reconstructed, indications, advantages and disadvantages of CT, CT compared to conventional radiography, special applications.
Magnetic Resonance Imaging (MRI): definition, physical principles, generation of the MR Image, indications, advantages and disadvantages of MRI. Nuclear Medicine (Scientegraphy): Principles, indications, advantages and disadvantages. Ultrasonography: principle and indications.

2- Inflammatory lesions  of Jaws (Ch. 20, pp325)
Review of: Acute apical periodontitis, acute dentoalveolar abcess, chronic apical periodontitis, Periapical granulomas, Radicular cyst. Clinical feature and radiographic appearance and differential diagnosis of Sclerosing osteitis, osteomyelitis and osteoradionecrosis.

3- Odontogenic and Non-odontogenic Cysts (Ch. 21, pp343)
Definition, general clinical and radiographic features.
Odontogenic cyst: clinical features, radiographic appearance and differential diagnosis of radicular cyst, residual cyst, dentigerous cyst.
 Non-odontogenic cysts: clinical features, radiographic appearance and differential diagnosis of nasopalatine duct cyst (incisive canal cyst).
Cyst-like lesions: clinical features, radiographic appearance and differential diagnosis of: simple bone cyst, developmental salivary gland defect (Stafne defect) pp574 .Aneurysmal bone cyst pp445.

4- Benign Tumors of Jaw Bones
A- Benign Odontogenic Tumors: (Ch. 22, pp )
Definition, clinical features, radiographic features (location, periphery and shape, internal structure, effects on surrounding structures).
Clinical features, radiographic appearance and differential diagnosis of: Ameloblastoma, Adenomatoid Odontogenic Tumor (AOT), Odontoma, and Odontogenic Myxoma. , and odontogenic kerato.

 B- Benign Non Odontogenic Tumors (Ch. 22, pp 410)
Hyperplastic lesion(367) :
Clinical features, radiographic appearance and differential diagnosis of torus palatinus, torus mandibularis, enostoses( idiopathic osteosclerosis), exostoses.
Non Odontogenic Tumors: clinical features, radiographic appearance  and differential diagnosis of Traumatic  Neuroma and Osteoma.

5- Malignant Tumors (Ch. 23, pp 405)
Radiographic characteristic of malignant tumors, difference between benign and malignant tumors.
Clinical features, radiographic appearance and differential diagnosis of: squamous cell carcinoma,  metastatic carcinoma and osteosarcoma.

6- Bone diseases with Jaw Manifestations (Ch. 24, pp 428)
Clinical features, radiographic appearance and differential diagnosis of: fibrous dysplasia, periapical cemetal dysplasia, ossifying cementifying fibroma, florid osseous dysplasia, cementoblastoma, giant cell lesion (cherubism, central giant cell gramuloma), osteopetrosis, Paget’s disease.

7- Soft Tissue Calcifications (Ch. 28, pp 526)
General clinical and radiographic features and calcification. Dystrophic Calcification: calcified lymph nodes, dystrophic calcification in the tonsils and calcified blood vessels (carotid arteriosclerosis). Idiopathic Calcification: Salivary Sialolith, and Phleboliths. Metastatic Calcification. Heterotopic Calcification: Ossification of the stylohyoid ligament and myostitis ossificans.

8-Trauma to the Facial structures (Ch 29  pp 548)
Introduction , radiographic signs of fracture.
Clinical and radiographic appearance of :
Mandibular fractures.
Mandibular condyle fractures.
Mid face fractures (Le Fort I, II, III).
Zygomatic complex fractures.

9- Systemic Disease Manifested in the Jaws (Ch 25, pp 454)
Hormonal: hyperparathyroidism, hypoparathyroidism, hyperthyroidism, hypothyroidism, diabetes mellitus.
Metabolic Bone Diseases: osteoporosis, rickets and osteomalacia, osteopetrosis.
Other Systemic Diseases: sickle cell anemia and thalassemia.

10- Maxillary Sinus Diseases and Imaging (Ch. 27, pp 506)
Review of normal development, anatomy, functions and diagnostic imaging.
Clinical features, radiographic appearance and differential diagnosis of inflammatory changes (thickened mucous membrane, sinusitis, empyema and polyps). Antroliths, Mucous retention cyst, mucocele, odontogenic cyst and benign neoplasm.
Malignant neoplasms: squamous cell carcinoma.

11- Salivary Gland Diseases and Imaging (Ch. 31, pp 678)
Review of anatomy, diagnostic imaging: intraoral and extraoral radiography (Periapical, occlusal, lateral oblique), sialography, CT and MRI.
Clinical features, radiographic appearance and differential diagnosis of obstructive and inflammatory disorders (sialolithiasis, sialadenitis, sialodochitits, autoimmune sialadenitis (Sjogren’s syndrome).
Radiographic appearance of benign and malignant tumors of salivary gland.

12- Temporomandibular Joint Disorders and Imaging (Ch. 26, pp 473)
A. Normal Anatomy
B. Imaging modalities.
I. Hard tissue imaging: Panoramic radiography and automatic double TMJ program, conventional tomography, Computed Tomography and CBCT.
II. Soft tissue imaging: MRI
C. Abnormalities of the TMJ
1. Developmental (bony): condylar hyperplasia and hypoplasia, coronoid hyperplasia, bifid condyle.
2. Soft tissue abnormalities: Disk displacement with reduction, Disk displacement without reduction, disk perforation and deformities.
3. Remodeling and Arthritic disorders: osteoarthritis, rheumatoid arthritis,
4. Trauma: Dislocation, fractures, ankylosis.

342 MDS Evaluation and Grades
First semester
CAT Written 20
Final exam Written 40

Second semester
Clinical Requirements 15
Case Presentations 15
Final Exam
Final  practical Exam  Slides 10
Total 100

Clinical Requirements:
• Two cases of 20CMS radiographic taking only.
•  Reports writing for 2 assigned 20CMS cases.
• One panoramic radiographic taking only.
• Reports writing one assigned panoramic case.

Required Textbook:
Oral Radiology principles and Interpretation, 6th edition (2009) By: White and Pharoah.