OBJECTIVE: To correlate the signals and symptoms observed on clinical examination of patients with temporomandibular disorder with the results demonstrated by magnetic resonance imaging. MATERIALS AND METHODS: Thirty patients presenting with signs and symptoms of temporomandibular disorders underwent clinical evaluation and subsequent magnetic resonance imaging. The magnetic resonance imaging studies were independently evaluated by two experienced radiologists. Magnetic resonance imaging studies consisted of 12 images in coronal, T1-weighted sequences with 3 mm-thick slices with the mouth closed, sagittal, T1- and T2-weighted sequences with both open and closed mouth positions, and on progressive opening/closing movement at 5 mm intervals, in order to demonstrate the full mandibular movement. The statistical significance between the clinical findings in the evaluation of the patients and results found on the magnetic resonance imaging studies was analyzed by means the kappa test. RESULTS: Interobserver agreement was respectively 56.7% (kappa = 0.1) and 56.7 (kappa = 0) for the left and right sides. CONCLUSION: No correlation was found between the clinical and magnetic resonance imaging findings in the diagnoses of disc displacement.

Keywords: Magnetic resonance imaging, Temporomandibular joint, Disorders

OBJECTIVE: The present study was aimed at evaluating the role of computed tomography in the local clinical staging of supraglottic tumors according to the TNM classification, as well as the interobserver agreement on the detection of the tumor extent. MATERIALS AND METHODS: Thirty-nine dossiers of inpatients of Hospital Heliópolis with supraglottic squamous cell carcinoma in the period between 1988 and 1998 were retrospectively evaluated. CT studies were individually analyzed by two radiologists. The kappa test was utilized for evaluating the interobserver agreement. RESULTS: Computed tomography has played a decisive role in the upstaging of 38.5% of cases, as a result of a deep tumor extent undetected at clinical examination. CONCLUSION: Interobserver agreement was considered as excellent for vocal folds and subglottis; good for supraglottic, paraglottic and preepiglottic spaces, thyroid and cricoid cartilages and for extralaryngeal tumor extension; and regular for the base of the tongue.

Keywords: Laryngeal neoplasms, Squamous cell carcinoma, Computed tomography, Tumors staging

OBJECTIVE: The aim of this study is to evaluate the role of computed tomography and magnetic resonance imaging in the characterization of deep tissue extension of malignant tumors of the nasal cavity. MATERIALS AND METHODS: Twelve patients diagnosed with malignant tumors of the nasal cavity were retrospectively evaluated at the Departments of Diagnostic Imaging and Head and Neck Surgery of the "Complexo Hospitalar Heliópolis", São Paulo, Brazil, between 1990 and 2000. All cases were confirmed by histopathologic examination. RESULTS: Extension to the maxillary and ethmoid sinuses was identified in six patients, extension to contralateral nasal cavity, orbit and lamina cribosa in five patients, extension to nasal pharynx and masticator space in two patients, extension to cavernous sinus, anterior/middle cranial fossa, pterygomaxillary fossa, inferior/superior orbital fissure, frontal sinus, contralateral ethmoid sinus, contralateral lamina cribosa, hard palate and pterygopalatine fossa in one patient. CONCLUSION: It is important to precisely assess the local extension and spread of tumor by computed tomography and magnetic resonance imaging in order to plan the approach to treatment, which will influence the prognosis.

Keywords: Nasal cavity, Malignant neoplasm, Computed tomography, Magnetic resonance imaging

Elongated styloid process or Eagle's syndrome is a multifactorial disease with unspecific characteristics on clinical and imaging examinations. The use of imaging methods in combination with the signs and symptoms are valuable in the confirmation of the diagnosis since they show the extension of the styloid complex, the muscles and ligaments, and adjacent structures. The diagnosis can be established when there is an association of clinical information and imaging findings. The authors report two cases of elongated styloid process including the imaging findings, mainly obtained using computed tomography.

Keywords: Eagle's syndrome, Diagnosis, Computed tomography

Ameloblastomas are benign odontogenic neoplasms of epithelial origin, nonmineralized, relatively uncommon which present an aggressive local behavior. They affect predominantly the mandible and they can reach varied proportions depending on the evolution time. Radiographically they appear as unilocular or multilocular cystic lesions. The clinical and radiological findings assist to the differential diagnosis, although the histologic evaluation is necessary in characterization of the lesions.

Keywords: Ameloblastoma, Mandible, Diagnosis

The authors report two cases of patients with Madelung's disease, a symmetric fat deposit in the neck and superior mediastinum that involves nerves and vessels. Computed tomography can reveal the fat contents of these masses and guide preoperative staging and post-surgical follow-up.

Keywords: Madelung's disease, Cervical lipomatosis, Computed tomography

Magnetic resonance imaging and computed tomography are important additional methods for the diagnosis of oral cavity diseases. The technical aspects of both methods are discussed including their advantages and limitations. The anatomy of the oral cavity is reviewed as well as some characteristics of squamous cell carcinoma, which is the most frequent neoplasia in this region.

Keywords: Oral cavity, Computed tomography, Magnetic resonance imaging

The authors studied seven patients with gingival carcinoma attended at the Head and Neck Surgery and Otorrhinolaryngology Service and the Diagnostic Imaging Service of "Complexo Hospitalar Heliópolis", São Paulo, SP, Brazil, between 1985 and 1996. Squamous cell type carcinomas were identified in all cases. All patients were male (100%) aged 48-72 years. Computed tomography was performed in six patients (85.6%). Four patients (57.1%) had not received any treatment before imaging examination whereas three patients (42.8%) had already been submitted to surgery or radiotherapy. The authors analyzed the primary site of the tumor and its extension to the mandible (5/7 cases; 71.4%), the floor of the mouth (3/7 cases; 42.8%), the floor of the maxillary sinus (1/7 cases; 14.2%) and the retromolar trigonum (1/7 cases; 14.2%). Metastatic lymph nodes were observed in five patients (71.4%). Diagnosis was confirmed by biopsy and histopathological examination in all cases. Comparison with surgical findings was possible in five cases (71.4%).

Keywords: Gingiva, Malignant tumors, Gingiva

In this case report we discuss the importance of panoramic x-ray as an auxiliary tool for the diagnosis, initial treatment and follow-up of patients with periodontal disease. The case presented involved an interdisciplinary approach between orthodontics and periodontics. A female patient with advanced periodontal disease was treated with the forced orthodontical eruption technique that resulted in bone and gingival growth at the end of the treatment. Placement of the implants and dental prostheses was also performed in an innovative approach of immediate prosthetic loading, i.e. implants and teeth placed within a 48 hours interval. These results indicate that our studies should continue since bone growth was obtained without a bone graft, the time of the treatment did not exceed 120 days, and that we may in future obtain further results that will contribute to surpass serious periodontal diseases without the need of several surgical stages, reducing the time of treatment, morbidity and costs.

Keywords: Periodontitis, Orthodontic extraction, Forced orthodontical eruption, Panoramic x-ray, Orthodontics, Periodontics, Dental implant

OBJECTIVE: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. MATERIALS AND METHODS: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. RESULTS: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. CONCLUSION: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method.

Keywords: Emission computed tomography; Fluorodeoxyglucose 18F; Head and neck neoplasms; Neoplasm staging; Squamous cell carcinoma.