CV
Brief Bio: Dr. Mel Mupparapu, a graduate of the University of Pennsylvania School of Dental Medicine, Philadelphia is a Board certified Oral and Maxillofacial Radiologist. Dr. Mupparapu served as the Director of Radiology at Rutgers School of Dental Medicine, Newark, NJ and currently he is the chief of Radiology at Penn Dental Medicine. Dr. Mupparapu has published over 200 peer-reviewed articles, multiple book chapters and several books on imaging A former Fulbright scholar to the University of Malta, he is currently involved in research related to AI, CT imaging, osteopenia and HIV disease and co-researcher in two NIH grants at Penn Dental Medicine. Dr. Mupparapu was inducted to the Master Educator's Guild at Rutgers and received the Credo in Action Award. At Penn, Dr. Mupparapu received the Senior Outstanding Teaching Award, the Basic Science Award, and the University of Pennsylvania’s prestigious Lindback Award for Distinguished Teaching.
Diagnostic Imaging of TMJ Disorders- State of the Art
Temporomandibular disorders (TMD) are caused by deranged or degenerated intra-articular components. Arthralgia is the diagnosis of pain in relation to a joint and is confirmed by replication of pain with TMJ palpation and or jaw movement. Several conditions are part of a TMD diagnosis, with osteoarthritis being the most common finding. Other conditions are related to either the bony components or the disc. The disc can be displaced with or without reduction and is often manifested by a crepitus. Other conditions that affect the TMJ include osteochondritis dissecans, idiopathic condylar resorption, osteonecrosis, synovial chondromatosis. Other forms of arthritis that affect TMJ include rheumatoid arthritis and psoriatic arthritis. `Out of all potential imaging options, MRI is currently considered the “gold standard.” Panoramic radiography remains the most useful screening tool and the plain radiographs are completely replaced by CBCT or MDCT. Skeletal scintigraphy is useful in evaluating developmental or growth abnormalities of the jaws only. Diagnostic or therapeutic arthroscopy is available if nonsurgical therapy does not yield good results.
Learning objectives
- To identify the imaging modality of choice for temporomandibular disorders
- To identify conditions that affect the mandibular condyle and the glenoid fossa
- To understand the utilization of MRI as an imaging technique for identification of disc derangements
- To understand the systemic health and TMD correlations and know the common forms of arthritis that can involve the TMJ
How to Interpret Panoramic X-ray Images in Clinical Practice. Tricks of the Trade
Panoramic radiography is a curved plane tomographic technique used to image the mandible, maxilla, and the maxillary sinuses. In the past, this modality was the most used diagnostic modality for both odontogenic and non-odontogenic jaw pathology and implant imaging until the advent of cone beam computed tomography. The panoramic image shows a section of jaws of variable thickness and magnification. Digital storage phosphor plates and charge coupled devices have replaced traditional film-based imaging. Complementary metal oxide semiconductors and solid-state technologies have replaced the first-generation sensors in the current machines. Interpretation of panoramic radiographs requires a good understanding of the patient anatomy, image layer formation, tomographic technique, and knowledge of radiographic pathology. A thorough knowledge of patient positioning and artifact identification is a must before interpretation. This presentation gives the dental practitioner training in identification of key anatomical landmarks as well as methodical review of radiographic pathology that may appear on panoramic radiographs with a comprehensive differential diagnosis.
Learning objectives
- To understand the panoramic radiographic anatomy of mandible, maxilla and the maxillary sinuses
- To identify the commonly noted odontogenic and non-odontogenic pathology on panoramic radiographs
- To understand the drawbacks of 2D imaging as it relates to panoramic tomography
- To understand how the film based techniques have been replaced by digital sensor technology
- To know how to acquire, store and retrieve digital panoramic data in a dental office