Interventional Radiology in Dentistry

PL Westesson

University of Rochester Medical Center Rochester, New York

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INTRODUCTION

Interventional maxillofacial radiology is an offspring of the general radiology interventions. This is one of the fastest growing areas of radiology where imaging techniques are used to perform procedures that previously needed an open approach. The minimally invasive approach have reduced morbidity, mortality and shortened hospital stays. It is now often possible to both diagnose and treat lesions that in the past, required an open surgical procedure.

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Diagnostic procedures TMJ

Salivary glands Eye

Biopsy

Therapeutic procedures Balloon dilatation

Botox Embolization

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TMJ arthrogram

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TMJ arthroscopy Diagnosis Lavage Lysis of adhesions

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Sialography

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Sialography Submandibular Gland

Regular technique Digital subtraction

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Sialography Parotid Gland Normal?

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Sialography Parotid Gland No – not normal

MR image DSA sialogram

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Biopsy of Deep Parotid Lesion

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CT Guided Biopsy Pleomorphic adenoma

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CT Guided Biopsy Needle for core biopsy

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Interventional Sialography

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Interventional Sialography After penetration with guidewire

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Balloon Dilatation

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Balloon Dilatation

Balloon in place

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Balloon Dilatation

After balloon dilatation

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Dacrocystogram

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Lacrimal Duct Stenosis

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Biopsy of Orbital Lesion Hemangioma

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Biopsy of Orbital Lesion Imaging can only take you so far

eventually you will need a diagnosis

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Bone biopsy Chondrosarcoma

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Botox Bruxism and tension headache Hyper salivation Perioral dystonia ALS CP Drooling children

30 units parotid 15 units submandibular

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Embolization

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Embolization

Before

After

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Surgery

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Diagnostic procedures TMJ arthrography TMJ arthroscopy Sialography Dacrocystography CT and MR guided biopsy

Therapeutic procedures

Salivary gland duct balloon dilatation Stone removals Tear duct dilatation and stent placement Botox in muscles of mastication Botox in salivary glands Embolization of nose bleeds Embolization of vascular lesion

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SUMMARY

This poster illustrates different procedures in interventional maxillofacial radiology. All of them can be done on an outpatient basis with local anesthetics and moderate sedation. The procedures are minimally invasive and have essentially no morbidity and mortality. They provide a high diagnostic yield with little complications.

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