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Sialolithiasis imaging — NDEB AFK MCQ

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HardDental Radiology and ImagingSialolithiasis imagingNDEB AFK

A 49-year-old has recurrent meal-time swelling under the right mandible. Examination shows reduced salivary flow from Wharton duct and a firm tender area in the floor of mouth. What is the most appropriate investigation?

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Correct answer: C — Mandibular occlusal radiograph or ultrasound for stone

Meal-time submandibular swelling and a tender ductal area suggest sialolithiasis; occlusal radiography can show radiopaque stones and ultrasound can assess ductal obstruction. Bitewings and periapicals aimed at teeth are not targeted to the suspected salivary duct. The pearl is that submandibular stones are common because saliva is more mucous and the duct course is uphill.

Reference: Canadian oral medicine/radiology reference texts; NDEB KSAs 2024