2: Radiographic Examination

Question 1

What radiological feature is the reference to determine bone loss?

Answer 1

CEJ

Question 2

T/F. Radiographs are diagnositic of periodontal disease.

Answer 2

False, they are not. they are used to correlate with clinical attachment level (CAL)

Question 3

How is bone loss percentage determined?

Answer 3

bone loss % = CEJ-Crest - 2mm / CEJ-Apex - 2mm

Question 4

The ___ of the beam can affect reading of bone levels.

Answer 4

angulation

Question 5

Mild bone loss is ≤ ___%. Moderate bone loss is ___% to ___%. Severe bone loss is ≥ ___%.

Answer 5

20; 21; 49; 50

Question 6

The height of the crest lies at a level approximately ___mm below the level of the ___ of adjacent teeth.

Answer 6

2l; CEJs

Question 7

What does normal crest follow?

Answer 7

the CEJ

Question 8

T/F. Inflammation does not destroy crestal bone.

Answer 8

False, it does

Question 9

What is the integrity of the crestal lamina dura not related to if evaluated on either PA or bite-wing radiographs?

Answer 9

• presence or absence of visual inflammation
• BOP
• periodontal pocketing
• loss of connective tissue attachment in the corresponding interdental area.

Question 10

Is it appropriate to use the integrity of crestal lamina dura as an indicator for the need of periodontal treatment?

Answer 10

No

Question 11

Which is parallel to the CEJ, angular (vertical) bone loss or Horizontal bone loss?

Answer 11

Angular (vertical) bone loss is diagnoal NOT parallel to the CEJ

Horizontal bone loss is parallel to the CEJ

Question 12

T/F. Osseous defects may be noted by the number (1-3) of remaining walls. This may or may not be seen on radiographs.

Answer 12

True.

Question 13

Describe a hemiseptal defect.

Answer 13

a vertical defect in the presence of adjacent roots; thus half of the septum remains on one tooth, AKA one-walled defect

Question 14

What is a cup- or bowl-shaped defect in the interalveolar bone?

Answer 14

crater

Question 15

Osseous ___ are found on the buccal and lingual walls forming a ___-walled defect.

Answer 15

craters; two

Question 16

What is a shallow crater an indicator for?

Answer 16

osseous surgery

Question 17

T/F. Craters show-up on perioapical film but they might not be seen on BW.

Answer 17

True

Question 18

What is an intrabony resorptive lesion involving one or more surfaces of supporting bone?

Answer 18

moat-like defect

Question 19

How does pathologic resorption of bone within a furcation show up radiographically ?

Answer 19

as radiolucency (furcation radiolucency)

this may be seen on BW or PA

Question 20

Furcation involvement can be detected by ___-___ point on X-ray film.

Answer 20

gutta-percha

Question 21

If a patient complains of pain from an endo treated tooth, what may be the problem?

Answer 21

root fracture

Question 22

What is the space between the tooth root and alveolar bone containing the periodontal ligament?

Answer 22

PDL space

Question 23

The PDL appears as the PDL space of ___mm to ___mm on radiographs. It tends to be ___ at the apex and ___ ___ and ___ in the mid-root areas.

Answer 23

4.0; 1.5; wider; alveolar crest; narrow

Question 24

What is seen with a thickened radicular lamina dura? What is the cause?

Answer 24

1. widened PDL space due to occlusal trauma

Question 25

Describe the trabecular pattern and gradient.

Answer 25

more trabeculae superiorly and anteriorly

Question 26

T/F. A more loose pattern of trabeculae can be seen in sickle cell anemia.

Answer 26

True.

Question 27

What are the two types of trabecular variations?

Answer 27

rarified and dense

Question 28

How are vessels within interdental bone describe on radiographs?

Answer 28

radiolucent lines bordered by thin radiopaque lines

Question 29

T/F. If the frontal sinus is close to or has invaginated among the roots of the maxillary teeth, there may be difficulties with surgical treatment of the periodontal problems (fistula).

Answer 29

False, If the MAXILLARY sinus is close to or has invaginated among the roots of the maxillary teeth, there may be difficulties with surgical treatment of the periodontal problems (fistula).

Question 30

A mandibular tori is a bony ___ on the ___ aspect of the mandible generally in the ___-___ region. It is seen as a radiopacity and commonly found bilaterally.

Answer 30

exostosis; lingual; premolar-molar

Question 31

Where can the mental foramen be seen?

Answer 31

as far forward as the distal of the 1st premolar and as far posteriorly as the mesial of the 1st molar

Question 32

How far apart must the roots be to have periodontal bone loss that affects the entire interproximal?

Answer 32

less than 2.5mm

Question 33

Define the crown to root ratio.

Answer 33

The ration of the length of the tooth outside of bone to the length of tooth in bone.

Question 34

T/F. The crown to root ration is not a linear measurement and takes into account other morphologic factors such as root number and shape.

Answer 34

False, The crown to root ration IS a linear measurement and DOES NOT take into account other morphologic factors such as root number and shape.

Question 35

Match 1. C:R = 1:2 2. C:R = 2:1 3. C:R = 1:1 A. Favorable B. Adequate C. Unfavorable

Answer 35

1 - A 2 - C 3 - B

Question 36

A periapical radiolucency might continue to develop a ___.

Answer 36

pocket

Question 37

___ tooth resorption begins from within the pulp.

Answer 37

Internal

Question 38

___ tooth resorption begins on the external surface.

Answer 38

External

Question 39

T/F. Bite registrations are used to standardize the projection.

Answer 39

true.

Question 40

What is used to assess the marginal bone changes around a dental implant?

Answer 40

digital subtraction radiography (DSR)

Question 41

How should an implant appear on a PA film if done correctly?

Answer 41

sharp threads with no overlaps on either side of implant indicates that the image is adequate to be used for assessment of the peri-implant bone conditions

Question 42

What technique visibly shows the sinus septum?

Answer 42

CBCT(easier to see) vs panoramic