6- Bitewing Radiography Flashcards
Name 3 diagnostic methods for assessing the teeth and restorations?
- History
- Clinical examinations
- Special tests
Name 4 different types of radiographs?
- bitewing
- periapical
- panoramic
- cephalogram
What is a bitewing radiograph?
A radiograph of the crowns of posterior teeth and their immediate supporting tissues
What 3 things are bitewings used for?
- Detection and diagnosis of dental caries
- Assessment of current restorations
- Assessment of periodontal attachment and bone loss
- Assessment of calculus levels
2 techniques of bitewings?
- Freehand - very inaccurate, poor results
2. Film holder - more accurate positioning, fewer rejects (guides x-rays directly onto receptor)
Radiograph intervals relative to risk?
High caries risk: every 6 months
Moderate: 12 months
Low: (kids: 12-18 months) adults 24 months
What is the caries susceptible zone?
at/just below the contact point, stagnation area for plaque as hardest to clean
How do caries look on radiograph?
Grey zones due to demineralisation
How much demineralisation is needed for caries to show up?
Approximately 40%
Approximal caries depth classification?
D1: Outer enamel D2: Inner enamel D3: Outer dentine D4: Inner dentine D5: Pulpal Involvement
Why in D1 and D2 just fluoride and OHI?
Enamel can remineralise
What is the primary diagnostic method of occlusal caries?
Clinical examination
At what stage can you usually see occlusal?
D3
What is root surface caries?
Caries where the centre of lesion is below the enamel and well below the contact point
What can root surface caries be misinterpreted as?
“cervical burnout”
What can cause cervical burn out?
caused by natural radiolucency in the anatomy of the tooth as below the enamel there is less material for the x-rays to be absorbed
How can you tell the difference between cervical burnout and caries?
Flat and uniform in colour, only present between bone surface and enamel
Periodontal bone attachment?
0.5 - 1.9mm
Why can we see restorations on radiographs?
due to their radiopacity?
What does radiopacity depend on?
material: atomic number, density and thickness
Highly radiopaque materials?
Gold, Amalgam
Lower radiopaque materials?
Composites, glass ionomer
What is recurrent caries?
Caries around the base of the restoration
Process of recurrent caries
marginal seal around restoration broken -> plaque retention -> demineralisation of enamel
