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DANB Radiology > Caries > Flashcards

Caries Flashcards

1
Q

Caries require 3 factors:

A

Bacteria, carbohydrates, tooth

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2
Q

Caries progression can be three types:

A

Incipient, moderate, severe.
(enamel only, involving dentin, involving pulp)

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3
Q

What is the typical location of proximal caries?

A

a few mm apical from the contact point

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4
Q

How to diagnose caries?

A

Clinical exam is always necessary: occlusal caries are easy to diagnose clinically, Labial/ Buccal?palatal caries: easy to diagnose clinically
Proximal Caries:may be difficult to diagnose clinically.

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5
Q

True or False: Radiography cannot reveal if a lesion is active or arrested

A

True

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6
Q

True or False: Bitewing Radiographs are Best to assess for proximal and occlusal caries

A

True

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7
Q

True or False: PA is good for identifying occlusal caries.

A

True

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8
Q

True or False: PA is reliable for incipient caries

A

False

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9
Q

True or False: CBCT is reliable for incipient caries

A

False

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10
Q

What are the minimum factors required for the development of caries?

A

Tooth, Bacteria, Carbohydrates.

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11
Q

Incipient caries are:

A

Dark or radiolucent area on the surface. Enamel only. 50% of lesions are actually visible on radiographs (50% not seen)

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12
Q

Proximal caries are:

A

Triangular dark area with its base to tooth surface. A few mm apical from the contact point

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13
Q

adumbration is more likely to be seen in which tooth?

A

A tooth that is triangular in cross section

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14
Q

Moderate Lesions_ Proximal caries

A

appears dark triangle with base on Dentin enamel junction and apex directed toward pulp

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15
Q

Moderate Lesions

A

Lesions extending more than halfway to the pulp

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16
Q

Occlusal Caries location:

A

Narrow at the occlusal surface, usually at the deepest pit. Wider in Dentin, and looks like upside-down cauliflower,

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17
Q

True or False: Occlusal Caries is easy to detect clinically

A

True

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18
Q

Cervical (Root) Caries

A

Diffuse, rounded radiolucency below Cervical enamel junction, associated with gingival recession, more rapid decay of cementum and dentin (softer).

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19
Q

Recurrent Caries

A

New Caries lesion after removal and restoration of caries lesions.

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20
Q

xerostomia is defined as:

A

Dry mouth

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21
Q

Xerostomia can come from:

A

Medications, Therapeutic Radiation, Sjogren’s Syndrome

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22
Q

Xerostomia Caries begins at:

A

Cervical Region causing extensive decay

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23
Q

Rampant Caries are:

A

Extensive Caries- encroaches on pulp quickly

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24
Q

Rampant Caries are found on what types of patients:

A

Pediatric Patients, Patients with poor Diet, Socio-economic factors, Meth use Patients

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25
Q

Caries Imitators are defined as:

A

Not true Caries

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26
Q

Cervical burnout- Adumbration

A

Often aligns with alveolar crest and Cement Enamel Junction, Outer tooth surface typically maintained

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27
Q

Mach Band Effect is:

A

Optical illusion, Characteristic uniform, thin radiolucent line at enamel dentin interface. Its subtle

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28
Q

True or False: image Sharpening is a form of Caries imitator

A

True

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29
Q

Image Sharpening is defined as:

A

Post processing alteration of image contrast, can creat generalized, uniform radiolucent bands next to restorations.

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30
Q

Caries Imitators can also be Dental pits/fissures/anomalies:

A

Hypoplastic pits, concavities produced by RPD Clasps, typically more well defined.

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31
Q

Bone Destruction will be shown as:

A

Radiolucent

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32
Q

Bone Sclerosis will be shown as:

A

Radiopaque

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33
Q

Poorly defined will be shown as:

A

Diffuse

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34
Q

Periodontal disease originates from the:

A

Alveolar crest/PDL junction

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35
Q

Periapical Disease originates from:

A

The pulp at the apex of the tooth or from accessory canals

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36
Q

Furcation

A

in the posterior teeth where the tooth bifurcates or trifurcation.

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37
Q

Role of Radiography: Bone will show us

A

Amount of bone present, orientation of the alveolar crest, condition of alveolar crest, bone loss in furcation areas.

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38
Q

Role of Radiography: PDL

A

Width of Periodontal ligament, density of the lamina dura. (can’t show ligament but will show space of ligament)

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39
Q

Role of Radiography: Local Factors

A

Presence of Calculus, overhanging restorations, crown/root

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40
Q

Diagnostic Steps:

A

Clinical exams, probing for pocket depth, Radiographs and clinical exams are complimentary

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41
Q

Bone Loss in Periapical and bitewing radiographs are:

A

shows bone loss on superior to inferior (also medial to distal) but does not show buccal to lingual

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42
Q

True or False: Pocket depth can not be found on Radiograph

A

True

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43
Q

True or False: Poor Geometry can create the appearance of bone loss or bone gain

A

True

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44
Q

True or False: Image density can create the appearance of bone loss or bone gain

A

True

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45
Q

Normal Alveolar Crest

A

0.5-2.0 mm apical to cemento enamel junction(parallel to line joining the CEJ of Adjoining teeth)

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46
Q

Alveolar Crest should Be ___________

A

Smooth

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47
Q

Alveolar Crest should be as dense as the __________ ________.

A

Lamina Dura

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48
Q

Lamina Dura and Alveolar Crest should have the same ___________

A

Density

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49
Q

Early Periodontitis

A

Loss of Crestal Cortication
(beware of image brightness setting and anatomically thin crest at anterior mandible)

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50
Q

Evidence of Early Periodontitis

A

Loss of sharp angle between lamina dura and crest
moderate widening of PDL near crest
Radiographic evidence of periodontitis is delayed compared to the clinical activity of the disease.

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51
Q

Early Destruction of Crestal Bone

A

Recession of Alveolar Crest, loss of crestal cortication,

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52
Q

Horizontal Bone Loss Defined:

A

Horizontal Bone Loss- crest of bone is parallel to CEJ line between adjoining teeth. The remaining bone is still horizontal but may be positioned apically

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53
Q

Vertical Bone Loss Defined:

A

Vertical Bone Loss: Crest of remaining bone is not parallel to the CEJ line between adjoining teeth (displays an oblique angulation to the CEJ line)

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54
Q

Classifying Bone Loss Healthy:

A

Healthy:.05-2.0 From CEJ

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55
Q

Classifying Bone Loss Early/Mild:

A

Up to 20% bone Loss

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56
Q

Classifying Bone Loss Moderate:

A

20-50% Bone Loss

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57
Q

Classifying Bone Loss Severe:

A

More than 50% bone Loss

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58
Q

Buccal or Lingual Bone Loss can be seen:

A

can see bi-level horizontal bone Level discrepancy

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59
Q

Factors of bone loss

A

Calculus, overhanging restorations, poor restoration contours.

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60
Q

Trauma without pulp exposure can cause:

A

Sterile Necrosis

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61
Q

Radiographic Exam: CBCT is

A

excellent for dental and periodical anatomy. Shows relationship of the lesion with cortical bones.

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62
Q

PA inflammatory Lesions will widen the

A

PDL space

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63
Q

Lesions commonly centered on ___________

A

Apex

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64
Q

If we have accessory canals we may have wider ________

A

Apex

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65
Q

Healthy Periapical Appearance:

A

Uniform, thin PDL, Uniform, thin Lamina Dura

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66
Q

Diseased Periapical Area:

A

Large restoration, PDL widening, LD displacement, LD loss or discontinuity (medial root), LD sclerosis (distal tooth), lesions centered on apices.

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67
Q

Pulp Calcification

A

Sclerotic response of tooth pulp tissues to trauma/inflammation, traumatic incident can be years prior.

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68
Q

Periapical Granuloma Definition:

A

Mass of chronic granulation tissues

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69
Q

Periapical abcess Definition:

A

Characterized by puss formation. May develop directly as an acute process or develop from pre-existing granuloma.

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70
Q

Periapical Cyst Definition:

A

A cyst is an epithelium lined cavity which is filled with fluid or semi-solid material.

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71
Q

True or False: Radicular Cyst is the Only cyst related to nonmetal pulp

A

True

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72
Q

Apical Periodontitis Definition:

A

Term that includes granuloma, access or small radicular cyst. This covers all three conditions (large region that displaces and expands adjacent structures are more likely to be radicular cysts.)

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73
Q

Regressive Changes occurs after:

A

eruption of the tooth

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74
Q

Attrition:

A

Physiologic

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75
Q

Abrasion:

A

Mechanical

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76
Q

Erosion:

A

Chemical

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77
Q

Attrition defined as:

A

Part of aging process, grinding of teeth (bruxism), incised, occlusal and inter proximal surfaces, (wearing away)

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78
Q

Abrasion Defined as:

A

Radiolucent defects at the cervical region, well defined semilunar defects, pulp chamber sclerosed.

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79
Q

Erosion defined as:

A

breaking down of teeth from outside factors, diet, acidic

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80
Q

Osteoclast resorbs

A

Resorb bone

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81
Q

Osteoblast make

A

Bone

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82
Q

Odontoclasts resorbs

A

Tooth

83
Q

“clast”

A

destroys

84
Q

External root resorption is caused by:

A

trauma, mechanical forces, presence of tumors or cysts, impacted teeth, osteosclerosis (increased density of bone), Ortho can cause external root resorption

85
Q

Idiopathic means

A

unknown causes

86
Q

Internal root resorption is caused by:

A

starts in the pulp canal (outline of the pulp chamber can be lost) trauma and idiopathic can cause internal resorption.

87
Q

Three causes of Tooth Trauma:

A

Concussion, Luxation, Avulsion

88
Q

Dental Fracture can be seen in three ways

A

Cornonal fracture, root fracture (vertical or horizontal), alveolar fracture.

89
Q

if pulp canal is not seen, it is

A

an old fracture

90
Q

if there’s a J shaped radiolucency or widening PDL space on one surface of the root it would be a _____________ fracture

A

Vertical root fracture

91
Q

Mandibular Fracture occur in

A

Subcondylar 30%
Angle 25%
Symphysis 22%
Body%

92
Q

Anatomic Radiolucency

A

Absence of Bone

93
Q

Pathologic Radiolucency

A

Destruction of Bone or replacement with sift tissue, fluid.

94
Q

Radiolucencies with distinct borders are:

A

Slow growing, fluid filled balloon, soft tissue mass, has a barrier around pathology, hydraulic pressure.

95
Q

Radiolucencies with Indistinct borders are:

A

Fast growing, destruction to different depth, no barrier to enclose the pathology.

96
Q

Cyst defined as:

A

Cavity filled with fluid, lined by epithelium, connective tissue wall. Round and well defined.

97
Q

Location of Cyst:

A

Usually inside bone, may be in soft tissues odontogenic cysts in tooth bearing areas.

98
Q

Border of Cyst

A

Well defined and corticated

99
Q

Shape of Cyst

A

Round or Oval

100
Q

types of Radicular Cyst:

A

Periapical cyst, apical periodontal cyst, dental cyst

101
Q

Radicular Cyst only associated with ______-_______ ___________

A

Non-vital Tooth

102
Q

Location of Radicular Cyst:

A

Centered around apex, except when related to an accessory canal.

103
Q

Border of Radicular Cyst:

A

Well defined, circular, corticated

104
Q

Effects on Adjacent Structures of radicular cyst:

A

Displacement and resorption of roots, displaces the sinus, cortex, and inferior alveolar canal.

105
Q

Dens in Dente:

A

infection in root that expands

106
Q

Residual Cyst Defined as:

A

A dental cyst that develops after incomplete removal of a cyst. Commonly in edentulous area.

107
Q

Dentigerous Cyst defined:

A

Always associated with crown of an impacted or unerupted tooth. Cyst of the Dental follicle .

108
Q

Types of Dentigerous Cyst:

A

Central, Lateral, Circumference. Lesion starts from the CEJ.

109
Q

Location of Dentigerous Cyst:

A

Most commonly mandibular 3rd molar and maxillary canine. Around the crown, attaches at CEJ.

110
Q

Border of Dentigerous Cyst:

A

Well-corticated radiolucency.

111
Q

Size of Dentigerous cyst:

A

if follicular space exceeds 3 mm in periodical radiographs, there is greater likelihood of dentigerous cyst. can be very large

112
Q

Odontogenic Keratocyst border:

A

Corticated, smooth, round or Orval, scalloped

113
Q

Effect on Adjacent structures of Odontogenic Keratocyst:

A

Minimal expansion in the body, some expansion in ramus.Displaces or resorbs teeth, but less than dentigerous cyst.

114
Q

Nasopalatine Duct Cyst

A

Only seen in incisive canal cyst, at the midline of maxilla between centrals. Can cause separation of roots, circular or oval, well defined, heart shaped when nasal spine is superimposed.

115
Q

Simple Bone Cyst

A

Traumatic Bone Cyst, Hemorrhagic Cyst, Cavity in Bone, In ages 17

116
Q

Location of Simple Bone Cyst

A

Mandible, well defined or ill defined. Scalloped between roots, No symptoms, incidental finding (Male/Female 2:1)

117
Q

Benign Tumor:

A

A tumor that does not spread to remote parts of the metastasis and does not invade adjacent normal tissues

118
Q

Malignant Tumor:

A

Invades surrounding tissues, may metastasize to sites, and are likely to recur, and may be fatal to the patient

119
Q

Benign (amelobblastoma)

A

Locally invasive, aggressive, yet benign
Multicystic (looks like soap bubbles)
More often in men in African men around age 40.

120
Q

Periapical Cemento-osseous Dysplasia (PCOD, PCD, POD)

A

Mixed or radiopacity, pulp is vital, patient is asymptomatic, no clinical signs. Patients are mostly females African americas, 40yrs old

121
Q

Location of PCOD

A

Seen in mandibular anterior areas, bilateral, multiple.

122
Q

three stages of PCOD

A

Stage 1: Radiolucent, Stage 2: Mixed Stage 3: radiopaque.

123
Q

Salivary Gland Depression is Called:

A

Stafne’s Defect

124
Q

Stafne’s Defect is a submandibular Salivary Gland ________

A

Defect

125
Q

Radiolucency near the angle of the mandible is due to ___________ Defect

A

Stafne’s

126
Q

True or False: There is no treatment needed for Stafne’s Defect

A

True

127
Q

Stafne’s Defect is located below the __________ __________

A

Alveolar Canal

128
Q

Cleft:

A

Involve lip, alveolar bone or palate or any combination.

129
Q

Cleft Lip and Palate: Most common developmental craniofacial abnormality

A

May be associated with syndrome

130
Q

Osteomyelitis

A

Infection of bone, involves marrow, cortex, periosteum, usually local source of infection. May have hematogenous source (infection spreading through bloodstream)

131
Q

Osteomyelitis

A

We will see Radiolucency and Radiopacity

132
Q

MRONJ

A

Medication Related Osteonecrosis of the Jaw (Bisphosphonate-related osteonecrosis of the jaw. Radiographic fetures are almost similar to Osteomyelitis.

133
Q

Squamous Cell Carcinoma

A

Radiolucent bony defect

134
Q

Border of Squamous Cell Carcinoma

A

Irregular, rarely smooth

135
Q

Squamous Cell Carcinoma has widened ___ of few teeth with loss of _______ ______

A

Widened PDL of few teeth with loss of Lamina Dura.

136
Q

Destruction of the cortex (destruction of Bone), and pathological fracture is seen in both: __________ and ________

A

Osteomyelitis and Cancer (Squamous Cell Carcinoma

137
Q

Floating Teeth is a sign of

A

Squamous Cell Carcinoma (Cancer)

138
Q

Irregular Bony destruction is a sign of:

A

Cancer

139
Q

Anatomic Radiopacity:

A

Normal increased density of Bone

140
Q

Pathologic Radiopacity:

A

Excess deposits of bone or (Calcification in soft tissue)

141
Q

Radiopacity

A

Bony opacities (variation of normal/ bony diseases)

Dental Anomaly
Soft Tissue Calcifications
Foreign Body

142
Q

Palatal Torus:

A

Hyperostosis (extra bone formation) or Exotosis (bone formation on outside of cortical plate)

143
Q

Palatal Torus as a bony growth on middle third of the ______ _______

A

Hard Palate

144
Q

___________ ____________ is On a PA or Pan Attached to and below the hard palate, Is well defined, corticated, lobulated, uniformly radiopaque.

A

Palatal Torus

145
Q

Mandibular Torus defined as:

A

Lingual hyperostosis or exostosis near the mandibular premolars

146
Q

__________ _________ is :Superimposed over cervical area of premolars, mostly bilateral, smooth, well defined, non corticated margin, uniformly radiopaque.

A

Mandibular Torus

147
Q

Enostosis:

A

Bony Growth on the inside

148
Q

Dense Bone Island or idiopathic Osteosclerosis is

A

Enostosis

149
Q

________ Is Well defined, no Lucent border, no cortication, blends. Uniformly radiopaque, may resorb or displace roots.

A

Enostosis

150
Q

Sclerosing Osteitis:

A

Body Tries to deposit extra bone due to the infection. It starts from root and travels to apex. Outer margin is not well defined.

151
Q

Idiopathic Osteosclerosis Vs Sclerosing Osteitis

A

Well defined margins. Fuzzy Margins
Asymptomatic. Has/had symptoms
Tooth is normal. Carious or tooth w/ RCT
No tx needed. Extraction or RCT

152
Q

Ondontoma can be two types

A

Compound and complex

153
Q

“Oma” means

A

some type of tumor

154
Q

Complex ondontoma is

A

no morphological similarity to a tooth

155
Q

Compound

A

Similar to a tooth, may be small denticles.

156
Q

Odontoma radiographically has

A

Enamel, dentin, pulp areas, follicle, tooth like entities.

157
Q

Displaces adjacent teeth, prevents eruption of normal teeth, large _________ may expand the jaws, dentigerous cyst.

A

Odontoma

158
Q

Sialolith

A

Obstruction of the salivary Duct

159
Q

Obstruction of the salivary duct can be plugged from

A

mucus or calcification

160
Q

Radiographic features of Sialolith:

A

Features are smooth, outline uniformly, calcified or layered.

161
Q

Tonsillar Calcification is

A

Multiple irregular radiopacities, superimposed over ramus.

162
Q

Carotid Calcifications

A

Near Angle of Mandible, Vertical, parallel, irregular, can be bilateral. in blood vessel.

163
Q

Bilateral:

A

Both sides

164
Q

What is the typical location of proximal caries?

A

Apical from the contact Point

165
Q

What are the minimum factors required for the development of caries?

A

Bacteria, tooth, Carbohydrates

166
Q

Adumbration is more likely to be seen in which tooth?

A

A tooth that is triangular in cross section

167
Q

What radiographic features would indicate that a patient has radiation caries?

A

Caries in the cervical areas of many teeth

168
Q

What is the best examination for detecting occlusal caries?

A

Clinical Exam

169
Q

What is the radiographic appearance of an incipient proximal caries?

A

Triangular with the base on the proximal surface

170
Q

What is the best way to differentiate active vs arrested caries?

A

Comparing radiographs over several months

171
Q

When can a periapical lesion be on the distal side of a root? A distal lesion happens due to:

A

accessory Canal

172
Q

What information cannot be obtained from a radiograph?

A

Pocket depth

173
Q

What is the best radiographic feature of a vertical bone loss?

A

Crest is not parallel to the CEJ line

174
Q

What is a radiographic feature of early periodontitis?

A

Recession of alveolar crest

175
Q

What is more reliable radiographic examination for diagnosing periodontal disease?

A

Vertical Bitewing

176
Q

Which examination can reliably differentiate periapical abscess, periapical granuloma and periapical cyst?

A

Because radiographs cannot differentiate between abscess, granuloma and a cyst, we conclude that biopsy would be the only way surely know.

177
Q

THis is not a feature of plural or endodontic lesion

A

Crystal Bone recession

178
Q

Which surface of a tooth is more likely to show dental floss trauma?

A

Distal

179
Q

Reasons that cause external root resorption

A

External root resorption may happen due to periapical lesions, cysts or benign tumors, orthodontic tooth movement, impacted teeth, trauma and unknown reasons.

180
Q

Reasons that can cuase internal root resorption:

A

Trauma and unknown reasons (idiopathic)

181
Q

How do attrition, abrasion and erosion differ?

A

Attrition is physiologic wearing away of tooth. Abrasion is mechanical wearing away of tooth. Erosion is chemical wearing away of tooth, without bacteria.

182
Q

What is the most common location of mandibular fracture?

A

Subcondylar

183
Q

What are signs of a fracture?

A

Horizontal radiolucent line in the root, step deformity of the root, sclerosis (narrowing) of the pulp canal, circular root resorption, and narrowing of the PDL space

184
Q

Your doctor has ordered periapical radiography for suspected fracture of the central incisor. What should be your technique to rule out fracture?

A

I will obtain three or four periapical radiographs by changing the vertical or horizontal angle of the PID.

185
Q

How do concussion, luxation and avulsion differ?

A

In concussion, the traumatized tooth is not displaced. In luxation, the tooth is dislocated but still in the jaw. In avulsion, the tooth has fully come out of the socket.

186
Q

What are a few features of dentigerous cyst

A

The radiolucent lesion is superimposed over the crown of an impacted canine, the lesion arises from the CEJ of the canine and the impacted canine is displaced. The border is corticated.

187
Q

On a Panoramic radiograph, a radicular cyst has an oval shape. What can you conclude from this appearance? The cyst is:

A

in contact with a hard surface

188
Q

What are a few features of stafne’s defect?

A

The defect is non-corticated radiolucency near the angle of the mandible. It is not in the area of a tooth. It is inferior to the inferior alveolar canal. The adjacent teeth appear normal

189
Q

A simple Bone Cyst

A

For a radicular cyst the lamina dura is displaced. The lamina dura in this radiograph is intact and uniformly wide. The tooth does not appear to be carious. The sharp cusps of all the teeth tells that the patient is young. A non-radiographic test would be a vitality test. A radicular cyst is associated with a non-vital tooth. Teeth adjacent to a simple bone cyst are vital.

190
Q

How does the margin of malignant Tumor (cancer) differ from a benign tumor?

A

The margins of benign tumors are well defined while the margins of malignant tumor or cancer are irregular and poorly defined.

191
Q

Which of the following lesions transform from a radiolucency to radiopacity in a later stage?

A

Periapical Cemento-osseous dysplasia

192
Q

Radiographically which disease will have appearance similar to MRONJ?

A

Osteomyelitis

193
Q

Radiographically, which disease will have appearance similar to osteomyelitis?

A

Malignant Tumor

194
Q

What are a few features of ameloblastoma?

A

This is a multilocular lesion that has expanded the alveolar crest and the inferior border of the mandible. The roots of a few teeth are resorbed by this lesion.

195
Q

Why does nasopalatine duct cyst have a heart shaped on the periapical radiograph?

A

Superimposition of the anterior nasal spine.

196
Q

A uniformly radiopaque mass without any lucency in the mandibular premolar region is likely to be?

A

Mandibular Torus

197
Q

What feature differentiates idiopathic osteosclerosis from sclerosis osteitis?

A

Vitality of Tooth

198
Q

On a panoramic radiograph, an oval radiopacity is near the inferior border of the mandible. A part of this radiopacity is outside the bony margin of the mandible. This radiopacity is likely to be

A

A sialolith

199
Q

On a panoramic radiograph, multiple irregular radiopacities are seen superimposed over ramus. These radiopacities are likely to be?

A

Tonsillary Calcification

200
Q

A smooth bony growh on the buccal cortical plate of the maxillary molars is called

A

Hyperostosis

201
Q

Idiopathic osteosclerosis is also known as

A

Dense bone Island

202
Q

What are a few features of carotid calcification?

A

The radiopacity is almost vertical, with two irregular lines that are almost parallel. This radiopacity is about 45° from the angle of the mandible.

203
Q

How does enostosis differ from exostosis? An exostosis is:

A

On the inside of a bone

DANB Radiology (4 decks)

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