caries on radiographs

Question 1

clinical evaluation report

Answer 1

legal requirement
clinical evaluation of the outcome of each exposure is (must be) recorded in accordance with the employer’s procedures
? by whom
for normal radiographs in GDH&S the responsibility is the Referrer’s
your patients – YOU
complete in the patient’s written notes only

Question 2

sites for caries

Answer 2

Pit and fissure:
Occlusal
Buccal – may be confused radiographically with occlusal

Smooth surface:
Interproximal
Lingual – may be confused radiographically with occlusal and buccal
Root – may be confused with “cervical burnout”

Secondary/recurrent – under restorations

Question 3

methods of caries diagnosis

Answer 3

Visual
Wet
Dry

Radiography: Film or Digital

Elective temporary tooth separation
Fibreoptic transillumination
Electrical methods
Laser fluorescence
Calcivis® - detects calcium ion loss from demineralising tooth surfaces

Question 4

cervical burnout

Answer 4

Phenomenon caused by relative lower X-ray absorption on the mesial or distal aspect of teeth, between the edge of the enamel and the adjacent crest of the alveolar ridge.

because of the relative diminished X-ray absorption, these areas appear relatively radiolucent with ill-defined margins. Cervical burnout out may mimic root surface caries.*

Bucco-lingual dimension of teeth variable
Structures to be traversed variable:
+/- enamel
+/- surrounding bone

Question 5

selection criteria for periodontal assessment

Answer 5

Radiography secondary to clinical examination and full mouth periodontal assessment

Pocketing 4-5 mm, horizontal bitewings

Pocketing =>6 mm, vertical bitewings + periapicals if bone not shown

Irregular – may supplement with periapicals

Panoramic useful for overview of all teeth, supplemented by periapicals if required, or full periapicals

Periapicals for suspected perio/endo leasions

Question 6

periodontal radiography

Answer 6

If panoramic choose orthogonal projection (P4)
Beam angulation crucial
Horizontal angle 90o to line of arch
avoid overlaps of adjacent teeth
Vertical angle 90o to long axis of tooth
Pockets may be difficult to show – consider GP point
Clinical pocket depth examination crucial