clinic Flashcards
steps of a periodontal exam
- gingival assessment
- biofilm presence
- presence, location and type of calculus
- measure presence, location and amount of recession
- periodontal probing depth - record 3mm or more
- record bleeding upon probing
- presence or amount of tooth mobility - grade I, II, III (horizontal and vertical mobility)
- frucation involvment - dregree I (upto 3mm), Degree II (more than 3mm), degree III (Nabers probe going through the other side)
- presence of overhang.
what is radiogrpahy
technique involved in producing radiographs
what is radiology
interpretation of radiographs
radiographs
image produced on sensitive plat or on film via x-ray
what is x-ray
type of ionising radiation
general rules surrounding radiogrpahs in dentistry
- must justofy all radiogrpahs - dont exposed patient and yourself to radiation if not needed
- no screening radiographs
- radiographs should not replace clincal examination and history taking
- weigh up benifits agains risks
types of intraoral plain radiography
- bitewing
- periapical
- occlusal
types of extraoral plain radiography
- plain skull radiographs
- pantomographs
- hand-wrist radiographs
- cone beam computerised tomography (CBCT)
what is a bitewing
- usually posterior teeth
- image of upper and lower tooth crowns, cervical portion of root, surrounding PDL and alveolar bone
- detection of caries, non-carious tooth loss, monitering loss of tooth structure, periodontal status.
what is periapical radiograph
- 1-3 complete teeth and surrounding PDL and alveolar bone
- detection of apical infection/inflammation, trauma to teeth and supporting bone, root morphology, endodontics diagnosis, periodontal assessment
what is occlucsal radiograph
- upper standard and lower true occlusal view
- image of either max or mand. arch - teeth, PDL, alveoral bone and some basal bone
- presence/absence of developing teeth, pathology not fully demonstrated in bitewin or periapical radiographs
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what is plain skull radiographs
- anterior posterior view
- posterior-anterior view (less radiation to eyes)
- TMJ
what is pantomography
- dental panoromic radiograph
what is hand-wrist radiograph
- detection of skeletal maturity - epiphyseal plate presence (thickness)
what is cone beam computerised tomography (CBCT)
- 3D rendering of structures
- dental, head and neck applications
4 reasons for use of radiography in dentistry
- diagnosis in conjucntion with clinical examination and history
- treatment planning - preventative plans
- treatment - e.g. root canal
- monitoring - e.g. progression of disease and effectiveness of treatment
what is radiation
- ## form of energy that travels as waves or particles
what is ionising radiation
- energy produced from natural and artificial radioactive material
- enough energy to change chemical composition of matter by ionising them –> change genes
how is diagnositc value of an image determined
- density and contrast of radiograpic images
- correct morpology in the radiograph
what are the 2 types of biological effects (damage) due to ionising radiation
- deterministic
- caused by cell death
- when dose threshold is exceeded
- not caused by doses used in diagnostic radiography
- e.g radiation induced skin burns - stochastic
- caused by sub-lethal DNA damage (cell survives but mutation of DNA)
- no minimal threshold dose :. can be caused by doses used in disgnostic radiography
- certain tissues more senstive than other (e.g. thyroid glands, breast tissues)
- e.g. skin cancer
what are the the 3 guiding principles in radiation for patientl, staff and public?
- justification –> ensure diagnositc benifit exceeds risk to harm
- optimisation –> As low as reasonably achieveable (ALARA); avoid repeats (unnecessary exposure); minimise technical positioning error; maintain equipment; proper trianing to staff; follow manufacturer’s instructions
- collimation
- primary = as beam exists generator
- secondary = rectangular collimator and end of tube
- exposure significantly reduced by using rectangular collimation –> scatter is reduced, contrast increased (improved diagnositc quality of image)
