clinic

Question 1

steps of a periodontal exam

Answer 1

1. gingival assessment
2. biofilm presence
3. presence, location and type of calculus
4. measure presence, location and amount of recession
5. periodontal probing depth - record 3mm or more
6. record bleeding upon probing
7. presence or amount of tooth mobility - grade I, II, III (horizontal and vertical mobility)
8. frucation involvment - dregree I (upto 3mm), Degree II (more than 3mm), degree III (Nabers probe going through the other side)
9. presence of overhang.

Question 2

what is radiogrpahy

Answer 2

technique involved in producing radiographs

Question 3

what is radiology

Answer 3

interpretation of radiographs

Question 4

radiographs

Answer 4

image produced on sensitive plat or on film via x-ray

Question 5

what is x-ray

Answer 5

type of ionising radiation

Question 6

general rules surrounding radiogrpahs in dentistry

Answer 6

• 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

Question 7

types of intraoral plain radiography

Answer 7

1. bitewing
2. periapical
3. occlusal

Question 8

types of extraoral plain radiography

Answer 8

1. plain skull radiographs
2. pantomographs
3. hand-wrist radiographs
4. cone beam computerised tomography (CBCT)

Question 9

what is a bitewing

Answer 9

• 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.

Question 10

what is periapical radiograph

Answer 10

• 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

Question 11

what is occlucsal radiograph

Answer 11

• 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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Question 12

what is plain skull radiographs

Answer 12

• anterior posterior view
• posterior-anterior view (less radiation to eyes)
• TMJ

Question 13

what is pantomography

Answer 13

• dental panoromic radiograph

Question 14

what is hand-wrist radiograph

Answer 14

• detection of skeletal maturity - epiphyseal plate presence (thickness)

Question 15

what is cone beam computerised tomography (CBCT)

Answer 15

• 3D rendering of structures
• dental, head and neck applications

Question 16

4 reasons for use of radiography in dentistry

Answer 16

1. diagnosis in conjucntion with clinical examination and history
2. treatment planning - preventative plans
3. treatment - e.g. root canal
4. monitoring - e.g. progression of disease and effectiveness of treatment

Question 17

what is radiation

Answer 17

• ## form of energy that travels as waves or particles

Question 18

what is ionising radiation

Answer 18

• energy produced from natural and artificial radioactive material
• enough energy to change chemical composition of matter by ionising them –> change genes

Question 19

how is diagnositc value of an image determined

Answer 19

• density and contrast of radiograpic images
• correct morpology in the radiograph

Question 20

what are the 2 types of biological effects (damage) due to ionising radiation

Answer 20

1. deterministic
   - caused by cell death
   - when dose threshold is exceeded
   - not caused by doses used in diagnostic radiography
   - e.g radiation induced skin burns
2. 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

Question 21

what are the the 3 guiding principles in radiation for patientl, staff and public?

Answer 21

1. justification –> ensure diagnositc benifit exceeds risk to harm
2. 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
3. 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)