Diagnosis and Radiology

Question 1

What is diagnosis?

Answer 1

The identification of disease from its signs and symptoms

Question 2

What are the sources of dental pain?

Answer 2

• Dentinal
• Pulpal
• periradcular
• Non odontogenic

Question 3

What are the sources of inflammation?

Answer 3

• Pulp
• Periradicular
• periodontal

Question 4

What classification system do we use of mobility?

Answer 4

Millers
Class 1: <1mm in BL/MD direction
Class 2: >1mm in BL/MD direction
Class 2: as class 3 + Axial movement

Question 5

What instruments can be used to identify cracks?

Answer 5

-Light (will not not pass though if there is a fracture present)
-Tooth sleuth
-Rubber dam rolled up
-

Question 6

When using pulp tests which nerves are we hoping to stimulate?

Answer 6

A delta

Question 7

Are pulp test methods more accurate in cases of pulp necrosis or vital pulp?

Answer 7

Pulp necrosis

Question 8

What could give rise to false positive results from EPT?

Answer 8

• Conduction from adjacent teeth

- Conduction from PDL

Question 9

During pulp testing How can you prevent transmission between teeth?

Answer 9

Isolation with acetate strips

Question 10

What methods do we have when assessing pulp disease?

Answer 10

• Clinical history
• PUlp tests: Thermal, Electrical, Sweet
• Radiographs

Question 11

What speed radiographic fills do we use?

Answer 11

F speed replacing E speed

Question 12

What are the benefits of using Digital radiographs?

Answer 12

• easier storage
• immediate processing
• easier to access from multiple computers
• Allows magnfication of areas

Question 13

Who are the four people identified by IRMER?

Answer 13

• operator
• Practitioner
• referrer
• lergal person (employer)

Question 14

According to IRMER what is the role of the practitioner?

Answer 14

Justify if the exposure

Question 15

What is the percentage reduction for exposure with F speed films compared with E speed?

Answer 15

20-25%

Question 16

What are the two types of digital radiographs (DR)?

Answer 16

• solid state detectors (sensors)

- photostimulable phosphor plates

Question 17

What are the two types of DR sensors?

Answer 17

• CCD charged coupled device
• CMOS complimentary metal oxide semiconductor

Question 18

How do CMOS’s work?

Answer 18

They convert X-ray to light via scintillator layer

Question 19

What is the advantage of phosphor plates over solid state sensors?

Answer 19

• Cheaper

- similar dimensions to conventional films

Question 20

What has the highest spatial resolution out of all the films?

Answer 20

Conventional

Question 21

What are some of the disadvantages of DR?

Answer 21

-Doesn’t always lead to dose reduction

Question 22

When assessing a tooth for endodontic treatment what should you assess on the X-ray?

Answer 22

• how many roots
• curvature
• canal sclerosis
• location of pulp chamber
• prev eno treatment
• Broken instreumrnts
• size and location of apical pathology
• resorption
• root fracture

Question 23

What are the three methods used when taking X-rays of teeth?

Answer 23

• Paralleling
• Parallax
• Bisecting angle

Question 24

What angle is there between X-ray beam and long axis of tooth in paralleling ?

Answer 24

90

Question 25

What are the advantages of paralleling?

Answer 25

- greater geometric accuracy - greater reproducibilty - fewer retakes - reduced radiation dose

Question 26

What happens to the image the bigger the distance between film and X-ray?

Answer 26

magnification

Question 27

How does the bisecting angle work?

Answer 27

xray beam is placed at 90 degrees to the angle between the tooth and the film

Question 28

What are the benefits of bisecting angle?

Answer 28

Quick and easy esp when rubber dam placed | -comfortable for patients

Question 29

What are the disadvantages of bisecting angle?

Answer 29

- does not avoid distortion - anatomical features are superimposed - cone cutting - difficult to reproduce

Question 30

How does parallax work?

Answer 30

- Horizontal and vertical | - set objects in 3D space will have altered relationships when viewing perspective is varied

Question 31

with regards to CBCT what is the downfall of higher resolution exposures?

Answer 31

Increases effective dose to patient | -increased risk of motion artefacts

Question 32

How many more periapical lesions do CBCT reveal compared with PA’s?

Answer 32

38%

Question 33

What are the indications for CBCT in Endo?

Answer 33

- resoprtion defect - planning surgery - teeth with unusual anatomy - anatomic superimposition - where there are non specific signs and sumps - trauma diagnosis

Question 34

What does sclerosing osteitis indicate?

Answer 34

zone of peripheral radiopacity - indicative of low grade long standing apical infection - often pulp is undergoing degeneration

Question 35

Causes of internal resorption:

Answer 35

CHRONIC PULPITIS

Question 36

What is the PAI index?

Answer 36

Systematic way of appraising changes to the apical regions-was developed using max incisors on PA's-more for epidemiological studies

Question 37

What is a PAI of 3

Answer 37

definite characteristic of AP

Question 38

What is a PAI 5

Answer 38

characterises of severe periodontitis with bone expansion

Question 39

What are the 3 potential spaces for infection spread from max teeth in dental abscess?

Answer 39

Canine space Buccal space Infratemporal Space (then to orbit)

Question 40

What spaces can dental infection spread from mandible teeth?

Answer 40

``` Parotid space Submandibular and sublingual spaces Masseteric space Pterygoid space Temporal Space Lateral pharyngeal Space ```

Question 41

Where can infection spread from retropharyngeal space?

Answer 41

Carotid sheath | retropharyngeal space

Question 42

What is pain?

Answer 42

unpleasant sensory and emotional experience associated with actual or potential tissue damage