Diagnosis and Radiology Flashcards
What is diagnosis?
The identification of disease from its signs and symptoms
What are the sources of dental pain?
- Dentinal
- Pulpal
- periradcular
- Non odontogenic
What are the sources of inflammation?
- Pulp
- Periradicular
- periodontal
What classification system do we use of mobility?
Millers
Class 1: <1mm in BL/MD direction
Class 2: >1mm in BL/MD direction
Class 2: as class 3 + Axial movement
What instruments can be used to identify cracks?
-Light (will not not pass though if there is a fracture present)
-Tooth sleuth
-Rubber dam rolled up
-
When using pulp tests which nerves are we hoping to stimulate?
A delta
Are pulp test methods more accurate in cases of pulp necrosis or vital pulp?
Pulp necrosis
What could give rise to false positive results from EPT?
- Conduction from adjacent teeth
- Conduction from PDL
During pulp testing How can you prevent transmission between teeth?
Isolation with acetate strips
What methods do we have when assessing pulp disease?
- Clinical history
- PUlp tests: Thermal, Electrical, Sweet
- Radiographs
What speed radiographic fills do we use?
F speed replacing E speed
What are the benefits of using Digital radiographs?
- easier storage
- immediate processing
- easier to access from multiple computers
- Allows magnfication of areas
Who are the four people identified by IRMER?
- operator
- Practitioner
- referrer
- lergal person (employer)
According to IRMER what is the role of the practitioner?
Justify if the exposure
What is the percentage reduction for exposure with F speed films compared with E speed?
20-25%
What are the two types of digital radiographs (DR)?
- solid state detectors (sensors)
- photostimulable phosphor plates
What are the two types of DR sensors?
- CCD charged coupled device
- CMOS complimentary metal oxide semiconductor
How do CMOS’s work?
They convert X-ray to light via scintillator layer
What is the advantage of phosphor plates over solid state sensors?
- Cheaper
- similar dimensions to conventional films
What has the highest spatial resolution out of all the films?
Conventional
What are some of the disadvantages of DR?
-Doesn’t always lead to dose reduction
When assessing a tooth for endodontic treatment what should you assess on the X-ray?
- how many roots
- curvature
- canal sclerosis
- location of pulp chamber
- prev eno treatment
- Broken instreumrnts
- size and location of apical pathology
- resorption
- root fracture
What are the three methods used when taking X-rays of teeth?
- Paralleling
- Parallax
- Bisecting angle
What angle is there between X-ray beam and long axis of tooth in paralleling ?
90
What are the advantages of paralleling?
- greater geometric accuracy
- greater reproducibilty
- fewer retakes
- reduced radiation dose
What happens to the image the bigger the distance between film and X-ray?
magnification
How does the bisecting angle work?
xray beam is placed at 90 degrees to the angle between the tooth and the film
What are the benefits of bisecting angle?
Quick and easy esp when rubber dam placed
-comfortable for patients
What are the disadvantages of bisecting angle?
- does not avoid distortion
- anatomical features are superimposed
- cone cutting
- difficult to reproduce
How does parallax work?
- Horizontal and vertical
- set objects in 3D space will have altered relationships when viewing perspective is varied
with regards to CBCT what is the downfall of higher resolution exposures?
Increases effective dose to patient
-increased risk of motion artefacts
How many more periapical lesions do CBCT reveal compared with PA’s?
38%
What are the indications for CBCT in Endo?
- resoprtion defect
- planning surgery
- teeth with unusual anatomy
- anatomic superimposition
- where there are non specific signs and sumps
- trauma diagnosis
What does sclerosing osteitis indicate?
zone of peripheral radiopacity
- indicative of low grade long standing apical infection
- often pulp is undergoing degeneration
Causes of internal resorption:
CHRONIC PULPITIS
What is the PAI index?
Systematic way of appraising changes to the apical regions-was developed using max incisors on PA’s-more for epidemiological studies
What is a PAI of 3
definite characteristic of AP
What is a PAI 5
characterises of severe periodontitis with bone expansion
What are the 3 potential spaces for infection spread from max teeth in dental abscess?
Canine space
Buccal space
Infratemporal Space (then to orbit)
What spaces can dental infection spread from mandible teeth?
Parotid space Submandibular and sublingual spaces Masseteric space Pterygoid space Temporal Space Lateral pharyngeal Space
Where can infection spread from retropharyngeal space?
Carotid sheath
retropharyngeal space
What is pain?
unpleasant sensory and emotional experience associated with actual or potential tissue damage
