Interpretation of periodontal disease Flashcards
how does the lamina dura appear on a radiograph?
appears as a dense radiopaque line in healthy tooth
how does the alveolar crest appear on a radiograph?
- about 1.5-2 mm apical to the CEJ
- in anterior teeth, alveolar crest is pointed and sharp and appears to be very radiopaque
- in posterior teeth, the alveolar crest appears flat and smooth, and parallel to a line between adjacent cementoenamel junctions
- appears a little less radiopaque than in anterior teeth
where is the periodontal ligament space?
- appears as a thin radiolucent line between the root of the teeth and the lamina dura
- continues around the root structure and of uniform thickness in healthy teeth
what is periodontal disease? what all is included in this term (range)? how does the gingiva appear
- a group of disease that affect the tissue around teeth
- may range from superficial inflammation of gingiva to destruction of supporting bone and periodontal ligament
- the gingiva appears swollen, red, and bleeding, with soft tissue pocket formation
how does periodontal disease appear in radiographs?
- appearance is different, alveolar crest appears indistinct, bone loss is seen
how can we detect periodontal disease?
- requires both clinical and radiographic examination
- the clinical exam provides info about soft tissue
- the radiographic exam provides info about bone
who can perform the clinical exam? what should this exam include?
- the dentist and dental hygienist
- should include evaluation of soft tissue for signs of inflammation such as redness, bleeding, swelling, pus
- a thorough clinical assessment must include periodontal probing
what is the purpose of a radiographic examination for perio patients? what film should be used and what exposure technique?
- provide an overview of the amount of bone present
- indicate the pattern, distribution and severity of bone loss
- ‘the periapical radiograph is the film of choice for the evaluation of periodontal disease’
- the paralleling technique is the preferred periapical exposure method for demonstrating anatomic features of periodontal disease
- bisected periapical films may appear to show less bone loss than is actually present
why should we not use the horizontal bite-wing or panoramic films for periodontal evaluations?
- has limited value in the detection of periodontal disease because you usually can’t see the apices of teeth
- severe interproximal bone loss cannot be adequately visualized on horizontal bite-wing radiographs
- the vertical bite-wing can be used to examine bone levels in the mouth
- the panoramic film has little diagnostic value in the detection of periodontal disease
what is bone loss? how can it be described?
- can be estimated as the difference between the physiologic bone level and the height of remaining bone
- it can be described in terms of the pattern, distribution and severity of loss
what is distribution in bone loss? what are the 2 types?
described as localized or generalized
- localized bone loss occurs in isolated areas (less than 30%)
- generalized occurs evenly throughout the dental arches (more than 30% of teeth affected)
what is pattern in bone loss? what are the 2 types?
described as either horizontal or vertical
- horizontal bone loss is the loss that occurs in a plane parallel to the CEJs of adjacent teeth
- vertical bone loss is the loss that does not occur in a plane parallel to the CEJs of adjacent teeth
what are the 3 classes regarding severity of bone loss?
- mild bone loss (crystal changes)
- moderate bone loss (bone loss of 10% to 33%)
- severe bone loss (bone loss of 33% or more)
what is gingivitis?
- not associated with bone loss (only gingival tissue)
- no radiographic change is seen in bone
- crestal lamina dura is present
what is mild periodontitis?
- associated with mild crystal changes
- lamina dura becomes unclear and fuzzy
- horizontal bone loss (3-4 mm apical to CEJ)
