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Endo I > L6 Endodontic Radiology > Flashcards

L6 Endodontic Radiology Flashcards

1
Q

how much bone do you need to see above an apices on a diagnostic radiograph

A

5mm above apex

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2
Q

what are paramount to determine a correct diangosis in a radiograph

A

optimization of image quality and relationship

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3
Q

what does a diagnostic radiograph include

A
  • areas of concern
  • no cone cuts
  • no overlapping
  • no elongation or foreshortening
  • 5mm above apex
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4
Q

what radiographs do posterior teeth require

A

2 P/A radiographs: one straight on and 20 degrees angled

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5
Q

why is it a good idea to take multiple angles of radiographs

A

to help guess the 3D anatomy

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6
Q

what qualifies as a current radiograph

A

1-2 months

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7
Q

what could indicate a new vertical root fx

A

drop off perio pocket or a DST

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8
Q

when should you take new radiographs

A

-if its not current
- a new restoration or any new information or complaint

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9
Q

what is the historical value of radiographs

A

a series of radiographs over time with similar angulation and exposure can be very helpful when following a new developing or healing lesion

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10
Q

what are the benefits of endodontic radiology

A
  • suggests LEOs and other pathosis
  • may indicate unseen canals and proximal anatomy
  • largely locates most curvatures
  • assists in working-length determination
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11
Q

if apex locator is wrong what would it tell you about your working length

A

working length will actually be longer

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12
Q

what are the risks of endodontic radiology

A

there are none

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13
Q

radiographs help develop a:

A

mental image

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14
Q

what are the 3 biggest risks of endodontic radiology

A
  • attempting to diagnose from radiographs alone
  • seeing something on the film that is not there
  • failure to see something on the film that is there
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15
Q

are mesio distal curvatures easier to notice or bucco lingual

A

mesio distal

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16
Q

what does a bullseye on a radiograph mean

A

you are seeing a facial or lingual root tip on end but you dont know if its curving lingual or facial

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17
Q

what population has a higher incidence of 4th distolingual root of the 1st molar

A

native american popularions and asian populations

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18
Q

what way does the extra 4th DL root in 1st molar curve

A

sharply to the facial

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19
Q

we want to work and fill at ______ short of the canal exit in most cases

A

1.0mm

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20
Q

how do you tell which canal in a radiograph

A
  • could take separate XR of each canal with a single file in a known canal and label XR (wastes time)
  • place files of varying radiographic appearance in each of the canals and remember which file went in each canal (only 1 file available in clinic)
  • increase the vertical angle of the radiograph, lingual canal will be longer and buccal shorter however lengths would be distorted
  • take a straight on radiograph then a shift shot of 20 degrees and remember which direction the xray cone was moved
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21
Q

SLOB RULE: as the angle of the XR cone is shifted, the object furthest from the XR cone will move ____ the XR cone

A

with

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22
Q

what are the common periapical lesions of endodontic origin (LEOs)

A
  • thickened PDL
  • P/A radiolucency
23
Q

what is the differential dx for a LEO shown by a thickened PDL

A

trauma from occlusion

24
Q

what are all of the things we need to know to make a dx

A
  • diagnostic XRs
  • history
  • clinical exam
  • clinical testing
  • etiology
25
a radiolucency of endodontic origin is often but not always associated with:
a pulpal dx of necrotic pulp
26
how do you tell the difference between an abscess, granuloma, and a cyst
biopsy
27
why cant you see a VRF on radiograph
crack is either in the plane of the film or obscured by the root itself
28
what might be a clue to root fractures
mobility of the tooth
29
what is a distinguising characteristic of a radiographic lesion of endodontic pathosis
the radiolucency stays at the apex regardless of cone angulation
30
what is an anatomical landmark that gets confused for a LEO
mental foramen
31
what are the differential dx for LEOs
- anatomical landmarks - radiographic artifact - another non endodontic lesion - oral manifestation of systemic disease
32
what are the common anatomical landmarks
- maxillary sinus - nasal cavities - incisive canal - mental foramen - mandibular depression
33
what is the maxillary sinus superimposed over
maxillary posterior apices
34
what should the PDL look like in a healthy tooth
distinctly uniform width and un interrupted
35
where are nasal cavities seen
superimposed over the central and lateral apices especially when high bisecting angle technique is used
36
what should you do to see if anatomical landmarks move away from apices
- pulp testing - percussion - palpation - angled radiographs
37
lamina dura remains intact in:
healthy teeth
38
pathology is seldom:
bilaterally symmetrical
39
what are key to diagnosing LEO
lamina dura and pulp tests
40
how do you tell if a radiolucent area is not associated with apex
if radiolucent area moves away from the apex on multiple films
41
why should you test vitality of teeth in area of interest
we must pulp test every tooth which we plan to restore
42
what is the most common anatomical landmark that gets confused with LEO
mental foramen
43
what are non endodontic radiolucencies which may mimic LEOs including oral manifestations of systemic disease
- lateral periodontal cyst (abscess) - PCOD - FOD - hyper parathyroidism - central giant cell granuloma - neoplasias
44
what symptoms would lateral periodontal cyst (abscess) mimic
- may be asymptomatic or - symptoms of SAP - symptoms of AAA - CC: pain, swelling, palpation positive, percussion positive, PARL not present - vital pulp - LD may or may not be intact
45
what is the etiology of lateral periodontal cyst
- infected perio pocket - if able to drain- aysmptomatic - if unable to drain - symptomatic
46
what are other names ofr periapical cemental osseous dysplasia (PCOD)
- cementoma - periapical fibrous dysplasia - periapical cemental dysplasia
47
describe periapical cemental osseous dysplasia
- a dysplastic rather than pathologic or inflammatory condition - all teeth were vital and asymptomatic - mixed radiolucent and radiopaque
48
what is a central giant cell granuloma
- a benign intraosseous lesion found in the anterior of the maxilla and the mandible in tounger people - characterized by large lesions that expand the cortical plate and can resorb roots and move teeth - composed of multi nucleated giant cells - more common in females slightly - appears as multilocular radiolucencies of bone
49
what does metastatic breast cancer do to teeth
- causes spiking and resorption of roots - poorly defined borders of lesion - loosening of teeth - pulp may still be vital - symptoms of neoplasia, esp in mandible may be pain as well as paresthesia - VIP lesion is usually ragged and asymmetrical
50
what are some other less common non endodontic radiolucencies
- osteosarcoma - ameloblastoma - ameloblastic fibroma - dentigerous cyst - globulomaxillary cyst - keratocyst - median palatine cyst - nasopalatine cyst - residual cyst - scar tissue - traumatic bone cyst
51
what does CBCT show
- creates multiple sections of an area to display: - unusual or extra canals - location and extent of cracks - aberrant anatomical features - otherwise unseen pathology
52
what should you treat first in multiple presentations of issues
the most serious or the chief complaint or most symptomatic tooth first
53

Endo I (13 decks)

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