Lec 6

Question 1

what must diagnostic radiographs have?

Answer 1

-must be distinct
-no overlap or cone cuts
-no elongation or foreshadowing
-must include all teeth
-5 mm apical to end of root

Question 2

what is considered current for radiographs?

Answer 2

1-2 months
(unless something has changed)

Question 3

benefits of endodontic radiology? (4)

Answer 3

-suggests LEO or pathology
-indicates unseen canals/anatomy
-locates most curvatures
-determines working length

Question 4

what is SLOB

Answer 4

Same Lingual
Opposite Buccal

Question 5

risks of endodontic radiology

Answer 5

artifacts
poor resolution
wrong angle
can lead to inaccurate dx

Question 6

3 biggest risks of endodontic radiology

Answer 6

1. diagnosing from radiographs alone
2. see something on film that is not there
3. failing to see something on film that is there

Question 7

what is a “Bullseye” on an x-ray

Answer 7

a facial or lingual root tip curving towards x ray

Question 8

what population often has a 4th DL root

Answer 8

Native American and Asian populations

Question 9

how to determine length of canal

Answer 9

place file of known length into canal and take radiograph
work and fill 1 mm short of canal exit!

Question 10

how to determine which canal you are seeing on radiograph?

Answer 10

take straight on PA and a shift shot PA
-remember the direction x ray tube moved

Question 11

lower molar XR cone shifted mesially
what will you see?

Answer 11

the MB canal will shift distal (OB)
the ML canal will shift mesially (SL) in the same direction as cone

Question 12

lower molar XR cone shifted distally
what will you see?

Answer 12

MB canal shifts mesial
ML canal shifts distal (w/ the cone)
SLOB

Question 13

what are 2 common LEOs

Answer 13

thickened PDL
PARL

Question 14

thickened PDL proves a LEO

Answer 14

NO
must see whole tooth to determine LEO, plus clinical tests
-could be bc of caries or trauma

Question 15

PARL means LEO

Answer 15

As long as clinical testing and other indications show along w/ radiographs, then yes
- A LEO is often associated w/ necrotic pulp (but not always)

Question 16

if the LEO does not shift when shifting the cone, what does this mean?

Answer 16

the LEO is associated w/ the tooth it is on
-this is characteristic of LEOs!

Question 17

what are possible LEOs

Answer 17

abscess
cyst
granuloma
-must perform biopsy to actually dx, not just x ray

Question 18

where do we see maxillary sinus

Answer 18

often superimposed on maxillary posterior apices
-examine lamina dura carefully at apex, PDL should be uniform for WNL

Question 19

where do we see nasal cavities

Answer 19

often superimposed over max central and lateral incisors, both sides
-pathology is seldom bilaterally symmetrical

Question 20

lamina dura and pulp tests are key to differential diagnosis

Answer 20

YES, must determine if LEO or normal anatomical landmark

Question 21

incisive foramen/canal will move away from apex when cone is shifted

Answer 21

YES
-if the radiolucency moves w/ the cone on multiple films, then probably not a PARL

Question 22

what is the most common landmark mistaken for a LEO

Answer 22

mental foramen
-it will move away from apex if cone shifts
-confirm w/ pulp test, intact lamina dura

Question 23

if a radiolucency moves with the apex on multiple films, what does this mean?

Answer 23

the radiolucency might be a LEO and is associated w/ the apex of that tooth

Question 24

bilateral lesions often indicate a LEO

Answer 24

no, most LEOs are not bilateral until proven otherwise

Question 25

what is a lateral periodontal cyst

Answer 25

an abscess
-may mimic AAA or SAP
-pulp test will be vital
-LD may or may not be intact

Question 26

what is a periapical cemental osseous dysplasia (PCOD)

Answer 26

dysplastic inflammatory condition
-all teeth will be vital and asymptomatic
-could be radiolucent or opaque
-common mistake

Question 27

what is a Brown’s tumor

Answer 27

due to hyperparathyroidism
-hypercalcemia
-hypophosphatemia
-radiolucent lesions seen
-get correct med hx to determine

Question 28

what is a central giant cell granuloma

Answer 28

benign lesion found in anterior maxilla and mandible in young pt (under 20, females higher)
-can resorb roots and move teeth
-large lesions
-multilocular radiolucencies
-pt will be asymptomatic

Question 29

what are some neoplasias seen

Answer 29

metastatic breast cancer can cause spiking and resorption of roots
-pulps may be vital still
-pain and parasthesia
-refer STAT