Lecture 6 (9/26) Flashcards
Traditional radiography we are looking at a _____ dimensional picture for a ______ dimensional situation
2D; 3D
A CBCT will show you a _______ image
3D
A static 2-dimensional shadow of a dynamic 3-dimensional situation
Traditional radiograph
Type of image that is a “snapshot in time”:
Radiograph
Ideally if we are going to do endodontic therapy we want a radiograph that is:
Exposed the day of treatment (although not 100% necessary)
Because a radiograph is only a 2D image, it is subject to:
Distortions and false interpretations
As long as there is no periaplical lesions we need to see _____mm of bone beyond the apex
If there is a periapical lesion we need to see:
2-3mm; all of the lesion
If the radiograph does not appear right, you should consider:
a better angulation
________ to the area of concern are paramount in helping to determine a correct diagnosis
Optimization of image quality and relationship
Optimization of image quality and relationship to the area of concern are paramount in helping to determine a correct:
Diagnosis
If your radiograph was taken before the patient had symptoms you should:
take a new radiograph
If your radiograph was taken before the patient had some operative work done you should:
take a new radiograph
old radiographs can be very useful, such as:
Viewing changes that occur
Diagnostic radiograph must be _____ and include all of the ares of concern in proper orientation without cone cuts, overlapping, elongation or foreshortening.
Distinct
Diagnostic radiographs must be distinct and include:
All of the areas of concerns in proper orientation
What diagnostic radiographs are required for all posterior teeth?
2 PA radiographs (straight-on & 20 degree H. angled)
When taking a diagnostic radiograph, its always a good ideal to take _____ to help _____
multiple angles; guess the 3D anatomy
Are your radiographs current? Think of all the ____ of a ____ pulpal-periodontal environment to a _____ state. You swill see most of these changes.
stages; healthy; diseased
What does a 5-year old sloppy x-ray tell you?
To take current radiographs
A current radiograph
1-2 months; Unless something has changed
NEVER EVER EVER try to make a diagnosis:
from 1 radiograph
The radiograph is a _____ that helps us arrive at a _____. But it is not _____.
Tool, diagnosis; NOT THE ONLY TOOL
A drop-off perio pocket or a DST could indicate:
a new vertical root frature
A new vertical root fracture could be indicated by:
a drop-off perio pocket or DST
Do radiographs have historical value?
Yes- allows you to visualize change over time
A series of radiographs over time with similar angulation and exposure can be very helpful when following:
a new developing lesion or healing lesion
Benefits of endodontic radiology include: (4)
- Suggest LEOs & other pathosis
- May indicate unseen canals & proximal anatomy
- Largely locates most curvatures
- Assists in working-length determination
When you see a canal “disappear on a radiograph” this shows us:
The canal splits at that point and becomes two canals (AKA a fast break)
When you look at lower first premolars 24% of the time you will see a _____ canal system and this indicates this is likely _______
(Double check this info)
Type IV (canal disappears I think); a case you need to refer
Mesio-distal curvatures are _____ to see
Buccal-lingual curvatures are _____ to see
(on radiographic images)
Easy; harder
Bullseye suggest that:
The root takes a 90 degree curve- very difficult to treat these cases! REFER REFER REFER
If a canal disappears this may be called a ____ meaning the canal has ____.
This is significant for ____
You probably want to ___ these cases
Fast break; split; lower first premolars; refer
Benefits of endodontic radiology:
Suggests ____ and other _____
LEOs and other pathosis
We want our working length and obturation to be _____ short, where the canal exits the root
1mm
Benefits of endodontic radiology:
May indicate ___ and _____
Unseen canals and proximal anatomy
Benefits of endodontic radiology:
Largely locates most:
Curvatures
Benefits of endodontic radiology:
Assists in ______ determination
working-length
Changes of horizontal angulation = _____
“SLOB” rule
Modern diagnostic Digital radiographs is _____ when appropriate radiation hygiene techniques are employed
without risk
The lingual canal will move the _____ direction as the shift shot.
The buccal canal is going to appear to move the ______ direction of the shift shot.
Same; Opposite
(line up pointer fingers - one infront of the other infront of face, if you move you head to the left/right, it appears the finger in the back is moving in the same direction as your head- this represents the lingual-palatal root)
There should be _____ about x-ray safety for adequate diagnostic/TX purposes
No question
Radiographs helps to develop a:
Mental image
Risks of endodontic radiology:
Many opportunities exist for ____ and ____
Confusion; inaccurate interpretation
Risks of endodontic radiology:
Results can be ____ leading to ____
Inaccurate diagnosis; incorrect treatment
A risk of endodontic radiology is that results can be inaccurate leading to incorrect treatment, because of this, its extremely important to:
Avoid making diagnose solely off radiograph
A risk of endodontic radiology is that results can be inaccurate leading to incorrect treatment, because of this, its extremely important to evaluate for: (3)
- artifacts
- poor resolution
- wrong angle
What are the three biggest risks of endodontic radiology?
- attempting to diagnose from radiographs alone
- seeing something on film that is not there
- failing to see something on the film that is there
Unless you like spending time and money in court: (its a saying)
Errors of commission = errors of omission
______ curvatures are more easily noticed than ______
Mesio-distal; buco-lingual
When you see a _____ on an image, you are seeing facial or lingual root tip “on end”. You don’t know if it curves to the facial or lingual (good opportunity to refer)
Bullseye
When you see a bullseye, you are seeing a ___ or ____ ____; you don’t know if it curves to the _____ or _____
Facial or lingual root tip; facial or lingual
When you see a bullseye on an image, its a good idea to:
Refer
This image shows an example of:
Bullseye
This 4th (disto-lingual) root is seen most frequently in ______ and ______ populations
Native American; asian
What kind of root is seen most frequently in Native American and asian populations?
4th disto-lingual root
Often the disto-lingual root and canal curve sharply to the _____ to present this classic appearance
facial
The 4th (disto-lingual) root is seen most frequently in Native American and asian populations. Often the D-L root and canal curve sharply to the facial to present this classic appearance.
This information can be of great value to the operator in being able to _______ to ______
visualize the unusual anatomy; avoid misadventures
A distal shift shot on #30 will make the ML root appear to move:
Distal to the MB root
Which of the following is not necessary for quality diagnostic routine endodontic films?
Panorex
(ALL posterior teeth require 2 P/A radiographs straight on and 20 degrees horizontal angle & a BW)
