maxillofacial radiology Flashcards
normal varieant
- an atypical finding that is seen in a % of the population which generally has no clinical significance
dense bony islands
found in md. (normal variation)
- close to apices of premolars or molars
- well defined radiopacites
- 1cm in size
- can have spiky periphery
- often in a periapical relationship with the mandibular dentiton
(compact bone inside the marrow spaces in mandible)
when can caries be detected radiographyically
30-40% demineralisation
interproxiaml caries identified as
enamel caries seen as triagular radiuolucneyc
apex towards aDJ
occulsal caries indentification
radiolucent line at ADJ with intact enamel can be indication
as lesion progresses becomes easier to detect
cervical burnout
- due to geometry of the tooth can still mimic root caries
- in cervical burnout there is still an image of the root edge and is in tact
- stops at level of alveolar crest, not sub crestally
- buccal to lingual there is a curve interproximally
recurrent caries
- appears as a zone of increased radiolucency along the margins of a restoration
- radiopaque materials such as metals can obscure recurrent caries and radiolucent lining materials can make detection difficult
- sometimes can be a radiolucent lining materail above the restorative material
radiograph signs of periapical periodontitis
- earliest sign is widening of the apical periodontal ligament, followed by loss of lamina dura
- white arrows at lamina dura around socket of lateral incisor (compact bone which anchors the PDL space fibres as they insert into alveolar)
- Next to lamina dura is a thin radiolucent line (normal periodontal ligament space), usually about 0.1-0.2 mm wide (black arrows, normal periodontal spcace, shpuld be normal throughout)
what can further be found radiographically as inflammation caries on from PDD
1) mainly bone resorption(rarefying osteitis)
- dissolution of bone
- increased radioluncey around the apex of a non vital tooth
- left lateral and central incisor
2) or mainly bone formation (Sclerosing osteitis)
- bone formation in an attempt of healing
- rare
- usually round at roots of lower molars in young patients
- area of increased bony density around apices of non vital tooth
- lower left 1st molar, repsonce to low grade chronic infection
- some dissolution but mainly scleorosing
periodical granuloma and how it appears on radiograph
formation of granulation tissue is stimulated in an attempt to heal from chronic apical periodontitis
- appears as a well define radiolucency surrounding the apex of a non vital tooth (more radiolucent than bone)
radicular cyst
lesion more than 1cm in diameter with a corticated (white) margin is probably a radicular cyst
- usually apical lucnecy is less than a 1cm periapical granuloma
sequelae of periodical peritonitis
Root resorption - roots of tooth absorbed by cells called odontoclasts (specific to tooth) - Radicular cyst formation - untreated granuloma can form a cyst - at apex of non vital tooth - has a white margin - diameter bigger than 1cm
Ossteomyelitis
- infection of marrow spaces in the mandible
- many small radiolucencies throughout it
- needs antibiotics to irradicate it
- can have serious conequences if not treated
horizontal boneloss
radiographic appearance when loss of alveolar bone occurs parallel to the occlusal plane
vertical bone loss
- bone loss that is typically restricted to one tooth that extends along the length of the tooth root
extent of bone loss staging
1) Mild stage (stage 1)
- less than 15% bone loss or less than 2mm
2) Moderate (Stage II)
- coronal 1/3 root
- horizontal bone loss in the 1st image
3) severe stage III
- middle 1/3 root
4) Stage IV very severe
- apical 1/3 root
interdental craters
A two walled trough (bone loss) interdentally between the buccal and lingual cortices
- periodontal picket is deeper in the middle of the alveolus than it is at either the buccal or lingual martins
- appears as a low density band of bone at the alveolar crest
- with periodontal probe, deeper in the alveolus than at either buccal or lingual marings
buccal or lingual cortex loss
Appears as two separate white lines with more lucenecy of the adjacent root
- impossible to tell which of the white lines represents the buccal plate and which represents the lingual plate
periodontal endo lesions
Combination of apical infection and periodontal disease at the same tooth or one mimicking the other
tooth structure abnormalities and what are they
- dens in dente (infolding of the outer surface of a tooth into the interior, at crown, at cingulum there is an infolding of the enamel and dentine into the pulp chamber, usually become non vital)
- dilaceration (sharp bend/90degree in the crown/root direction, can be due to previous trauma to a deciduous tooth, fold is the thin lateral line)
- taurodontism (enlarged pulp chambers, short roots (cow teeth) usually of no clinical significance, usually in people with syndromes)
dentinogenesi imperfect can lead to
- can have short roots bulbus crowns
- can lead to obliteration of pulp chambers
odontomes
- hamartoma (abnormal formation of normal tissue) forming dental hard tissues, compound or complex
types of odontomes
1) compound
- lots of small denticles in a capsule and often occurs in the anterior maxilla
- insicor canine region
- often stops the eruption of permanent teeth, therefore can see if they have not erupted at the correct time
2) complex
- amorphous solid mass of calcified tissue that usually occurs in the posterior mandible
