Radiograph interpretation

Question 1

Why?

Answer 1

Orthodontics, endodontics, interproximal caries etc.

Question 2

What can you see?

Answer 2

Enamel, dentine, pulp (horn and chamber), pulp stones, possibly floor of antrum, trabecular bone, restoration (overhangs/ recurrent caries), caries lesion etc.

Question 3

Types (intraoral)

Answer 3

Bitewing shows crown

Periapical shows root tips and crown

Question 4

Grade 1

Answer 4

Excellent, no errors or positioning/ exposure/ processing

Question 5

Grade 2

Answer 5

Diagnostically acceptable but some errors

Question 6

Grade 3

Answer 6

Unacceptable, radiograph unusable

Question 7

Errors

Answer 7

Artefacts: 
-orientation dot misinterpreted
-cervical burn out
-under/ overexposure
-processing errors
Common defects:
-superimposed contact points
-contact points between premolars not included

Question 8

Report

Answer 8

Size (width and height in mm/cm)
Shape (regular: round, triangular, rhomboid or irregular)
Location (MD, inferior-superior or posterior-anterior) and view
What teeth are seen?
Density (radiopaque, radiolucent or mixed)
Borders (well or poorly demarcated)
Audit score 1-3
Bone quality/ pathology?
Calculus present?/ Amount of bone/ bone level
Check restorations - ledges/ defects/ voids
Any caries? Where? Extent?
Pulpal tissues. Stones? Root canal?
Artefacts

Question 9

Hazards

Answer 9

Radiation dose
Indication
Pregnancy
Consent must be gained
Reporting is legal requirement for all radiographs

Question 10

Hazards: deterministic vs stochastic

Answer 10

Deterministic hazards: cause and effect e.g. effect proportional to dose
Stochastic hazards: chance e.g. the probability of dose not related to damage

Question 11

Hazards: radiation dose

Answer 11

Cumulative hazards
Two bitewings roughly equals one day of background radiation
Risk higher in young as they will live longer
Around 10 fatal tumours due to dental radiographs per annum

Question 12

Hazards: indication

Answer 12

Analyse caries risk and risk factors
Must be justified
Should add new info to aid patient

Question 13

Hazards: pregnancy

Answer 13

Normal criteria applied but may suspend

Question 14

When to take radiographs

Answer 14

Has to be justified and on an individual patient basis
Not done routinely
Use for endo - need multiple views of root
Always look at previous radiographs to check if useful
Should be used for current treatment

Question 15

Orientation dot

Answer 15

Lump sticking up is correct way round