radiograph reporting and the radiographic presentation of caries. Flashcards

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1
Q

What determines the different appearances on an X-ray image?

A

Attenuation on an X-ray beam

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2
Q

name some examples of things which appear opaque on x-rays?

A

Metal restorations
Enamel
Dentin

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3
Q

Out of dentin, cementum/bone and enamel, rank in order or most to least opaque

A

Most opaque is enamel
Then dentin
Then cementum/bone

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4
Q

What are the most lucent things on an X-ray?

A

Soft tissues
Fluid
Air

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5
Q

What colour is air and why?

A

All X-ray particles are reaching the plate/passing through

Appears black

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6
Q

What colour is radio-opaque?

A

White opaque

E.g. Enamel

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7
Q

What colour is radiolucent?

A

Black / darker

E.g. air

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8
Q

Ona radiograph, should you write down what is normal and abnormal?

A

Yes, write both

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9
Q

Why take a bite wing radiograph?

A
  1. DETECTION OF CARIES MONITORING THE
  2. PROGRESS OF CARIES
  3. ASSESSMENT OF EXISTING RESTORATIONS
  4. ASSESSMENT OF THE PERIODONTAL STATUS
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10
Q

What do you report when recording notes?

A
  1. Date and image was taken
  2. Grading and justification
  3. Right if left side
  4. Say what you see
    - tooth and partial views
    - bone levels (normal or otherwise)
    - any restorations present, are they sound, size, type and location etc
  • use alongside clinical examination
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11
Q

What are the first 2 ways to classify caries?

A
  1. Anatomical site
  2. Primary/secondary/residual
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12
Q

What is are primary caries?

A

Unrestored surfaces

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13
Q

What are secondary caries?

A

Adjacent to or under restorations

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14
Q

What are residual caries?

A

Demineralised tissue left behind before filling the tooth (usually uninflected, sound but stained dentin)

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15
Q

How do you classify carries after you determine the site and if it is primary/secondary?

A

Level of activity

Active/arrested

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16
Q

When do you see active caries?

A

Childhood… fizzy drinks or med

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17
Q

What are arrested caries?

A

Inactive lesions that are remineralised or partially remineralised

Many be brown spots or white spot lesion

18
Q

Where do you find the pit/fissure caries?

A

Occlusal surface

19
Q

How do you tell if caries are active?

A

Soft upon probing

20
Q

Where is a susceptible zone on the posterior teeth?

A

Proximal zone

21
Q

How much mineral has to be lost in order to see a change on a radiograph?

A

40-50% - the beam will not be well attenuated - areas appears darker

22
Q

Why do caries appear darker on a radiograph?

A

Beam is not so well attenuated and area appears darker due to less mineral (pass through more easily)

23
Q

Do caries appear better or worse than they actually are on a radiograph?

A

They appear not as bad as they actually are in real life

Not enough definition between light and dark zones

24
Q

What factors can effect the appearance of caries on a radiograph?

A

Buccolingual thickness of tooth - the thicker the tooth the harder it I to see the extend of caries

Limitation in 2D film - the extend of buccolingual surface cannot be seen in this direction

25
Q

What type of caries is shown?

A

Occlusal caries

26
Q

What surface has this carie penetrated?

A

Dentin

27
Q

When can you allow an occlusal cavity to just be monitored?

A

Not penetrated the dentin

28
Q

What type of carie is this?

A

Root caries

29
Q

When are lot caries likely to be present?

A

Older people, periodontal patient or historic, dry mouth

30
Q

What is cervical burnout?

A

Artefact (bitten out) lesion on every single tooth

31
Q

What are the levels of disease with regards to caries? (WHO)

A

D1-D4

32
Q

Describe a D1?

A

Clinically detectable enamel lesions with. Intact surface

33
Q

Describe a D2

A

Clinically detectablele cavities limited enamel

34
Q

Describe a D3

A

Clinically detectable lesions in dentin

35
Q

Describe a D4

A

Lesions into the pulp

36
Q

Would you say the level of disease (D1-D4) when recording radiographs?

A

Yes, can say looks like D1 etc (not always easy to be sure but give it a good go)

37
Q

Rate lesions 1-4 and why

A

D1
D2
D3
D4

38
Q

How would you treat lesions D1 and D2?

A

Treated with prevention only

39
Q

How would you treat lesions D3 and D4?

A

Restorative treatment

40
Q
A

A = enamel
B = dentin
C = pulp

41
Q

Where is this carie located?

A

Dentino-enamel junction

42
Q

Which side caries is advanced and which is severe?

A

Left advanced (D2)

Right severe (D4) - looks like D3 but radiograph does not show full demineralisation