radiograph reporting and the radiographic presentation of caries. Flashcards
What determines the different appearances on an X-ray image?
Attenuation on an X-ray beam
name some examples of things which appear opaque on x-rays?
Metal restorations
Enamel
Dentin
Out of dentin, cementum/bone and enamel, rank in order or most to least opaque
Most opaque is enamel
Then dentin
Then cementum/bone
What are the most lucent things on an X-ray?
Soft tissues
Fluid
Air
What colour is air and why?
All X-ray particles are reaching the plate/passing through
Appears black
What colour is radio-opaque?
White opaque
E.g. Enamel
What colour is radiolucent?
Black / darker
E.g. air
Ona radiograph, should you write down what is normal and abnormal?
Yes, write both
Why take a bite wing radiograph?
- DETECTION OF CARIES MONITORING THE
- PROGRESS OF CARIES
- ASSESSMENT OF EXISTING RESTORATIONS
- ASSESSMENT OF THE PERIODONTAL STATUS
What do you report when recording notes?
- Date and image was taken
- Grading and justification
- Right if left side
- 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
What are the first 2 ways to classify caries?
- Anatomical site
- Primary/secondary/residual
What is are primary caries?
Unrestored surfaces
What are secondary caries?
Adjacent to or under restorations
What are residual caries?
Demineralised tissue left behind before filling the tooth (usually uninflected, sound but stained dentin)
How do you classify carries after you determine the site and if it is primary/secondary?
Level of activity
Active/arrested
When do you see active caries?
Childhood… fizzy drinks or med
What are arrested caries?
Inactive lesions that are remineralised or partially remineralised
Many be brown spots or white spot lesion
Where do you find the pit/fissure caries?
Occlusal surface
How do you tell if caries are active?
Soft upon probing
Where is a susceptible zone on the posterior teeth?
Proximal zone
How much mineral has to be lost in order to see a change on a radiograph?
40-50% - the beam will not be well attenuated - areas appears darker
Why do caries appear darker on a radiograph?
Beam is not so well attenuated and area appears darker due to less mineral (pass through more easily)
Do caries appear better or worse than they actually are on a radiograph?
They appear not as bad as they actually are in real life
Not enough definition between light and dark zones
What factors can effect the appearance of caries on a radiograph?
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
What type of caries is shown?
Occlusal caries
What surface has this carie penetrated?
Dentin
When can you allow an occlusal cavity to just be monitored?
Not penetrated the dentin
What type of carie is this?
Root caries
When are lot caries likely to be present?
Older people, periodontal patient or historic, dry mouth
What is cervical burnout?
Artefact (bitten out) lesion on every single tooth
What are the levels of disease with regards to caries? (WHO)
D1-D4
Describe a D1?
Clinically detectable enamel lesions with. Intact surface
Describe a D2
Clinically detectablele cavities limited enamel
Describe a D3
Clinically detectable lesions in dentin
Describe a D4
Lesions into the pulp
Would you say the level of disease (D1-D4) when recording radiographs?
Yes, can say looks like D1 etc (not always easy to be sure but give it a good go)
Rate lesions 1-4 and why
D1
D2
D3
D4
How would you treat lesions D1 and D2?
Treated with prevention only
How would you treat lesions D3 and D4?
Restorative treatment
A = enamel
B = dentin
C = pulp
Where is this carie located?
Dentino-enamel junction
Which side caries is advanced and which is severe?
Left advanced (D2)
Right severe (D4) - looks like D3 but radiograph does not show full demineralisation
