Radiographic anatomy and localisation Flashcards
11 is erupted but has another structure superimposed on it
For better definition a periapical was also taken -PA has been taken with a slightly steeper vertical angle than the panoramic
Radiographically, is the supernumerary buccal (labial) or palatal?
Palatal
The incisal edge of the supernumerary has moved up relative to the central and lateral incisors in the periapical
Patient has an erupted mesiodens
21 is displaced and rotated
How can you describe the rotation of 21?
Where is 21’s incisal edge in relation to 11 and 22 (labial or palatally)?
labio-distally or palato-mesially
* describe what position a surface that can be seen is now in)
21 incisal edge is labial to both 11 and 22 – it has moved down in the occlusal view
13 and 23 are unerupted
Describe their orientation and possible bucco-palatal positions from this view
13 is mesially inclined, crown superimposed on roots of 12 and 11
23 is more vertical, crown superimposed on root of 22
Both must have a buccal or palatal relationship to the line of the arch, as we can see roots of the incisors through them
How is the crown of 13 related to the root of 11? And to 12?
What has happened to the root of 12? What does this tell you about the orientation of 12?
is 23 the same?
crown of 13 is palatal to the root of 11
Crown of 13 is in close proximity to the root of 12, which shows resorption and is not seen through 13 like the other incisors on the periapical
12 must be orientated with its root more palatal than the root of 11
23 is palatal to both 21 and 22
which molar teeth absent and how did you decide?
first molars are absent
in the lower jaw this is clear from the mesial tilt of the first-standing molars; there is slight tilting of the upper sevens
what do you know about 23
what don’t you know - how will you find out
23 is impacted and mesially inclined, crown superimposed on roots of 21 and 22; query a radiolucency within crown of 23
We can’t tell its bucco-palatal position
* A second view to allow parallax is needed – upper anterior oblique occlusal or upper left lateral oblique occlusal would be useful
has the relationship between the crown of 23 and the roots of 21 and 22 changed? What does this tell you about their bucco-palatal relationship?
crown of 23?
23 has moved up in the occlusal view (closer to apex of 22), and is therefore palatal to roots of 21 and 22
23 shows loss of hard tissue in the crown, due to caries or internal resorption
age of pt
about 14 (based on root formation of 7s)
where are 13 and 23
describe
how to get more info
13 and 23 are clinically absent, but visible above the upper molars
13 and 23 are horizontal, neither along the line of the arch or perpendicular to it, crowns facing distally
Need to determine their bucco-palatal position and more precise orientation, as the panoramic view is not ideal for that – the beam is not at 90o to the line of the arch at this region
* An occlusal view will be helpful
13 and 23 descibe orientation in this occlusal view
13 and 23 can now be seen crossing the arch between the 6s and 7s; at this posterior part of the occlusal view we are looking straight down on the teeth – molars seen in cross-section – so we are using this as a view at almost right angles to the panoramic
radiolucencies palatal to 17 and 27
caused by the naso-lacrimal ducts (not the greater palatine foramina)
15-year-old has a clinically missing upper left canine
Is it evident in this view
what else do you see? Can you explain the features related to 22?
what view next?
no evidence of 23
22 open apex and inflammatory change – dens invaginatus
Retained 63
need OPT
where is 23
what else about dentition
what view is needed to localise the canine
vertical and inverted, with its apex lower than apices of 24 and 25
Erupted mesiodens present; 26 absent; 28 is the only developing third molar
occlusal
describe the canine in the occlusal view - Where is the crown tip in relation to the arch and the root apex?
23 has a cross-sectional appearance in the occlusal (therefore same orientation as X-ray beam); both crown and root are higher than apices of 24 and 25
Crown tip buccal to the arch, root apex palatal
age of pt
what is strange object, how many of them? where are they?
13yo based on eruption of lower 7s and root formation
safety pin superimposed on maxilla - 1 pin on RHS (image on left is horizontally magnified)
must be within focal trough as clear image on RHS - abve hard palate, inside or outside of pt (maybe right side of bony nasal cavity)
type of parallax and where are they
horizontal
canine is palatal (23 crown palatal to 21 root)
type of parallax and where are they
vertical parallax
palatal 13 and 23
type of parallax and where are they
horizontal parallax
13 crown palatal to 12 and 11 roots
How is the crown of 13 related to the root of 11?
And to 12?
What has happened to the root of 12?
What does this tell you about the orientation of 12?
Is 23 the same?
See apex 11 above the crown on PA but not on occlusal, hidden 21 apex on PA but not on occlusal
PALATAL??
where is the internal resorption
2 have resorption (31, 41)
Radiolucent area in upper half RC, RC thin and faint
41 – resorptive area distolingual
31 – resorptive are lingual
what is the radiopacity
option - issue on film, in the person
here it is moving on different films so therefore anatomical - is the left mandibular tori
what is the radiopaque line on PA
Left zygomatic buttress/zygomatic bone (radiopaque)
Poor PA – cusps of premolar exaggerated, not ideal (vertically placed)
what is the Speckled, cauliflower radiopacity at left posterior of OPT
Tonsillolith in left palatine tonsil
what is the radiopaque lines
Nasogastric tube
