Radiographic Examination Flashcards
T/F - Radiographs are diagnostic of periodontal disease
False - Radiographs can help us see clinical attachment loss that is caused by periodontitis
T/F - Radiographs are diagnostic of periodontal disease
False - Radiographs can help us see clinical attachment loss that is caused by periodontitis
What can radiographs tell us about the alveolar bone/bone loss
Amount of bone loss
Condition of the alveolar bone
Pattern of bone loss
Bone with loss in furcation areas
Width of the PDL space
Pathogenics
Anatomical considerations
Root proximity and C/R ratios
How do you calculate bone loss?
(CEJ - Crest) / (CEJ - apex) = bone loss percentage
What percentage of bone loss is considered ‘slight’?
<20%
What percentage of bone loss is considered ‘moderate’?
21-49%
What percentage of bone loss is considered ‘severe’?
≥50%
Why is correct Vertical beam angulation important?
If vertical angulation is incorrect, it can make the bone levels appear different than they actually are
What is the normal height of the alveolar crest?
2mm below the level of the CEJs on adjacent teeth
Why do crestal changes occur during inflammation?
Pathogens start to destroy the alveolar crest
When looking at the crestal lamina dura, how do we determine if it “has integrity”
If the crestal lamina dura is continuous, then it has integrity
When looking at the crestal lamina dura, how do we determine if it “has integrity”
If the crestal lamina dura is continuous, then it has integrity
What can radiographs tell us about the alveolar bone/bone loss
Amount of bone loss Condition of the alveolar bone Pattern of bone loss Bone with loss in furcation areas Width of the PDL space Pathogenics Anatomical considerations Root proximity and C/R ratios
How do you calculate bone loss?
(CEJ - Crest) / (CEJ - apex) = bone loss percentage
What percentage of bone loss is considered ‘slight’?
What percentage of bone loss is considered ‘moderate’?
21-49%
What percentage of bone loss is considered ‘severe’?
≥50%
Why is correct Vertical beam angulation important?
If vertical angulation is incorrect, it can make the bone levels appear different than they actually are
What is the normal height of the alveolar crest?
2mm below the level of the CEJs on adjacent teeth
Why do crestal changes occur during inflammation?
Pathogens start to destroy the alveolar crest
T/F - We can use the integrity of the crestal lamina dura on radiographs to indicate the need for periodontal treatment
False - We have to use this information and also observe clinically before we can make an assessment
When looking at the crestal lamina dura, how do we determine if it “has integrity”
If the crestal lamina dura is continuous, then it has integrity
Vertical bone loss v horizontal bone loss
Horizontal = bone loss occurs on the same plane Vertical = bone loss occurs steeper in one area
How can you determine if an osseous defect is a 1, 2, or 3-walled defect?
Count the remaining osseous walls (ones that haven’t been destroyed)
If there is 1 remaining wall = 1 walled-defect
If there are 2 remaining walls = 2-walled defect
If there are 3 remaining walls = 3-walled defect
What is an osseous crater?
A two-walled defect where the buccal and lingual walls are intact, but the proxmial bone is deficient
What type of radiographs can you view osseous craters?
Periapical film (may not show up on BW)
What is a Moat-like defect
An intrabony resorptive lesion involving one or more surfaces of supporting bone
Bone loss in the furcation areas
Pathologic resorption of bone within a furcation
Shows up radiographically as a radiolucency in the furcation areas
How can you detect furcation involvment?
Gutta-percha point on X-ray film
What does a normal PDL look like on a radiograph?
The space between the tooth root and alveolar bone containing the PDL
The PDL appears as the PDL space of 0.4-1.5 mm on radiographs
Tends to be wider at the apex and alveolar crest
Tends to be narower in the mid-root areas
What is a thickend radicular lamina dura and a widened PDL space a sign of?
Occlusal Trauma
Where in the mouth are there more trabeculae?
Anteriorly and Superiorly
What do vessels within interdental bone look like radiographically?
They appear as thin lines bordered by radiopaque lines in the bone traveling up towards the teeth
Why can the maxillary sinus be an issue?
IF the maxillary sinus is close to or has invaginate among the roots of the maxillary teeth, there may be difficulties with surgical treatment of the periodontal problems
Mandibular Tori radiographical image
A bony exostosis on the lingual aspect of the mandible
Seen generally in the premolar-molar area bilaterally
Where is the mental foramen seenradiographically?
The image of the mental foramen can be seen as far forward as the distal of the first premolar and as far posteriorly as the mesial of the first molar
What is a potential issue of roots in close proximity?
If roots are less than 2.5 mm apart, periodontal bone loss will affect the entire interproximal area
What can Crown-Root ratio help us determine?
Can help us determine the patient’s prognosis related to periodontitis
1: 2 C:R ratio is ideal, and is favorabole
2: 1 ratio is unfavorable
What are the different types of root resorption
Internal resorption
External resorption
Internal resorption
Tooth resorption beginning from within the pulp
External resorption
Reorption of tooth structure beginning on the external surface
If a radiograph shows an implant with blurred threads, what does this indicate?
Unacceptable angulation of the X-ray tube
