radiographic interp

Question 1

term

Answer 1

1) x-rays
- ionizing beam
2) radiograph
- image obtained using x-ray

radiation is cumulative over time

Question 2

diagnostic value

Answer 2

1) caries
2) pulp
3) tooth integrity
4) bone
5) development
5) anomalies
6) post op treatment

Question 3

carious lesions

Answer 3

1) incipient detection
- 40-50% otherwise overlooked
- caries progresses faster in primary (wider pulp, thinner enamel, less dentin)
2) size and depth
- early detection = early intervention
- consider tooth lifespan
- alloy/resin/GI or SSC

Question 4

pulpal exam

Answer 4

1) proximity of caries to pulp
2) signs of abscess in intra radicular (posterior) and periapical (anterior)
- abscess in furcation:
3) internal resorption or calcification in canals
4) eval of pulpotomy q 1year

Question 5

alteration in bone

Answer 5

1) perio
2) trauma

Question 6

alteration in dental formation

Answer 6

1) amelogenesis imperfecta
2) dentinogenesis imperfecta
3) idiopathic hypocalcification and hypoplasia
4) other anomalies

Question 7

emergencies

Answer 7

1) history of pain, swelling, trauma
2) mobility, except normal exfoliation

Question 8

post operative review

Answer 8

1) post surgery
2) restoration quality
- margins, contour, contacts
3) pulp therapy
- typically not taken except for q 1 year evals of pulpotomies in primary teeth

Question 9

for children, x-rays:

Answer 9

1) lead apron and thyroid shield
2) digital sensor or fast F speed film
3) properly collimated and filtered x ray
4) long open cone
5) exposure record

• in peds, instructor must approve all radiographs

Question 10

for parent

Answer 10

1) lead apron
2) thyroid shield
3) should not assist if pregnant

Question 11

for dental staff

Answer 11

1) never hold sensors or film in place
2) stand behind a shield or 6 ft away

Question 12

technical considerations

Answer 12

1) digital sensor / F speed
2) good sensor placement
3) careful management of images
4) careful handling sensors
5) safety

Question 13

risk benefit considerations

Answer 13

1) opportunity to education parent about safety, risk/benefit
2) parent wavier of necessary radiographs legally invalid
3) proceeding without necessary radiographs puts dentist and patient at risk

Question 14

digital radiographs

Answer 14

1) direct
- charge coupled device
2) indirect
- photo stimulable phosphor plate
- typical in peds clinic

Question 15

size 0

Answer 15

1) peds
2) smallest
3) less than 7 years
4) BWZ and PA

Question 16

size 1

Answer 16

1) adults and children over 7

Question 17

size 2

Answer 17

1) adult posterior
2) older children, BWX and PA and modified anterior occlusals

Question 18

size 4

Answer 18

1) large occlusal
2) for most children
3) for max or mand occlusals
5) extraoral lateral view

Question 19

film holding device

Answer 19

1) snap a ray
- holding device
- BWX 0,1,2
- BWX 0 (vertical)
- posterior PA 0,1,2
- anterior PA 0,1,2

Question 20

BWX tabs

Answer 20

1) adhesive tab for psp sensor to bite on

Question 21

paralleling holder

Answer 21

1) XCP
2) bulky for kids
- rarely used

Question 22

pano

Answer 22

1) growth and development
2) permanent canine eruption trajectory
- can cause damage if not correct
3) dental anomalies
4) oral pathology
5) TMJ problems

Question 23

pano disadvantage

Answer 23

1) teeth are magnified
2) often overlapped
3) 15-22 seconds may be too long
4) midline distortion
- take PAs
5) moving parts are distracting

Question 24

pano quality

Answer 24

1) see entire border of mandible
2) TMJs
3) minimal distortion

Question 25

cephs

Answer 25

1) lateral and AP views 2) growth patterns 4) less useful for quantifying growth 5) cervical maturation as growth and development measure

Question 26

BWX for

Answer 26

1) diagnosis of interprox caries 2) eval of alveolar bone 3) eval restorations and pulp

Question 27

BWX capture

Answer 27

1) distal of canine to mesial of perm 1st molar (if erupted) 2) open contacts 3) early adult dentition - without perm 2 molars (1 BWX) - with perm 2 (two BWX)

Question 28

modified anterior occlusals

Answer 28

1) caries detection 2) pulpal pathosis 3) trauma 4) abnormalities in number of teeth 5) eval dental age and development 6) #2 sensor or film

Question 29

PA look at

Answer 29

1) intraradicular and periapical status 2) bone level 3) post trauma changes 4) pulpal therapy 5) dental age and development 6) mandible and maxilla (more distortion)

Question 30

occlusal radiographs

Answer 30

1) >6 years size 4 2) supernumerary teeth 3) tooth displacement 4) abnormal eruption 5) fractures, esp mandibular 6) same technique as modified anterior occlusals

Question 31

prescribing radiographs

Answer 31

1) no standard prescriptions 2) do it if it will change TP - is the info already available from patient record 3) consider - age - caries risk - patient history - patient cooperation - clinical exam

Question 32

behavioral technique

Answer 32

1) parents can assist - young child, under 3 year - child with disability - difficult children 2) gagging - avoid the word gag - distraction - salt back of tongue - topical anesthetic - N2O