Radiographic Interpretation Flashcards
Middle of the tooth, ____ and it has a space and it would be radiolucent (dark).
Pulp Canal
Surrounding the pulp space is the ____ and can be seen all throughout
Dentin
The highest in mineral content, so it is the most opaque (white) of the structures
Enamel
unable to see or identify ____ because it is the least mineralize and is very thin
Cementum
There’s nothing, very radiolucent (dark)
Air space
if the arrow is pointed at the chamber, then we label this as ____.
Pulp Chamber
if the arrow is pointing near the root, then it is called ____.
Root Canal Area
If root canal and pulp chamber is combined, then it is called ____.
Pulp Canal
It is very radiopaque (white), since it is a very dense cortical bone.
Lamina Dura
It is continuous and it goes around the anatomy of the root
Lamina Dura
The area that follows the anatomy of the tooth
Lamina Dura
Around the lamina dura is the spongy bone where the bony trabeculae is seen
Trabecular Bone
Everything is the spongy bone, but that is interspersed within area of cortical bone of bony trabeculae
Trabecular Bone
Also called as nasopalatine foramen
Incisive Foramen
Found at the lingual part of the central incisors
Incisive Foramen
since it is a foramen, then it has a space and it would appear radiolucent (dark)
Incisive Foramen
Appears like an elongated structure
Incisive Foramen
Looks like an oblong area, fade gray area; depending on the exposure time and it can appear also very dark, but notice it is found in the root area
Incisive Foramen
There is a degree of difference in the radiolucency
Incisive Foramen
Must identify that this is an anatomical landmark and not a cyst
Incisive Foramen
Inside that the incisive canal, this a smaller foramina.
Superior Foramina of the Incisive Canal
Sometimes it can be mistaken for a lesion or cyst because they are round and very small.
Superior Foramina of the Incisive Canal
Posterior to the incisive foramen
Median Palatine Suture
It’s a slit-like
Median Palatine Suture
The thin line in the middle of the incisive foramen.
Median Palatine Suture
Apparently, it looks like it is found between the central incisors, but because of the direction of the x-ray beam, then it would not appear as bisection.
Median Palatine Suture
Divides the left and right palatine processes.
Median Palatine Suture
When using a vertical angulation that is very high and the PID is positioned in the landmark of the central incisors (tip of the nose), then the nasal area of the nasal cavity is seen.
Nasal Cavity
It divides the nasal cavity to a right and left area.
Nasal Septum
Band of dense cortical bone.
Nasal Septum
A very radiopaque (white) structure in the apical area.
Nasal Septum
Protrusion on the anterior parts of the apices of the central incisors on the midline.
Anterior Nasal Spine
Pointed structure, V-shaped.
Anterior Nasal Spine
Sometimes this can be identified as incisive foramen.
Anterior Nasal Spine
The incisive foramen is found on the lower part, compared to the ____.
Anterior Nasal Spine
Thin plates of bone
Inferior Nasal Conchae
Fan like structure
Inferior Nasal Conchae
It is inside or within the nasal cavity
Inferior Nasal Conchae
The soft tissue cannot be seen, but depending on the contrast of the film, then a very thin line is seen
Soft Tissue Outline
Ala cartilage of the nose (black arrows)
Lateral Fossa
Prominent depression between the lateral incisor and canine.
Lateral Fossa
Why is this seen? because the lateral incisor has a smaller root and the canine has a bigger root, this causes a depression or a fossa that is now called the ____.
Lateral Fossa
From canine to premolar area
Nasolabial Fold
On some radiographs, these lines (pointed by the arrows) may be seen.
Nasolabial Fold
Because some will think it’s an artifact, meaning it’s not supposed to be there, but it is the.
Nasolabial Fold
When will this be clear? depending on the contrast of the image, different degrees of gray are seen.
Nasolabial Fold
refers to the maxillary sinus, inverted because of its form
Inverted - Y or Antral - Y
this signifies the junction of the anterior part of the maxillary sinus
Inverted - Y or Antral - Y
Looks like a letter Y
Inverted - Y or Antral - Y
Where does the maxillary sinus start?
Anterior edge right above the canine
At the anterior edge right above the canine, that’s why it forms together with the anterior part of the nasal area
Maxillary Sinus and Border of the Maxillary Sinus
Have the inverted Y is seen
Maxillary Sinus and Border of the Maxillary Sinus
A very radiolucent part extending to the posterior teeth
Maxillary Sinus and Border of the Maxillary Sinus
Usually seen near the apices, starting from the premolar or even the canine, down to the molars
Maxillary Sinus and Border of the Maxillary Sinus
Notice in an edentulous area, the border of the sinus appears to dip down, that is called pneumatization.
Maxillary Sinus and Border of the Maxillary Sinus
Notice in an edentulous area, the border of the sinus appears to dip down, that is called ____.
Pneumatization
It is not a structure, it is like a dipping down of the sinus when there is an edentulous area of the posterior teeth
Maxillary Sinus and Border of the Maxillary Sinus
Just like if the septa within in the nasal cavity, the ____ is also interspersed with thin plates of bone.
Maxillary Sinus and Border of the Maxillary Sinus
It is not an artifact
Maxillary Sinus and Border of the Maxillary Sinus
Notice the ____ approximates or is very near the apices of the premolars up to the molars
Maxillary Sinus and Border of the Maxillary Sinus
The posterior part of the maxillary alveolar bone.
Maxillary Tuberosity
The thin line above the maxillary tuberosity is the pneumatization of the ____.
Maxillary Tuberosity
This is very clear when getting a radiograph of the 3rd molar.
Maxillary Tuberosity
When taking radiographs of the 1st molar,
sometimes the maxillary tuberosity is unable to be seen.
Maxillary Tuberosity
The attachment of the muscles of mastication
Lateral Pterygoid Plates
Posterior to the maxillary tuberosity
Lateral Pterygoid Plates
Posterior to the maxillary tuberosity
Lateral Pterygoid Plates
It is a fan-like structure
Lateral Pterygoid Plates
Part of the sphenoid bone, which is the attachment of the muscles.
Hamulus
It is a hook-like structure, just very near or appears to be near the maxillary tuberosity area. Notice it’s already taking the 3rd molar area
Hamulus
Very posteriorly located
Hamulus
On the radiograph, it is a thick bone
Zygomatic Process of the Maxilla
It is very radiopaque (white) from the form, and that will relate to the form it gives in a periapical radiograph.
Zygomatic Process of the Maxilla
It depends on the positioning of the film and the overlap of the structures.
Zygomatic Process of the Maxilla
It is a curved plate of very dense bone
Zygomatic Process of the Maxilla
In the radiograph, this very radiopaque, like a hook/curve, that is the zygomatic process, and if you look at your cheekbone, it extends usually more posterior or is at the same area of your zygomatic process.
Zygoma/Zygomatic Bone/ Cheekbone/ Malar Bone
Because of the change of the horizontal or vertical angulation, then of course the structure will also change depending on the angulation used.
Which is the very radiopaque thick, curved bone
Zygomatic Process
the zygomatic process, which is the very radiopaque thick, curved bone; then just posterior to that is the ____.
Zygoma
Is a radiolucent structure part of zygoma
Maxillary Sinus
Then the radiopaque structure, when it is seen, look at the palate of the patient
Because if they have any torus palatinus, then that will also be seen in the radiograph
Since it is a thick structure, bony exostosis or thickening of bone, then it will also appear radiopaque
Here is another view of the torus palatinus and the nasal concha
The ____ is very thin and grayish;
The ____ is a very radiopaque structure.
Nasal Concha and Torus Palatinus
These canals are not always clear, but when there is very good contrast, these very minute radiolucent areas are seen
Nasal Canal for the PSAN
These are not fracture lines.
Nasal Canal for the PSAN
It can be anywhere; it can appear within the sinus, between teeth.
Nasal Canal for the PSAN
Those areas are where the nerves and blood vessels pass as they go the teeth being supplied, they are called ____.
Nasal Canal for the PSAN
If the dentist does not look at the patient clinically, these may be mistaken as enamel defects.
Lower Lip Lines
A band right across the crowns of the teeth
Lower Lip Lines
Don’t look for the lip structure, these are just shadows of the lip structure
Lower Lip Lines
Very thick plate of bone
Lower Border of the Mandible
Right on the edge of the apical part
Lower Border of the Mandible
Radiolucent (dark) dot in the middle
Lingual Foramen
Elevation of bone
Genial Tubercles/Mental Spine
Found on the lingual
Genial Tubercles/Mental Spine
These are attachments for the muscle
Genial Tubercles/Mental Spine
Radiopaque (white) structure around the lingual foramen
Genial Tubercles/Mental Spine
Approximately a bit part of the posterior teeth
Internal Oblique Ridge/Mylohyoid Ridge
They are not below to the anterior border of the mandible
Internal Oblique Ridge/Mylohyoid Ridge
Found on the inner side of the mandible
Internal Oblique Ridge/Mylohyoid Ridge
When palpating the area, there is an elevation on the lingual side
Internal Oblique Ridge/Mylohyoid Ridge
At the buccal side
Counter part of the mylohyoid ridge; different appearances
Two bands of radiopaque: the higher one is the ____ and the one that is nearer to the apices is the ____.
External Oblique Ridge and Internal Oblique Ridge
Between the area of the mylohyoid ridge, there is a deepening of the area which is the ____.
Submandibular Fossa
Where the submandibular gland is located
Submandibular Fossa
Since this is a fossa and it is adjacent to the mylohyoid ridge, it is radiolucent.
Submandibular Fossa
Bigger area than the mandibular canal
Submandibular Fossa
- upper right: more radiolucent
- lower right: degree of change of radiolucency and inferior to the mylohyoid ridge
Submandibular Fossa
What are the three structures at the outer part of the Mandible:
- Mental Ridge
- Mental Fossa
- Mental Foramen
Elevated portion and found on the anterior radiograph.
Mental Ridge
Deepening and since it is a deepening there is a less bone on that area, so it would appear radiolucent.
Mental Fossa
The exit of the mental nerve, between the premolars on the buccal side.
Mental Foramen
Common location is between the apices of the lower premolars o sometimes ____ is right on the apex and that could be mistaken as a chronic periapical lesion or abscess.
Mental Foramen
When taking a radiograph of the premolar and there is a radiolucency at the tip, it is important to determine if it is the abscess or the foramen.
TRUE OR FALSE
TRUE
So, the dentist must take another radiograph and change the horizontal angulation (moving the cone mesially or distally) o one is the normal and the other is the radiograph of the changed horizontal angulation
TRUE OR FALSE
TRUE
The location of this will change or shift together with the shape of the cone
Foramen
it will remain the same or attached
Periapical Lesion
As the inferior alveolar nerve enters the foramen, it courses along the length of the mandible to go to supply the mandibular posterior teeth o it courses around and exits as the mental nerve.
Mandibuolar Canal
The inferior alveolar nerve is seen as passing around the ____.
Mandibular Canal
How to determine Mandibular Canal:
- here are two thin plates of bone
- presence of mandibular nerve
- seems to have two lines just around it
brown arrow:
green arrow:
broad band/ violet:
red arrow:
- Mandibular canal
- Submandibular fossa
- Mylohyoid ridge/internal oblique ridge
(near the apices) - External oblique ridge
One structure of the mandible
Coronoid Process
Overlaps the maxillary arch and can be seen when taking a maxillary radiograph
Coronoid Process
Has a thick plate of bone on the lingual side. It is hard, radiopaque and can be mistaken as a normal anatomic structures.
Mandibular Tori
The dentist must take another radiograph to have a diagnostic radiograph.
TRUE OR FALSE
TRUE
It will allow the dentist to view the structures that will be seen in a specific area
Diagnostic Radiograph
It can only be diagnostic if it meets all the three criteria:
- Properly placed
- Exposure to film to the x-ray
- Processing the film
What are the 2 Film Exposure Error
- Exposure Problems
- Time and Exposure Factor Problems
- Unexposed film
- Film exposed to light
Exposure Problems
- Overexposed film
- Underexposed film
Time and Exposure Factor Problems
Cause: unexposed film to opened under light
Blank Film
When the film is opened and it is white; Sometimes, it is in the greenish side
Blank Film
That’s why never attempt to open an unexposed film with natural light. Only open the film. In the processing room, because there are sensitive areas on the film that is sensitive to light.
Blank Film
Cause: film exposed to light or prolonged exposure time.
Dark Film
Do not use the term black film
Dark Film
Cause: less exposure time
Light Film/Unexposed Film
Can still see the images, but they are very light
Light Film/Unexposed Film
Do not use the term white
Light Film/Unexposed Film
3 Common Technique Errors:
A. Film placement
B. Angulation problem
C. PID alignment problem
- Absence of apical structures
- Dropped film corner
Film placement
- Incorrect horizontal angulation
- Incorrect vertical angulation
Angulation problem
The 2 Incorrect vertical angulation
a. Foreshortened image
b. Elongated image
- Cone cut
PID alignment problem
Cause: film positioned too high or too low occlusally
Absence of Apical or Crown Structure
Cause: film not placed parallel to occlusal surfaces
End point of the periapical radiograph should show the occlusal or incisal edges are parallel to the edge of the film and it should not slanted.
Dropped Film Corner
Cause: inverted film
Wrong Location of Identification Dot
The identification dot should always be in the incisal or occlusaL.
Wrong Location of Identification Dot
Cause: incorrect horizontal angulation
Overlapping of Contact Areas
X-ray beam should be directly hitting the contact areas of the molars.
Overlapping of Contact Areas
The contact areas should appear radiolucent and not radiopaque.
Overlapping of Contact Areas
Cause: incorrect vertical angulation; too high
Foreshortened Image
The teeth will look small, unless the patient really has small teeth.
Foreshortened Image
Cause: incorrect vertical angulation; too low
Elongated image
Cause: the film is not centered to the cone
Cone Cut
Where should the film be in relation to the cone?
Center
Only a part of the film is exposed to the radiation
Cone Cut
Cause: too much pressure on the finger stabilization
Bent or Distorted Film
Especially if patient is supporting the film with their fingers
Bent or Distorted Film
The film gets bent
Bent or Distorted Film
When using finger stabilization, apply just enough pressure to support the film or else it will have a bent image.
Bent or Distorted Film
Cause: film is sharply bent and emulsion was cut
Film Crease
Cause: when the patient is holding the film with their two fingers
Phalangioma
When the radiation passes through, the bone of the finger or thumb, whichever is exposed to radiation, will also be taken.
Phalangioma
Uncommon or is very hard to have a
Phalangioma
Bone of the finger is seen
Phalangioma
Cause: when tube side and film side is reversed o the film side facing the x-ray beam - tire-track or herringbone appearance
Reversed Film
Cause: carelessness; using the film twice, or double exposure.
Double Exposure
The moment a film is taken, separate it from the rest.
Double Exposure
Cause: movement of
the cone or movement of the patient
Blurred Film
2 common Processing Errors:
A. Time and temperature errors
B. Chemical contamination errors
- Underdeveloped film
- Overdeveloped film
- Cracked film
Time and temperature errors
- Developer spot
- Fixer spot
- Yellow-brown stains
Chemical contamination errors
Cause: exposed too long in the developer solution
Overdeveloped film
Cause: exposure too less in the developer solution
Underdeveloped film
The solution and water should be the same temperature.
Cause: the developer and water are of different temperature o tend to crack the emulsion
Cracked Film/Reticulation
Cause: carelessness; developer solution hit on the developed film
Developer Spots (Dark Spots)
Developer spots is also known as ____.
Dark Spots
The moment processing is done and film is washed, do not expose it to the developing solution.
Developer Spots (Dark Spots)
Cause: carelessness; fixer solution hit on the
developed film
Fixer Spots (White)
Are also knows as white spots.
Fixer Spots
Cause: insufficient rinsing or exhausted solution and these are very common
Yellow-Brown Stains
Cause: area was not properly fixed or placed in the fixer solution
Fixer Cut (Black Line)
Cut is black, compared to the fixer spots which are white
Fixer Cut (Black Line)
Cause: a certain part was not properly immersed in the developer solution
Developer Cut (White Line)
Underdeveloped portion is white
Developer Cut (White Line)
Cause: when processing two or more
films
Overlapped Film
Films are not dried properly and stick together, then put in the fixer.
Overlapped Film
Cause: immersed films quickly into the developer, creating air bubbles
Just dip the films slowly into the developer solution and shake or swish it, to remove air bubbles that somehow might get trapped
Air Bubbles (Tiny White Spots)
Film artifact; any artificial product
Air Bubbles (Tiny White Spots)
A structure or appearance that is not natural, but is due to manipulation
Air Bubbles (Tiny White Spots)
Cause: holding the film with bare hands, thus cutting the emulsion
Fingernail Artifact (Black-Crescent Shape)
Use the film clip and clip it in the identification dot
Fingernail Artifact (Black-Crescent Shape)
Radiolucent on the bottom of the pic is the fingernail artifact.
Fingernail Artifact (Black-Crescent Shape)
Cause: holding the film
Fingerprint Artifact
The solution is very sensitive, which could cause an imprint.
Fingerprint Artifact
Very seldom
Static Electricity
Cause: when there is difference in humidity; the film is suddenly opened, causing cracks on the film
Static Electricity
Cause: the film is not yet totally dried
Film Scratches
One of the most common
Film Scratches
Film is kept moist after processing and was
accidentally touched
Film Scratches
A part of the film was removed
Film Scratches
Cause: during processing, part of the film was exposed to light.
Part of the Film was Exposed To Light
When processing, make sure the door in the
processing area is closed and nobody will enter.
Part of the Film was Exposed To Light
Because the moment someone goes in and the film is still in the developer solution, then this will happen.
Part of the Film was Exposed To Light
But when the film is already in the fixer solution, then it is already safe.
Part of the Film was Exposed To Light
Cause: either there was scattered radiation, or an old or expired film was used
Fogged Film (Blurred)
The solutions will not work well on the processing
Fogged Film (Blurred)
Storage of film is important
Fogged Film (Blurred)
Do not put them in hot areas, because when the film is developed, the image will be blurred
Fogged Film (Blurred)
