Radiographic Interpretation of Periodontal Disease A

Question 1

periodontium

Answer 1

the tissues that invest and support the teeth
gingiva and alveolar bone

Question 2

anatomic landmarks of alveolar bone

Answer 2

lamina dura
alveolar crest
PDL

Question 3

periodontium: alveolar crest health

Answer 3

1.5-2 mm below CEJ

Question 4

periodontium: alveolar crest health anterior region

Answer 4

pointed and sharp
very radiopaque

Question 5

periodontium: alveolar crest health posterior

Answer 5

flat and smooth
parallel to a line between adjacent CEJ
less radiopaque than anterior region

Question 6

periodontium: lamina dura

Answer 6

health: dense radiopaque line around roots
perforated by numerous small foramina
traversed by blood vessels, lymphatics and nerves, which pass between the PDL and bone
changes in the angulation of the x-ray beam can alter its appearance

Question 7

periodontium: PDL space

Answer 7

a thin radiolucent line between the root of teeth and the lamina dura
continuous around the root structure and of uniform thickness in healthy teeth

Question 8

description of perio disease

Answer 8

alveolar crest: greater 1.5-2 mm below AC, bone loss
no longer radiopaque
appears indistinct
difficult to detect bone loss <3mm on radiograph

Question 9

detection of perio disease

Answer 9

both clinical and dental image examination
info about soft tissue and info about bone

Question 10

clinical examination

Answer 10

must be performed
evaluation of soft tissue for signs of inflammation such as redness, bleeding, swelling, exudate
thorough clinical assessment must include perio probing

Question 11

dental image examination

Answer 11

provides an overview of the amount of bone present
indicates the pattern, distribution and severity of bone loss
documents periodontal disease at specific points in time

Question 12

paralleling

Answer 12

preferred method
height of crestal bone is accurately recorded in relation to the tooth root

Question 13

bisecting

Answer 13

dimensional distortion due to errors in vertical angulation
images may appear to show less bone loss than is present

Question 14

horizontal bite-wing

Answer 14

limited value in the detection of periodontal disease
severe interproximal bone loss cannot be adequately visualized on horizontal bite-wing images

Question 15

vertical bite-wing

Answer 15

can be used to examine bone levels
best for post-treatment and follow-up purposes

Question 16

panoramic image

Answer 16

minimal diagnostic value in the detection of periodontal disease

Question 17

furcation area on radiographic examination

Answer 17

between the roots of multirooted teeth
may not be detected on a dental image because of the superimposition of buccal and lingual bone
especially max molars

Question 18

what areas may be difficult to evaluate during radiographic examination

Answer 18

buccal and lingual

Question 19

detecting periodontitis

Answer 19

very earliest signs must be detected clinically, not radiographically
by the time it is detected radiographically it has progressed past early stage

Question 20

a radiograph cannot accurately display the shape of bone deformities because it is not

Answer 20

3D

Question 21

a radiograph with poor technique and excessive angulation can obscure

Answer 21

bone loss

Question 22

bone loss can be estimated as

Answer 22

the difference between the physiologic bone level and the height of remaining bone
recorded in percentage of bone loss not on amount remaining
pattern, distribution, severity of loss

Question 23

bone loss pattern: horizontal

Answer 23

most common bone loss pattern
fairly even, overall reduction in height of the alveolar bone
alveolar bone reduced in height but the margin of the alveolar crest remains, more or less, perpendicular to the long axis of the tooth
occurs in a plane parallel to the CEJs of adjacent teeth

Question 24

normal alveolar bone height

Answer 24

1.5 to 2 mm below and parallel to the CEJ

Question 25

horizontal crest contour

Answer 25

crest of the interproximal bone will have a horizontal contour when the CEJs of the adjacent teeth are at the same level

Question 26

horizontal bone loss results in bone levels that are

Answer 26

approximately at the same height on adjacent tooth roots

Question 27

on a radiograph, if an imaginary line drawn between the CEJs of adjacent teeth is

Answer 27

approximately parallel, then the bone loss is described as horizontal bone loss

Question 28

bone loss pattern: vertical

Answer 28

angular bone loss
does not occur in a plane parallel to the CEJs of adjacent teeth
uneven reduction in the height of the alveolar bone
resorption progresses rapidly in the bone next to the root surface
leaves a trench-like area of missing bone alongside the root

Question 29

vertical bone loss results in

Answer 29

an uneven reduction in bone height on adjacent tooth roots

Question 30

on a radiograph, if an imaginary line drawn between the CEJs of adjacent teeth is not parallel then the bone loss is described as

Answer 30

vertical bone loss

Question 31

normal vertical contour

Answer 31

crest of the interproximal bone will have a vertical contour when one of the adjacent teeth is tilted or erupted to a different height

Question 32

bone loss distribution: localized

Answer 32

occurs in isolated areas, less than 30% teeth involved have attachment and bone loss

Question 33

bone loss distribution: generalized

Answer 33

occurs evenly throughout the dental arches
more than 30% of the teeth involved and occurs evenly throughout the dental arches