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Clinical oral radiology > Radiographic Interpretation of Periodontal Conditions > Flashcards

Radiographic Interpretation of Periodontal Conditions Flashcards

1
Q

Periodontal Diseases - Disease processes involving the __

A

periodontium

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2
Q

Supportive apparatus surrounding a tooth

A

Periodontium

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3
Q

The periodontal ligament is made of the

A

PDL space (radiolucent)

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4
Q

The alveolar bone consists of

A

alveolar crest
lamina dura

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5
Q

Know alveolar crest, lamina dura, periodontal ligament space, CEJ on a radiograph

A

look at pics in powerpoint

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6
Q

What is the distance between the alveolar crest and the CEJ

A

0.5-2 mm

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7
Q

Characterized by an inflammatory host response in the periodontal tissues that may lad to localized or generalized alterations in the supporting cone and soft tissues

A

Periodontal diseases

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8
Q

Dental __ play a primary role in periodontal disease

A

plaque biofilm

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9
Q

During the inflammatory response of periodontal disease, there is a release of inflammatory mediators. There is a loss of and apical migration of __

A

the junctional epithelium

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10
Q

With the loss of and apical migration of the junctional epithelium there is __ formation and further __

A

periodontal pocket
bacterial colonization

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11
Q

Inflammatory response of periodontal disease stimulates osteoclastic __

A

bone resorption

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12
Q

Diagnosis of periodontal diseases: First __

A

clinical examination

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13
Q

What is involved in the clinical examination of diagnosis of periodontal disease

A

Gingival index, periodontal probing (bleeding sites, gingival recession, clinical attachment loss), tooth mobility

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14
Q

For diagnosis of periodontal diseases radiographic examination is

A

complementary

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15
Q

What can be shown on the radiographs for periodontal disease

A

Extent of destruction of the alveolar process
Local irritating factors
Record of the course of the disease

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16
Q

What are the best exams for periodontal assessment

A

Bitewings (for posterior teeth)

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17
Q

When is a vertical bitewing indicated for assessment of periodontal disease

A

When the extent of bone loss cannot be depicted on a regular bitewing

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18
Q

This may show the overall status of the alveolar crests, but not the best image due to important limitations

A

Panoramic

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19
Q

What are 3 limitations with a panoramic x-ray for periodontal assessment

A

Superimpositions
Distortions
Lower resolution

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20
Q

What are 3 technical quality considerations when assessing periodontal health on a radiograph

A

Pt must bite down and bite block = centered
Correct horizontal angulation matters
Correct vertical angulation matters
(Can cause false effect of healthy bone levels)

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21
Q

What are some early bone changes we see on radiographs - very initial sign of perio disease

A

localized erosion of the inter-proximal alveolar crest
PIC IN POWERPOINT
- cortical surface of the alveolar crest may appear diffuse
- round appearance (loss of sharp inter-proximal angle)

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22
Q

This bone change seen on a radiograph is approximately parallel to an imaginary line between CEJ’s (first sign of bone loss)

A

Horizontal bone loss
PIC IN POWERPOINT

23
Q

This bone change seen on a radiograph is oblique to imaginary line between CEJ’s. Angular or triangular shaped defects

A

Vertical bone defects
PIC IN POWERPOINT

24
Q

Vertical bone defects are usually associated with

A

local exacerbating factors

25
Q

Types of vertical bone defects

A

3 walled bone defect
2 walled bone defect
1 walled bone defect
(loss of all 4 walls is a horizontal defect)
PIC IN POWERPOINT

26
Q

Horizontal bone loss is greater than __ mm

A

2

27
Q

Resorption of cortical plate adjacent to the teeth

A

Buccal or lingual cortical plate loss

28
Q

This bone loss may occur alone or in association with another type of bone loss

A

Buccal or lingual cortical plate loss

29
Q

Most common type of bone loss, normally a generalized position

A

Horizontal bone loss

30
Q

Other radiographic signs associated with periodontal disease

A

Changes to density and trabecular pattern of bone : A mixture of radiolucent and radiopaque patterns is common

31
Q

What would be a radiopaque pattern seen radiographically with periodontal disease

A

sclerotic bone reaction –> thicker trabeculae
May extend some distance from the periodontal lesion

32
Q

Local contributing factors to other radiographic signs associated with periodontal disease

A

Calculus
Defective restorations
Open inter-proximal spaces

33
Q

A certain degree of calcification is required before __ is seen on a radiograph

A

calculus

34
Q

Presence of calculus on a radiograph my be __

A

underestimated

35
Q

Types of defective restorations seen on a radiograph

A

overhangs
Misfits / voids
(On a radiograph we can only asses cervical inter-proximal defects)

36
Q

If there are open inter-proximal contacts, __ may facilitate the progression of PD

A

food impaction

37
Q

Periodontal disease often progresses in

A

bursts

38
Q

With the progression of periodontal disease there are __ periods of active inflammation and tissue destruction, followed by times of quiescence with no appreciable changes

A

Cyclic

39
Q

The nature of bacterial pathogens and the host responses effects the progression of periodontal disease and the manifestation of it as mild, moderate or severe. What effects this

A

Oral hygiene practices
Age, stress, smoking, systemic diseases, hormonal changes

40
Q

Mild vs moderate vs severe periodontal progression on a radiograph

A

Mild - cervical third of tooth showing
Moderate - middle third of tooth showing
severe - apical third of tooth showing

41
Q

Widening of the PDL space at the apex of the interradicular bony crest

A

Furcation involvement

42
Q

Periodontal lesion that extended to the apex causing secondary endodontic disease

A

Endodontic-Periodontic Lesions

43
Q

Periapical inflammatory disease from endodontic origin extending coronally to alveolar crest

A

Endodontic-Periodontic Lesions

44
Q

RBL for stage I-IV perio

A

Stage I: coronal third <15%
Stage II: coronal third 15-33%
Stage III and IV: middle third of root and beyond

45
Q

Perio grade based off bone oss

A

Bone loss / age
= age = grade B
> age = grade C

46
Q

Irreversible anatomical changes of residual ridges following dental extraction

A

Alveolar ridge atrophy
PIC in powerpoint

47
Q

Is alveolar ridge atrophy related to periodontitis

A

No

48
Q

The increased distance CEJ-AC is not necessarily the result of periodontal disease with

A

supraeruption

49
Q

Radiographic signs of stabilization of the disease can be seen occasionally - interproximal cortex of the alveolar crest can reform after __

A

successful periodontal therapy

50
Q

Malignant neoplasms that when involving the alveolar process may mimic the radiographic appearance of periodontitis

A

Squamous cell carcinoma

51
Q

Squamous cell carcinoma is differentiated from periodontitis by

A

clinical appearance and failure to respond to treatment
(irregular widening of the PDL space along its entire length and destruction of the lamina dura are suggestive of infiltration by a malignancy rather than perio)

52
Q

Intra oral radiographic evaluation: changes in bone levels around implants - images taken at baseline for future reference

A

Peri-implant conditions

53
Q

Discriminate between health and disease states for peri-implant conditions

A

Absence of bone loss beyond bone level changes resulting from initial bone remodeling (bone loss should not exceed 2mm)

Clinical oral radiology (7 decks)

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