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Perio I Supplemental Cards > Radiographic Perio > Flashcards

Radiographic Perio Flashcards

1
Q

radiographs are a valuable tool in periodontology. they aid in what 4 areas?

A
  • diagnosis of periodontal disease
  • determination of the prognosis
  • treatment options
  • evaluation of the outcome of treatment
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2
Q

T or F:

radiographs can be used by themselves to diagnose periodontitis

A

false

they are an adjunct to the clinical examination, not a substitute for it

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3
Q

without radiographic images, the clinician cannot effectively evaluate what 4 findings?

A
  • alveolar crestal bone architecture
  • crown-to-root ratio/calculus presence
  • possible vertical or furcation defects
  • amount of horizontal bone loss
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4
Q

how many basic intraoral radiographic techniques are used to asses bone status in patients with clinical features of periodontitis? name them.

A
  1. horizontal bitewings - used to detect carious lesions, crestal bone height
  2. vertical bitewing - can see more of the tooth, so more bone is visible for assessment
  3. periapical - can see the entire tooth from occlusal surface to area at the root tip, used for interproximal and apical surface assessment
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5
Q

horizontal bitewings are usually ordered when the patient has suspected “___” horizontal bone loss

A

mild to moderate

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6
Q

when properly positioned, the clinician should expect to see what 3 features?

A
  • superimposition of the buccal and lingual/palatal cusps
  • a sharp or well-defined alveolar crestal margin
  • no horizontal “overlap” between adjacent teeth
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7
Q

vertical bitewings are useful if the patient has demonstrated deep probing depths on clinical examination and the clinician expects the patient to have “___” horizontal bone loss

A

moderate to severe

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8
Q

vertical orientation reduces the image information in an ___-___ dimension and additional vertical image is generally required for complete coverage of the structures being examined

A

anterior-posterior

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9
Q

generally, vertical bitewings are more informative than horizontal bitewings on detecting ___ periodontal disease

A

moderate to severe

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10
Q

is the osseous crest better captured on a horizontal or vertical bitewing?

A

vertical bitewing

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11
Q

is accurate assessment of bone height essential to successful periodontal disease management?

A

yes

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12
Q

periapical radiographs have a tendency to ___ the distance between the alveolar osseous crest and CEJ compared to a bitewing. this is due to ___

A
  • distort
  • angulation of the xray beam
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13
Q

describe the long-cone paralleling technique

A
  • x-ray beam head parallel to the film and the tooth
  • most realistic image to evaluate level of alveolar bone
  • helps alleviate the tendency to distort bone height
  • utilized when taking periapical radiographs
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14
Q

periapical radiographs are essential for assessing what 4 features?

A
  • crown-to-root ratio
  • root morphology
  • periodontal ligament spaces
  • periapical status
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15
Q

a line drawn from CEJ to CEJ of adjacent teeth will parallel the ___ in healthy tissues.

A
  • alveolar crest
  • health is further implied if the CEJ and alveolar crest are about 1.5-2 mm from each other
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16
Q

where is the interdental septum located?

A

between the roots of adjacent teeth

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17
Q

what does the lamina dura look like in a radiograph?

A

it is a radiopaque line that continues apically as alveolar bone proper

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18
Q

the shape of the interdental septum is a function of the ___ of the contiguous teeth. it appears ___ rather than horizontal when the crest of interdental bone is different than the level of the CEJ

A
  • morphology
  • angulated
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19
Q

what does the periodontal ligament space look like on a radiograph?

A
  • thin radiolucent line interposed between the root and the radiopaque line that outlines the root (lamina dura)
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20
Q

___ of the PDL is important in diagnosis of various conditions, such as occlusal trauma

A

width

21
Q

___ of the PDL space is seen with occlusal trauma as well as vertical root fractures and progressive systemic sclerosis (scleroderma)

A

widening

22
Q

PDL varies in thickness ___-___mm

A

0.1-0.25mm

23
Q

PDL is ___ during heavy occlusion, and ___ in nonfunctional teeth

A
  • widest
  • thinner
24
Q

PDL statistics

what is the surface area of the socket wall?

A
  • 150-275 sq mm single root
  • 450 for multirooted
25
Q

how many PDLs are in non-functional vs functional teeth? (# of ligaments)

A
  • 28,000/sq mm in functional
  • 2000/sq mm in non-functional
26
Q

as a general rule, bone loss is generally ___ than it appears in the radiographs

A

greater

27
Q

what percentage of bone mineral density is lost before it is detected radiographically?

A
  • 30%
  • this is one of the major reasons why periodontal disease cannot be detected by radiographs alone; a periodontal probe would be much more effective in detecting bone loss before it reaches the severity required for it to show up on a radiograph
28
Q

radiographs show the amount of bone ___, rather than the amount ___

A
  • remaining
  • lost
29
Q

do radiographs indicate internal morphology/ depth of crater-like defects (angular/vertical)?

A

no, just evidence that it exists, but probing is required to get confirmation

30
Q

do radiographs show the extent of facial/lingual involvement in bone loss?

A

no

31
Q

if a line connecting CEJ to CEJ of adjacent teeth is parallel to the alveolar crest, but the depth is greater than 2mm, what does that indicate?

A

horizontal bone loss

32
Q

if a line connecting CEJ to CEJ of adjacent teeth is not parallel to the alveolar crest, and the alveolar crest plunges apically on one tooth but is normal on the other, what does that indicate?

A

vertical bone loss

33
Q

distribution of bone loss is an imporant diagnostic sign for a ___ vs ___ problem

A

local vs. generalized

34
Q

distribution of bone loss points to the location of ____ in different areas of the mouth in relation to different surfaces of the same tooth

A

destructive local factors

35
Q

loss of bone in the furcation areas of molar teeth may occurs as a result of what? where are these changes usually seen?

A
  • periodontitis
  • endodontic infection
  • root perforation during dental procedures
  • occlusal trauma
  • usually seen in the mandibular molar region because they only have 2 roots
36
Q

why are early changes in furcation of maxillary molars more difficult to assess?

A

because most maxillary molars have 3 roots

37
Q

defects occurring between the ___ and ___ roots and between the ___ and ___ roots are often easier to detect radiographically than buccal furcation defects

A
  • mesiobuccal and palatal roots
  • distobuccal and palatal roots
38
Q

what is a furcation arrow?

A

describes the radiographic finding of a loss of bone in the mesial and distal furcations

39
Q

what is a cervical enamel pearl (CEP)?

A

a tooth anomaly in the furcation of maxillary molars that can lead to bone loss if exposed

40
Q

what is the incidence of CEPs?

A

1.1-9.7% (ave. 2.69%)

41
Q

what teeth are CEPs most commonly found on?

A

maxillary 3rd molars > maxillary 2nd molars > maxillary 1st molars

42
Q

in the radiographic interpretation of root proximity, close proximity of tooth roots will have ___ interproximal septum, which leads to an increased risk of ___ and ___

A
  • thin
  • bone loss
  • periodontal destruction
43
Q

are clinically significant calculus deposits often seen on routine radiographic exmination?

A

yes, but radiographs are not sensitive indicators of calculus

44
Q

when radiographic subgingival calculus is observed, it is usually indicative of what?

A

very heavy calculus deposits

45
Q

is all calculus seen in radiographs?

A
  • no; generally, only heavy calculus deposits are seen on radiographs
  • most subgingival calculus deposits will not be present radiographically
46
Q

what is a periodontal abscess?

A

an acute, destructive process inthe periodontium resulting in localized collections of pus communicating with the oral cavity through the gingival sulcus or other periodontal sites and not arising from the tooth pulp

47
Q

describe the radiographic appearance of a periodontal abscess

A

a discrete area of radiolucency along the lateral aspect of the root

48
Q

what are 3 features of aggressive periodontitis?

A
  • rapid rate of attachment and bone loss
  • minimal local factors
  • familial aggregation of diseased individuals (genetics)

Perio I Supplemental Cards (7 decks)

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