Radiographs in periodontology Flashcards
Radiographs are a valuable aid in the
*Diagnosis of periodontal disease
*Determination of the prognosis, and
*Evaluation of the outcome of treatment
Radiographs are a valuable aid in the
*Diagnosis of periodontal disease
*Determination of the prognosis, and
*Evaluation of the outcome of treatment
Fig. 20.1 is very important
Radiographs are helpful in evaluation of
Amount of bone present
Condition of alveolar crests
Bone loss in furcation areas
Width of the Periodontal Ligament (PDL) space
Local factors which can cause or intensify periodontal disease (calculus, overhanging restorations)
Root length and morphology
Anatmocical considerations
Pathological considerations
Types of periodontitis in radiology
Incipient periodontitis
Early periodontitis
Moderately advanced periodontitis
Advanced periodontitis
Normal (important)
Thin layer of radiopaque cortical bone often covers the alveolar crest [ Height is about 1-1.5mm (sometimes 2mm) below CEJ]
Well mineralized cortical outline of the alveolar crest
Alveolar crest is continuous with the lamina dura of adjacent teeth (and is continuous from tooth to tooth)
Anterior teeth – alveolar crest is pointed
Posterior teeth – Alveolar crest is more flat (form almost a box)
PDL (radiolucent space between the root and lamina dura) space is usually even (sometimes not) around the whole tooth (tend to be wider at apex and alveolar crest)
Alveolar bone
Anterior maxilla
Small and numerous
Posterior maxilla
Larger when compared to that of anterior maxilla
Stepladder pattern
Radiographic assessment of periodontal condition
Amount of bone present
Condition of alveolar crest
Bone loss in furcation area
Width of PDL space
Local initiating factors (calculus, overhanging restorations)
Root length and morphology
Crown root ratio
Anatomical considerations
Pathological considerations (caries, periapical lesions, root resorption)
LIMITATIONS OF THE RADIOGRAPH
- The condition of gingiva cannot be predicted from the
radiographic appearance of alveolar crest - Radiographs provide two-dimensional views of three
dimensional situations. They often fail to disclose
osseous destruction particularly that confined to the
buccal or lingual surfaces of teeth - Radiographs typically show less severe bone destruction
than is actually present - Measure of bone level from the CEJ is not valid when
there is over eruption or severe attrition with passive
eruption.15 - Radiographs do not demonstrate the soft tissue to hard
tissue relationship and thus provide no information about
the depth of soft tissue pockets. However, if a radiopaque
material, such as gutta-percha is inserted into the pocket,
the base of the pocket can usually be recorded on
the radiograph - Widening of PL space on radiograph does not necessarily
indicate tooth mobility (Fig. 18) - They do not specifically distinguish between the
successfully treated cases and the untreated cases
