Radiography of Periodontal Disease Flashcards
What do you ned to carry out before reaching a diagnosis?
- Need to take a full history of the patient
- Need to carry out examinations nd screening
- Can als tae radiographs
Give the key reliable feature we use to check if the periodontium is healthy on a radiograph
If the distance between the crystal bone and cemento enamel junction (CEJ) is 2-3mm then theres no loss of attachment so no periodontitis
Give other radiographic features of a healthy periodontium
- Thin, smooth evenly corticated margins to the interdental crystal bone
- Thin, even pointed margins to the interdental bone
- Interdental crystal bone is continuous with the lamina dura
- Thin even with to the mesial and distal periodontal membrane space
Why is cortication not evident in radiograph of a healthy periodontium
Because theres a sallows about of bone between the teeth anteriorly
Give some limitations of radiographs
- 2D view of a 3D situation
- Bony defects may be hidden
- Only interproximal bone seen clearly
- Radiographs under estimate boen destruction
- 30-50% of the bone mineral content must be lost before changes are detected radiographically
- No info on soft tissues
What can radiographs show
- Bone loss
- Mobility
3, Oclusal trauma - Calculus and marginal overhangs
- Crown-root ratios
- Sclerosis
What information can radiographs give about bone levels?
The extent and pattern of bone loss
What 2 things do we record in relation to bone levels?
- Staging
2. Grading
How do we stage bone levels?
We record the inter proximal bone loss at the worst sire to determine the severity of the disease
What does grading show and how do we grade bone loss?
Grade= % of bone loss divided by patients age
this helps us determine the RATE of progression of the disease
How do we determine the severity of bone loss?
By recording the inter proximal bone loss at the worst sire in the mouth
How do we determine the rate of progression of bone loss?
By dividing the % of bone loss by eh patients age
How Is extent of bone loss measured ?
- Recording the % root length if the apex can be seen
2. Recording m if magnification is 1:1
Give the3 patterns of bone loss
- Horizontal
- Vertical
3, Furcation involvement
How can you see horizontal bone loss on a radiograph?
- The crest will be horizontal relative to occlusal plane
- Bone levels will be positioned apically to normal levels
3 There may be loss of buccal and lingual plates and intervene bone
How can you detect furcation involvement?
- Check if here are local plaque retentive factors
- May be detectable by probing
- Radiolucency at furcation
- On the upper molar look fo arrowhead
What are combined lesions?
Bone loss involving apex and root face
Why might combined lesions arise?
May arise from non vital toot and discharge along periodontal membrane space
How can you see mobility on a radiograph?
Can see widening of the periodontal membrane space
How can you see occlusal trauma on a radiograph?
- Marginal widening
- Angular defect
- Root resorption
- Hypercementosis
- Root fracture
- Loss/thickening of lamina dura
- Bone sclerosis
Name the only way we can record crown root ratios
By taking radiographs
Name the 3 types of radiographs we use
- Bitewings
- periapicals
- Panoramic
What do panoramics show?
The entire dentition in one film
Give some disadvantages of panoramics
- Overlapping teeth In some areas
2. Careful patient positioning required
Give some advantages of panoramics
- Time efficient
- Lower patient dose
- Patient tolerance
Give some advantages of bitewings to detect periodontitis
- Bitewings are more reproducible
2. May already have them for caries diagnosis
Give some disadvantages of bitewings to detect periodontitis
As you can’t se the apex bone losses an estimate
Give some advantages of Periapicals to detect periodontitis
- High quality and reproducible
Give some disadvantages of Periapicals to detect periodontitis
- Need a film holder and paralleling technique
2, Full mouth periodicals can be time consuming - Can expose patient to a relatively high dose of radiation
