Radiology Flashcards
By what percentage can Bitewing radiographs increase diagnosis of interproximal caries?
25%
By what percentage does bone have to be decalcified by in order to be viewed on a radiograph?
by 50%
Do radiographs over or underestimate the depth of decay?
underestimate
which part of the enamel lesion can you see on a radiograph?
body of the lesion
Why do radiographs underestimate the extent of caries?
only show tissues that have been decalcified by 50%
How can you describe a carious lesion?
By site, depth, restoration status of the tooth, periodontal status of the tooth
What are rampant caries?
Sudden uncontrolled destruction of the teeth that often has a trigger and involves tooth surfaces usually caries free
What are the risk factors for root caries?
Low saliva flow due to age, systemic factors, medications etc; poor OH, Periodontal bone loss and food packing
How can you tell cervical burnout from caries?
location is between enamel and the alveolar bone level; it is triangular in shape compared to the more rounded shape of caries in the cervical region; usually multiple teeth are affected in the same way especially small premolars
How can you assess a restoration radiographically?
Type and Density of restorative material, contouring of the restoration, overhang or under-restored, contact points, adaptation of restoration to base of cavity, marginal fit of cast restorations, presence of a lining material and its radiolucency
How can you assess the tooth underlying a restoration radiographically?
whether there is recurrent or residual caries, the size of the pulp chamber, whether there is internal resorption, the root filling material and completeness, presence and position of pins or posts
Name three pulpal changes associated with pulpal inflammatory change
rounding of pulp horns, pulpal sclerosis, internal resorption
What is periodontal disease?
the clinically detectable destruction of host tissues with the loss of soft and hard tissue attachment and bone
What is the role of radiographs in periodontal disease?
To assess the extent of bone loss and furcation involvement; To determine the presence of any causative factors; To assist in treatment planning; To evaluate treatment, particularly guided tissue regeneration
What classified mild periodontal bone loss?
1-2mm, 1/3 of alveolar bone lost
What classifies moderate bone loss?
2mm, 2/3 bone loss
What classified severe bone loss?
over 2/3
What are the positives of radiographs in periodontal disease?
To identify the extent of alveolar bone destruction; To identify local contributing factors; To show the bone present and the pattern of disease; To show the condition of bony crests and furcation involvement; To show the PDL width and the possibility of traumatic forces; To show irritating factors such as: calculus, overhangs, food packing areas; To show root:crown ratio
What are the two ways periodontal tissue changes can occur due to occlusal trauma?
Excessive force on a normal, intact periodontium; Normal forces on a compromised, reduced periodontium
What are some radiograph features of occlusal trauma?
Increased PDL width, Thickening of the lamina dura, Angular destruction of the inter-septal bone, Bone loss, Increase in number and size of trabeculae, Eventually can lead to hypercementosis and Root Fracture
What can cause perio-endo lesions?
Periodontal disease which has caused devitalisation of the pulp OR Pulpal disease which has caused periodontal bone loss
On a radiograph, which are the 3 most important periapical features to observe?
PDL space; Lamina Dura; Trabecular pattern and the density of the surrounding bone
What is the Lamina Dura?
The hard bony lining of the socket between the bone and PDL
What is dentinal sclerosis?
A form of secondary dentine that is chronic and progressive. It appears as overall narrowing of the pulp chamber and root canal
What are pulp stones?
Areas of calcification in the pulp often seen in young people. The pulp chamber widens around the stone, the remaining pulp is normal
When is pulpal enlargement considered normal?
In newly errupted teeth
When is pulpal enlargement considered abnormal?
If age and pulp chamber size does not correlate or if the pulp chamber is drastically different to the surrounding area
What is hypercementosis?
abnormal thickness of cementum
Describe the radiological features of Hypercementosis
Smooth bulbous enlargment of the root due to increase in thickness of cementum. Intact PDL and Lamina Dura.
Name four causes of Hypercementosis
Over-eruption of tooth, Apical Inflammation, Traumatic occlusion, Systemic Conditions
What is internal resorption?
resorption within the tooth
What are radiographic features of internal resorption?
even enlarged pulp chamber or canal with clear, sharp, defined margins. You cannot see the outline of the normal canal.
What is external resorption?
Resorption outside the tooth
What are some radiographic features of external resorption?
short, blunt, square apex
What are some radiographic features of normal pulp?
healthy PDL space and Lamina Dura
What are some radiographic features of Reversible Pulpitis?
Identification of the cause of pain, Healthy PDL Space and Lamina Dura
What are some radiographic features of Symptomatic Irreversible Pulpitis?
Identifiable cause of pain, Healthy PDL Space and Lamina Dura
What are some radiographic features of Asymptomatic Irreversible Pulpitis?
Healthy PDL Space and Lamina Dura
What are some radiographic features of Pulp Necrosis?
Excessively lucent pulp chamber and canal, complete pulpal sclerosis
What are some radiographic features of previously treated pulp?
Evidence of pulp chamber entry with or without permanent restoration
What are some radiographic features of Previously Initiated Pulpal therapy?
Evidence of previous pulp chamber entry with or without temporary restoration
What are some radiographic features of Normal Periapical tissues?
Healthy PDL space and Lamina Dura
What are some radiographic features of symptomatic apical periodontitis?
Depending on the stage of disease, there may be normal apical tissues or PDL widening and early loss of lamina dura and lucency
What are some radiographic features of asymptomatic apical periodontitis?
Apical widening of PDL, loss/thickening of Lamina Dura, surrounding periapical lucency which is non-corticated and up to 15mm
What are some radiographic features of chronic apical abscess?
Apical widening of PDL space, loss and/or thickening of lamina dura, surrouding periapical lucency which is non-corticated, often has a draining sinus
What are some radiographic features of acute apical abscess?
May be normal apical tissues or PDL widening and an early loss of lamina dura, and lucency which may be: small or large, diffuse
What are some radiographic features of condensing osteitis?
Localised bony sclerosis often surrouding a periapical lucency
What are some radiographic features of an Apical Granuloma?
circular radiolucency extending from the apex, surrounding cancellous bone may become sclerotic, if the area is larger than 16mm it is likely to be cystic
What are some radiographic features of attrition?
sclerosis of the pulp chambers and canals, simultaneous loss of alveolar bone, widening of PDL space, hypercementosis
What are some radiographic features of abrasion?
cervical radiolucencies, borders have increased density, sclerosis of pulp chambers
What are some radiographic features of erosion?
defects on crown margins, edges are normally quite rounded
What is the first line radiography method in children?
intra-oral
Are all bitewings taken intra-orally?
no
Is the risk of radiation damage higher in young or old patients? why?
young, their tissues are more radiosensitive and their life spans are longer
How often should you perform bitewing radiographs for high caries risk patients?
every 6 months
How often should you take bitewing radiographs for moderate caries risk patients?
every year
How often should you take bitewing radiographs for low caries risk patients?
every 12-18 months in primary dentition, every 2 years in mixed and permanent dentition
Is the time interval for taking radiographs shorter or longer in adults than in children?
longer
Why is it important to include radiographs in your referral for general anaesthesia?
to ensure the treatment plan is complete
What is the indication for taking bitewings in children?
detection of caries in primary, mixed, and permanent dentition
What is the indication for taking periapicals in children?
dental trauma
What is the indication for taking panoramics in children?
to assess disturbances in tooth development and growth
What is an indication for taking occlusals in children?
assessing pathology, caries, trauma, unerupted teeth
