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Yr 3 - Radiology > Selection criteria > Flashcards

Selection criteria Flashcards

1
Q

What is it important to remember when taking X-rays?

A

They are a 2D representation of a 3D structure (need views from other angles and what we already know needs to be applied)

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2
Q

What are the main indications for bite wings?

A

Detection of dental caries
Monitoring the progression of dental caries
Assessment of existing restorations
Assessment if periodontal status of pocket depths up to 6 mm using vertical bitewing

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3
Q

Caries diagnosis and radiographs:

A

Screening for interdental caries (not clinically evident)
Posterior bite wings increase diagnostic yield of inter-proximal lesions X4 compared to clinical examination
Needs 50% demineralisation before you can visualise caries radio graphically
Need good contrast between enamel and dentine to detect caries (lower kV gives better contrast)
N.b. Various lesions are always larger clinically than they appear on X-rays

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4
Q

Periodontal and radiographs:

A

Needs less contrast than caries diagnosis (uses higher kV - just over 70)

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5
Q

How often should you take posterior bite wings for caries diagnosis?

A

High caries risk: 6 monthly
Moderate caries risk: annually (but if start to see caries they become high caries risk)
Low caries risk: 12-18 months (primary dentition) and 24 months (permanent dentition)

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6
Q

What is the recommendations by the European Association of paediatric dentistry?

A

Radiographs should be taken only if considered necessary for adequate treatment

5 y/o should be considered although cooperation may be poor
8-9 y/o
12-14 y/o = 1-2 yrs after eruption of premolars and second molars

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7
Q

What is the recommended interval for children age 5 at baseline bitewing exam?

A

Low caries risk 3 years

High caries risk 1 year

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8
Q

What is the recommended interval for children age 8-9 at baseline bitewing exam?

A

Low caries risk 3-4 years

High caries risk 1 year

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9
Q

What is the recommended interval for children age 12-14 at baseline bitewing exam?

A

Low caries risk: 2 years

High caries risk: 1 year

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10
Q

What is the recommended interval for children age 16 at baseline bitewing exam?

A

Low caries risk: 3 years

High caries risk: 1 year

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11
Q

When are periapical radiographs indicated/ required?

A

Root/ pupal pathology or development
Extent of crown pathology in anterior teeth
Assessment of apical pathology
Assessment of local anatomy including tooth development

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12
Q

What are the two techniques used to take periapical radiographs?

A
  1. Long cone paralleling (used wherever possible)

2. Bisecting angle

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13
Q

What are the different types of occlusal radiographs?

A
  • upper standard (nasal occlusal) = large bisected angle periapical
  • upper oblique occlusal
  • lower 90 degree occlusal
  • lower 45 degree occlusal = large bisected angle periapical
  • lower oblique occlusal
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14
Q

When is taking a upper standard occlusal indicated?

A

When unable to take periapical
Trauma
Palatal pathology
2nd view to aid localisation

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15
Q

When us an upper oblique occlusal indicated?

A

When unable to take bitewing/ periapical

To provide view from different angle

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16
Q

When is a lower 90 degree occlusal indicated?

A

Reduced exposure for salivary calculus
Fractures of the anterior mandible
Buccolinguallu expansion of cortical bone
Localisation

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17
Q

When is a Lower 45 degree occlusal indicated?

A

Unable to tolerate periapical film
Lesion too large to visualise on intraoral film
Anterior fracture of the mandible

18
Q

When is a lower oblique occlusal indicated?

A

Cannot tolerate periapical film

Imaging submandibular gland

19
Q

What are the selection criteria for radiograph types for periodontal assessment?

A 
Diagnosis of periodontal disease depends on clinical exam 
Requires reproducibility (assess changes in bone levels) 
Utilise radiographs taken to assess caries already
20
Q

What are the uses of radiographs in periodontal assessment?

A

Determine bone loss and furcation involvement
Determine presence of causative factors (overhanging restoration margins)
Assist in treatment if planning
Evaluation of treatment

21
Q

What are the guidelines for radiography in periodontal disease?

A
  • uniform pocketing 4-5 mm (BPE Max 3)with little or no recession use horizontal bite wings
  • pocketing 6mm+ (BPE 4) = vertical bite wings +/- paralleling technique periapicals
  • irregular pocketing = bite wings (horizontal/vertical) +/- paralleling technique periapicals
22
Q

Why would you not use DPT’s /CBCT for periodontal disease?

A

Distorts levels of bone I.e. DPT beam aimed up = lower looks like less bone than there is

23
Q

When should you use paralleling technique periapicals?

A

If a Perio/endo lesion is suspected

= lower dose but takes longer

24
Q

When should you radiograph in endodontics?

A

Preoperatively:
- at least 1 to determine working lengths unless other reliable means available (if preset file is >2mm from the radio graphic apex it is advisable to reset the file and retake the radiograph)

Operative:
- immediately following obturation (treatment) = baseline and quality

Post-operative:
- a symptomatic teeth = 1 year after completion of root filling and 4 years after completion of treatment

25
Q

What radiographs are required following trauma?

A
  • a baseline radiograph (unless minor tooth trauma I.e. Chip)
  • review radiographs at intervals appropriate to findings (no evidence to support any particular frequency/ duration of review)
  • DPT = Mandibular fracture but also with additional supporting views I.e. Buccolingual to assess displacement
26
Q

Heavily restored dentition…

A
  • uk average denture adult has 7 filled teeth
  • > 45 years half teeth filled or crowned
  • 34% adults have at least 1 crown
  • 5% adults have >6 crowns
27
Q

Before preparing any tooth for crown or bridge retainer or as a denture abutment what type of radiograph should be taken and why?

A

A periapical

For baseline info and to make sure not putting it on a tooth that will soon fall out/ need extracting

28
Q

Which part follow up radiographs should be taken if crowned teeth?

A

Posterior bite wings as recommended for caries assessment
Periapical radiographs before 2 years and beyond 10 years post cement action are unlikely to give a high yield of radio graphic findings (no benefit)

29
Q

What are the suggested selection criteria for DPTs?

A

Prior to dental surgery under GA
Where a bony lesion or unerupted tooth is of size or position which precludes its complete demonstration on intraoral radiographs
Prior to dental clearance/ multiple extractions where a clinical decision to remove the teeth has already been made
Orthodontic assessment
Trauma
As part of an assessment of the periodontal bone support where pocket depths are >6mm and no other radiographs available
Implant assessment

30
Q

In DPT what distortions happens?

A

Beam is aimed up so looks like there is more bone in the mandible and less in the maxilla

31
Q

When should DPTs be taken?

A

ONLY IN THE PRESENCE OF SPECIFIC CLINICAL SIGNS AND SYMPTOMs (no justification for reviews at arbitrary time intervals)

32
Q

When are oblique lateral radiographs used?

A

For children who can’t stay still for DPT (especially those with special needs)

33
Q

When with TMJ dysfunction are radiographs necessary?

A

Normally only need clinical diagnosis unless….

  • history of trauma
  • unusual symptoms
34
Q

Which radiographs are used for TMJ disorders?

A

DPT/ specific TMJ views

MRI to see soft tissue I.e. Disc

35
Q

When are lateral cephalometric radiographs indicated?

A
  • assess skeletal pattern
  • angulation of incisors
  • orthognathic surgical planning
  • tracings (to measure disocclusion)
36
Q

Which skull views are uses to assess trauma to the mandible?

A 
PA skull view (maxilla and zygomatic complex) - also to look at expansion of tumour buccolingually
CT scan (complicated fracture = shows soft tissue)
37
Q

When is cone beam ct scanning indicated?

A

Implants = to see where bone is thickest and to see where the ID nerve canal is

38
Q

When are ultrasonics indicated?

A

First line imaging for all head and neck lumps and salivary gland disease
= cheap, quick, no radiation, but very operator sensitive

39
Q

When is sialography indicated?

A

Obstructive salivary gland disease to demonstrate strictures and stone mobility

40
Q

When are MRIs indicated?

A

Soft tissue lesions, particularly such as salivary tumours and cancer of the head and neck

41
Q

When is nuclear medicine indicated?

A

Rarely used = inject radioisotopes

E.g. TMJ hyperplasia

42
Q

When might we wish to take a dental radiograph?

A

Pathology affecting the tooth and or supporting structures
Require knowledge of root/ pupal morphology
Screening for dental caries
Localisation of teeth/foreign bodies

Yr 3 - Radiology (9 decks)

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