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What is an unexposed radiograph and what is the cause and solution
- Receptor was not exposed to x-rays
- Results in clear image
- Cause:Machine not turned on, electrical failure, malfunction of machine
- Correction: Be sure unit is turned on and listen for the exposure button signal
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What is a radiograph exposed to Light (film only) and what is the cause
- Receptor exposed to white light
- Appears black
- Cause:Unwrapping film in a room with white light
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What does an overexposed film appear as and what is the cause?
- Receptor appears dark
- Cause:Excessive exposure time, kV, mA or a combination
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What does an underexposed radiograph appear as and what is the cause?
- Receptor appears light
- Cause:Inadequate exposure time, kV, mA or a combination
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Edge of receptor should be ______ with the incisal or occlusal surfaces to avoid a _______
- parallel
- tipped (diagonal) occlusal plane
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What technique error is this?
Dropped receptor corner
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Horizontal angulation causes what technique error
Overlapping
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Vertical angulation being too flat or insufficient causes what technique error
Elongation
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Vertical angulation being too steep or excessive causes what technique error
Foreshortening
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What technique error is a cone cut
Centering
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What technique error is this?
bent film
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What technique error is this?
Excessive bending
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What technique error is this?
Double exposure
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What technique error is this?
Herringbone (Traditional Film placed Backwards)
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What are the two causes of cone cut?
- PID is not centered over the receptor
- Improper Assembly of XCP
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Pulpal lesions viewed on radiographs include:
Sclerosis, Obliteration, and Stones
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Describe Pulpal Sclerosis and the cause
- Thin, atrophic pulp chambers and canals
- Diffuse calcification of chamber and canals
- Associated w/ aging
- No clinical signs or symptoms
- NO TX RECOMMENDED
- Only problem occurs if endo is needed
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Describe Pulpal Obliteration and the cause:
- Pulp chamber and canals are absent
- Due to formation of secondary dentin in response to irritants to the pulp: Attrition, abrasion, caries, dental restorations, trauma, abnormal mechanical forces
- NON-VITAL/NO TX NECESSARY
- Tooth may clinically appear discolored
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Describe Pulp stones and the cause
- Calcifications in pulp chamber or canals
- Cause unknown
- Round, ovoid, or cylindrical radiopacities.
- NO CLINICAL SIGNS SYMPTOMS
- NO TX RECOMMENDED
- Of little significance unless endo is required.
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What is Physiological resorption
Normal root resorption of primary teeth
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What is Pathological resorption and what are the two types:
- occurs when tooth is subjected to abnormal stimuli
- Internal vs. External
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Where does internal resorption occur, what is the appearance and the cause?
- Occurs within the crown or root of the tooth.
- Involves pulp chamber, pulp canal, and surrounding dentin.
- Appearance: Round to ovoid radiolucency in the middle of the crown or root.
- Cause: Trauma, pulp capping, pulp polyps (act as irritants that destroy surrounding dentin)
- Generally asymptomatic
- More common in anteriors
- Treatment varies depends on severity/tooth structure involvement:
- Endodontic Treatment or Extraction
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Where is external resorption located and what is the cause and treatment
- Located along the periphery of root (usually at apex).
- Root appears blunted, shortened
- Lamina dura, bone appear normal
- Not detected clinically/no symptoms
- No treatment available for external resorption
- Associated with: Re-implanted teeth, abnormal mechanical forces, trauma, chronic inflammation, tumors or cysts, impacted teeth, or idiopathic causes
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______, _______, and ______ are the most common periapical radiolucencies
Periapical granulomas, cysts and abscesses
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What is a periapical granuloma?
- Localized mass of chronically inflamed granulation tissue at the apex of a nonvital tooth.
- Results from pulpal death and necrosis
- Most common sequela of pulpitis (infl of pulp)
- Typically asymptomatic but w/ previous sens. to hot/cold
- Treatment: RCT or extraction w/ currettage of apical area
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What is the appearance of a Periapical Granuloma
- Widened PDL at apex that gradually enlarges to form a round or ovoid RL
- Lamina dura is NOT visible between root apex and the apical RL lesion
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What is a periapical cyst and what is it also known as?
- AKA “radicular cyst”
- Most common of all tooth related cysts
- 50-70% of ALL cysts in the oral region
- Lesion w/ epith lining at apex of a non-vital tooth
- Develops over a prolonged period
- Most begin as a granuloma
- Results from pulpal death and necrosis
- Typically asymptomatic
- Left untreated, can expand
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What is the appearance and treatment of a periapical cyst
- Appearance: Round/ovoid RL at apex/Lamina dura not visible between root and lesion
- Treatment:RCT or extr. w/ curretage
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What is a periapical abscess
- Collection of pus in periapical regionNon-vital tooth/Results from pulpal death and necrosis
- May be acute (intense, throbbing, painful): having features of an acute, pus-producing inflammation of the pulp; or may result from an area of chronic infection such as a PA granuloma
- May be chronic (long-standing, low grade, pus-producing/draining process/usually asymptomatic) resulting from acute abscess or a PA granuloma
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What are the symptoms of Acute Periapical Abscess
- Intense pain: throbbing & constant
- Sensitive to pressure, percussion, and heat
- Tooth is non-vital
- Early changes: none or widened PDL
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What are the symptoms of Chronic Periapical Abscess
- Asymptomatic due to pus drainage through bone or PDL space
- Gum “boil” may be present
- Chronic PA abscess appears as round or ovoid RL at apex w/ poorly defined margins
- Lamina dura cannot be seen between root apex and RL lesion
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What is the treatment of a periapical abscess
Drainage of the area and RCT or extraction
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What are the three Periapical Radiopacities
Condensing Osteitis, Sclerotic bone and Hypercementosis
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What is Condensing Osteitis and what is the cause
- Believed to be a physiological reaction of bone to inflammation
- Tooth is non-vital
- Typically associated w/ large carious lesion/restoration
- Result of long-standing pulpitis, pulpal necrosis
- Opacity represents proliferation of periapical bone that is a result of low-grade inflammation or mild irritation
- MOST COMMON PA RADIOPACITY IN ADULTS
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What is the appearance, treatment and most common location of Condensing Osteitis
- Well-defined RP at apex
- Varies in size/shape
- Does NOT appear to be attached to root
- No treatment necessary
- MOST COMMON LOCATION: MD 1ST MOLAR
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What is sclerotic bone
- AKA “Osteosclerosis” or “Idiopathic periapical osteosclerosis”
- Well defined radiopacity below the apices of vital, noncarious teeth
- Cause unknown (not believed to be associated with inflammation)
- Asymptomatic –typically discovered during radiographic examination
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What is the appearance of Sclerotic Bone
- Well-defined
- Not attached to root
- Varies in shape/size
- Borders may be smooth, irregular, or diffuse
- Borders continuous w/adjacent normal bone
- No RL outline
- Not necessary to remove the bone, but treatment of the non-vital tooth requires RCT or extraction
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What is Hypercementosis
- Excessive formation of cementum on all or part of root surfaces (most commonly at apical area)
- Cause is at times not obvious; or from supraeruption, inflammation, trauma
- No clinical signs or symptoms
- Teeth are vital and do not require treatment
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What is the appearance of Hypercementosis
- Apical area appears enlarged/bulbous
- Normal appearing PDL and lamina dura
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A Periapical abscess results from ________ while a periodontal abscess results from __________
- an infection within the pulp
- Bacterial infection within periodontal tissues (preexisting periodontal condition where opening of pocket becomes obstructed)
- RL area lateral to root
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