DHE119 Continue Rad Analysis slides 18-51

• Functions as an attachment of the tooth to the lamina dura of the socket
• Appears as a thin radiolucent line surrounding the tooth root
• A widening of PDL space on radiograph indicates tooth mobility.

• alveolar bone,
• periodontal ligament space,
• lamina dura, and
• cementum.

accurate radiographs.

• Radiographs illustrate:
• ¨-Bony changes caused by disease
• ¨-Tooth root morphology
• ¨-Relationship of the maxillary sinus to the periodontal deformity
• ¨-Widening of the PDL space
• ¨-Advanced furcation involvement
• ¨-Periodontal abscess
• ¨-Local factors (crown, overhang)

• Early bony changes
• Horizontal bone loss (most common)
• Vertical bone loss
• Bone defects
• Furcation involvement(multirooted teeth)

• Widening of the PDL space caused by bone resorption on either the mesial or the distal of the interdental crestal bone
• Also called funneling
• 

• Finger-like radiolucent projections extending from the crestal bone into the interdental alveolar bone.
• Represent a reduction of mineralized tissue adjacent to blood vessel channels in the alveolar bone.
• Anteriors (normal): thin, pointed.
• Posterior (normal): rounded, flat.
• 

by using the CEJ of adjacent teeth as points of reference

• —bone destruction parallel to a line between CEJs of adjacent teeth
• 

• greater bone loss on the interproximal aspect of one tooth than on the adjacent tooth.
• 

• Radiograph is a “snapshot” of an instant in time in the disease process.
• Radiograph reveals the bone remaining rather than the bone lost.

TRUE

• Is not seen on the radiograph until the bone resorption extends past the furcation area
• Easier to see on mandibular than maxillary
• Maxillary palatal root appears superimposed over furcation of the tooth.
• Furcation involvement often is greater than it appears on the radiograph

¤Calculus deposits

¤Faulty restorations

¤Trauma from occlusion

¨Large interproximal calculus deposits may be visible on radiographs.

¨Large facial and lingual deposits may be visible if there is severe bone loss on the surfaces.

¨Ability to visualize on radiographs depends on the degree of mineralization and angulation of the x-ray beam.

• Can cause gingival inflammation, periodontitis, and alveolar bone resorption
• Can be detected on radiographs
• Faulty contours between the first and the second molar restorations create an open contact that may cause food impaction.
• 

• Creates many visible shades of gray that make it easier to see subtle changes in bone loss
• Obtained by using a high kVp or digital imaging

• ¨Crestal bone loss of 5 mm+ may not allow optimum coronal bone visualization with horizontal bitewings.
• ¨Vertical bitewings are indicated.
• ¨Long axis of the film is rotated 90 degrees.
• ¨Vertical bitewing adaptor for film holder is used.

• Vertical
• 

• ¨It is only a 2D image of a 3D structure.
• ¨Buccal bone can hide bone loss on the lingual aspect.
• ¨Palatal root makes furcation detection on the maxilla difficult.
• ¨Radiographs do not provide information about noncalcified components.
• ¨Radiographs do not show disease activity.
• ¨They do show effects of the disease.

never

• Presence or absence of periodontal pockets
• Early bone loss
• Exact morphology of bone destruction
• Tooth mobility
• Early furcation involvement
• Condition of the bone on the buccal and lingual surfaces Level of the epithelial attachment

clinically, not radiographically.

not usually

difficult

• X-ray beam alignment may conceal the presence or extent of involvement.
• Use of furcation probe is necessary in determining the actual clinical involvement.

• ¨Crestal bone loss of >5 mm or greater may cause the coronal bone to be poorly seen on normal bitewing radiographs.
• ¨Vertical bitewings are more appropriate.
• ¨Long axis of the film is rotated 90 degrees to be perpendicular to the occlusal plane.

the best possible diagnostic evidence.

changes in the periodontium.

periodontitis.