DHE119 Continue Rad Analysis slides 18-51

  1. Periodontal Ligament Space:
    • 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.
  2. Components of the periodontium that can be identified radiographically include the:
    • alveolar bone,
    • periodontal ligament space,
    • lamina dura, and
    • cementum.
  3. A periodontal assessment is incomplete without ______.
    accurate radiographs.
  4. What are the benefits of using radiographs in a periodontal examination?
    • 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)
  5. Radiographic Signs of Periodontal Disease:
    • Early bony changes
    • Horizontal bone loss (most common)
    • Vertical bone loss
    • Bone defects
    • Furcation involvement(multirooted teeth)
  6. Early Radiographic Signs of Disease:3?
    Image Upload 1
  7. Early Radiographic Signs of Disease:
    Image Upload 2
  8. Early Radiographic Signs of Disease:
    Image Upload 3
  9. Early Radiographic Signs of Disease:
    Radiolucent lines?
    Image Upload 4
  10. Triangulation:
    • Widening of the PDL space caused by bone resorption on either the mesial or the distal of the interdental crestal bone
    • Also called funneling
    • Image Upload 5
  11. Interseptal Bone Changes:
    • 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.
    • Image Upload 6
  12. How is bone loss determined?
    by using the CEJ of adjacent teeth as points of reference
  13. Horizontal bone loss
    • —bone destruction parallel to a line between CEJs of adjacent teeth
    • Image Upload 7
  14. Vertical bone loss—
    • greater bone loss on the interproximal aspect of one tooth than on the adjacent tooth.
    • Image Upload 8
  15. Assessment of Bone Loss:
    • Radiograph is a “snapshot” of an instant in time in the disease process.
    • Radiograph reveals the bone remaining rather than the bone lost.
  16. Even though bone loss occurs on all surfaces, radiographs are not able to show the extent on the facial and lingual surfaces.
    True or False?
  17. Assessment of Furcation Involvement:
    • 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
  18. Risk factors detectible on radiographs are?
    ¤Calculus deposits

    ¤Faulty restorations

    ¤Trauma from occlusion
  19. Calculus Detection:
    ¨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.
  20. Faulty Restorations:
    • 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.
    • Image Upload 9
  21. Long-Grayscale/Low Contrast Images:
    • 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
  22. Vertical Radiographs:
    • ¨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.
  23. _____bitewings show more of the coronal bone than horizontal bitewings.
    • Vertical
    • Image Upload 10
  24. Limitations of radiographs?
    • ¨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.
  25. ¨Radiographic examination is ______ a satisfactory substitute for a clinical periodontal assessment.
  26. Radiographs do not reveal the Following:
    • 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
  27. Early Bone Loss must first be detected _____.
    clinically, not radiographically.
  28. Interseptal bony defects less than 3 mm are ____ detected radiographically.
    not usually
  29. Facial and lingual bone height are ___ to evaluate radiographically.
  30. Early Furcation Involvement in radiograph?
    • X-ray beam alignment may conceal the presence or extent of involvement.
    • Use of furcation probe is necessary in determining the actual clinical involvement.
  31. Extensive Bone Loss in radiographs?
    • ¨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.
  32. Recognizing limitations of radiographs and utilizing appropriate radiographic techniques will ensure ___________.
    the best possible diagnostic evidence.
  33. Radiographs assist the hygienist in detecting _____.
    changes in the periodontium.
  34. Radiographs are an essential diagnostic tool in the diagnosis of _____.
Card Set
DHE119 Continue Rad Analysis slides 18-51
DHE119 Continue Rad Analysis slides 18-51