Reporting on clinical radiograph - 2.5
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Questions and Answers

What factors should be considered when selecting a radiographic technique?

Clinical presentation, required image quality, and dose-benefit based on available equipment.

In what scenario is a periapical radiograph using a paralleling technique indicated?

When a periodontal or endodontic lesion is suspected.

What is the recommended radiographic approach for patients with pocketing of 6mm or more?

Vertical bitewings supplemented by intraoral periapical views using the paralleling technique.

When is panoramic radiography particularly justified?

<p>When a bony lesion or unerupted tooth cannot be demonstrated completely on intraoral radiographs.</p> Signup and view all the answers

What is essential before taking panoramic radiographs?

<p>Specific clinical signs and symptoms must be present; routine screening is not justified.</p> Signup and view all the answers

What positioning is indicated for the dot in bitewing radiographs?

<p>The dot should be towards the mandibular teeth.</p> Signup and view all the answers

Describe the characteristics of posterior cervical burnout in dental radiographs.

<p>It appears as a more radiolucent area due to the invagination of proximal root surfaces allowing more x-rays to pass through.</p> Signup and view all the answers

What is Grade A evidence according to the SIGN system of classification?

<p>Grade A evidence requires at least one randomized controlled trial of overall good quality addressing specific recommendations.</p> Signup and view all the answers

What is classified as C-2 caries in dental radiology?

<p>C-2 caries is enamel caries penetrating more than halfway through enamel but not involving the dentino-enamel junction.</p> Signup and view all the answers

Explain the selection criteria for high caries risk in children.

<p>High caries risk is defined as having a percentage range of 167% to 800%.</p> Signup and view all the answers

What does the level of evidence C indicate in terms of clinical studies?

<p>Level C indicates absence of directly applicable clinical studies of good quality and is based on expert opinions.</p> Signup and view all the answers

What does incipient caries refer to, and how is it classified?

<p>Incipient caries refers to enamel caries less than halfway through enamel, classified as C-1.</p> Signup and view all the answers

Why is routine radiograph taking based solely on time elapsed since the last appointment not supportable?

<p>It lacks strong evidence and does not consider individual patient conditions and risks.</p> Signup and view all the answers

What should be the interval for radiographic examinations in patients with high caries risk?

<p>6 months</p> Signup and view all the answers

For low caries risk individuals, what is the minimum recommended interval for permanent dentition radiographic exams?

<p>2 years</p> Signup and view all the answers

Why should CBCT not be used routinely for caries diagnosis?

<p>It is not indicated as a routine method.</p> Signup and view all the answers

What adjunct method should be used with bitewings for caries diagnosis?

<p>FOTI</p> Signup and view all the answers

What is the recommended imaging for a patient with generalized pocketing of 4-5mm and minimal recession?

<p>Horizontal bitewings with possible periapicals for selected anterior teeth.</p> Signup and view all the answers

What role do panoramic radiographs play in periodontal assessment?

<p>They can assess all teeth and their periodontal support.</p> Signup and view all the answers

What caution should be exercised when using optical caries detection devices?

<p>Some may give false positives.</p> Signup and view all the answers

In patients with moderate caries risk, how often should radiographic examinations be conducted?

<p>Once a year</p> Signup and view all the answers

Where should the dot be placed on a periapical radiograph?

<p>To the crown</p> Signup and view all the answers

What is posterior cervical burnout?

<p>Invagination of the proximal root surfaces, which allows more X-rays to pass through, making it appear more radiolucent.</p> Signup and view all the answers

What is the function of the SIGN* system of classification?

<p>It classifies the level of evidence for recommendations regarding dental care.</p> Signup and view all the answers

What are the different grades of evidence in the SIGN* system?

<p>Grade A, Grade B, Grade C</p> Signup and view all the answers

A Grade A recommendation requires at least one randomized controlled trial.

<p>True</p> Signup and view all the answers

What is the difference between C-1 and C-4 radiographic caries classifications?

<p>C-1 caries are not as extensive. C-4 caries involve both enamel and dentin</p> Signup and view all the answers

What level of evidence is recommended for diagnosing caries in a child?

<p>Level B</p> Signup and view all the answers

CBCT is recommended as a routine method of diagnosing caries.

<p>False</p> Signup and view all the answers

What are FOTI*s? How are they used for caries diagnosis?

<p>FOTI* stands for fiber optic transillumination. In dental care, it is a tool used to detect caries in the early stages. It is helpful in identifying cavities that may not be visible with conventional clinical examination or dental radiographs. FOTI* works by using a bright light source to illuminating the tooth and highlighting areas of reduced light transmission, suggesting the presence of caries.</p> Signup and view all the answers

What are the types of Bitewings recommended in periodontal assessment?

<p>Horizontal Bitewings, Vertical Bitewings and Periapical Bitewings.</p> Signup and view all the answers

CBCT is recommended as a routine method for imaging periodontal bone support?

<p>False</p> Signup and view all the answers

When is panoramic radiography recommended for a patient with generalized pocketing?

<p>When the patient has a BPE score of 4 or higher in any sextant</p> Signup and view all the answers

Panoramic radiography is a good alternative to periapical radiography for assessing all teeth and their periodontal support.

<p>True</p> Signup and view all the answers

It is always necessary to review panoramic radiographs at arbitrary time intervals?

<p>False</p> Signup and view all the answers

What are the common errors that can occur with OPG?

<p>Common errors during OPG include incorrect chin positioning, poor tongue placement, patient movement during the scan, and head tilt. These can result in image distortions such as blurry teeth, a distorted appearance, or an incomplete view of the dentition.</p> Signup and view all the answers

Study Notes

Reporting on Clinical Radiographs

  • Bitewing radiographs show dots towards mandibular teeth
  • Periapical radiographs show dots towards the crown
  • Posterior cervical burnout: proximal root surfaces allow more x-rays to pass through, appearing more radiolucent
  • Anterior cervical burnout: space between enamel and bone overlaying a tooth, more radiolucent than enamel or bone-tooth combination

Selection Criteria

  • Descriptions of clinical conditions, derived from patient signs, symptoms, and history, identify patients likely to benefit from a specific radiographic technique
  • Guidelines are not rigid constraints on clinical practice, but rather concepts of good practice used to consider individual patient needs

Levels of Evidence - SIGN System

  • Grade A: Requires at least one randomized controlled trial, with good quality and consistency, addressing the specific recommendation.
  • Grade B: Requires well-conducted clinical studies but not randomized clinical trials on the topic of the recommendation.
  • Grade C: Requires evidence from expert committee reports, opinions, and/or clinical experience of respected authorities. Indicates absence of directly applicable clinical studies.

Classification of Radiographic Caries

  • C-1: Enamel caries less than half way through enamel; sometimes called incipient caries.
  • C-2: Enamel caries penetrating more than half way through enamel but not involving the dentino-enamel junction
  • C-3: Enamel and dentine caries at or through the dentino-enamel junction, extending less than half way into dentine towards the pulp cavity.
  • C-4: Enamel and dentine caries extending more than half way into dentine towards the pulp cavity.

Selection Criteria for Child Bitewings

  • High caries risk: 167-800%
  • Moderate caries risk: 150-270%
  • Low caries risk: Significant caries number over clinical examination (some studies show 2-3x more carious lesions)

Level of Evidence B for Caries Diagnosis

  • Diagnosis of caries should be as early as possible
  • Early management is crucial for preventing cavitation and pulpal involvement
  • Identifying caries-active patients and those at increased risk is essential

Level of Evidence C for Adult Bitewings

  • High caries risk: 6-month intervals.
  • Moderate caries risk: 1-year intervals.
  • Low caries risk: 2-year intervals intervals until no new or active lesions are detected

Selection Criteria - Newer Radiographic Methods

  • CBCT should not be used as a routine method for caries diagnosis (Level B)

Selection Criteria - Periodontal Assessment

  • CBCT is not routinely indicated for imaging of periodontal bone support (Level C).

Selection Criteria - Panoramic Radiography

  • Panoramic radiography is suitable for assessment of all teeth and periodontal support (Level C)
  • Used when a bony lesion or unerupted tooth is not fully demonstrable on intraoral radiographs (Level C)
  • Use for assessment of third molars prior to surgical intervention (Level B)

Review of Panoramic Radiographs

  • Panoramic radiographs should only be taken in the presence of specific clinical signs and symptoms (Level B).
  • No justification for arbitrary time intervals for review.

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Reporting on Clinical Radiographs - 2.5 PDF
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Description

This quiz covers key concepts in reporting on clinical radiographs, including bitewing and periapical radiographs, as well as the significance of cervical burnout. It also discusses the selection criteria based on patient conditions and levels of evidence in clinical practice. Understand the guidelines and their application to enhance patient care.

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