Dental Anomalies and Periapical Dysplasia Quiz
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Questions and Answers

What best describes the internal structure of an early-stage periapical cemento-osseous dysplasia lesion?

  • Completely radiopaque with a thin radiolucent rim
  • Mixed stage with a radiopaque center
  • Radiolucent replaced by fibrous tissue (correct)
  • Radiopaque structure with no surrounding radiolucency

What change occurs in periapical cemento-osseous dysplasia as it matures?

  • It becomes structureless with a V-pattern
  • It starts as radiopaque and then becomes radiolucent
  • It becomes completely opacity (correct)
  • It transitions from mixed to solely radiolucent

How can one differentiate between periapical cemento-osseous dysplasia and rarefying osteitis?

  • By assessing the mixed stage features
  • By examining the radiopaque center only
  • By identifying the presence of a thin radiolucent rim
  • By performing a vitality test (correct)

What characterizes the mixed stage of periapical cemento-osseous dysplasia?

<p>It contains a radiopaque center within a radiolucent region (A)</p> Signup and view all the answers

What is a notable characteristic of mature periapical cemento-osseous dysplasia?

<p>Radiopaque center with mature cementoblastoma appearance (B)</p> Signup and view all the answers

What dental anomaly is characterized by the presence of too many teeth?

<p>Hyperdontia (B)</p> Signup and view all the answers

Which condition is considered the most common type of supernumerary tooth?

<p>Mesiodens (A)</p> Signup and view all the answers

Which of the following conditions involves the primitive form of two separate teeth being united?

<p>Fusion (D)</p> Signup and view all the answers

Which condition is related to the absence of one or more teeth?

<p>Hypodontia (C)</p> Signup and view all the answers

What is the term for the condition where a tooth is unable to erupt due to obstruction?

<p>Impaction (C)</p> Signup and view all the answers

Which dental anomaly is typically associated with excessive growth of the dental pulp leading to an abnormal tooth shape?

<p>Taurodontism (C)</p> Signup and view all the answers

Which syndrome is characterized by the presence of multiple supernumerary teeth and is associated with a significant risk of malignant transformation?

<p>Gardner’s syndrome (C)</p> Signup and view all the answers

Which term describes the absence of all teeth?

<p>Anodontia (A)</p> Signup and view all the answers

Which of the following syndromes is commonly associated with oligodontia?

<p>Ectodermal Dysplasia (B)</p> Signup and view all the answers

Macrodontia typically affects which of the following characteristics?

<p>Only one tooth is larger than normal (D)</p> Signup and view all the answers

Which of the following is the most common single missing tooth?

<p>Maxillary lateral incisors (A)</p> Signup and view all the answers

What does oligodontia specifically refer to in terms of tooth absence?

<p>Missing more than six teeth (C)</p> Signup and view all the answers

Microdontia is characterized by which of the following aspects?

<p>Teeth are smaller than normal and may have abnormal form (A)</p> Signup and view all the answers

Which of the following conditions may result from macrodontia?

<p>Crowding and impactions (B)</p> Signup and view all the answers

What is a common complication associated with ectodermal dysplasia?

<p>Missing hair, nails, and teeth (A)</p> Signup and view all the answers

What two factors can lead to the necrosis of pulp in teeth?

<p>Caries and trauma (C)</p> Signup and view all the answers

Which condition can arise from long-standing infections in the body?

<p>Osteomyelitis (B)</p> Signup and view all the answers

Which radiographic feature indicates the involvement of periodontal ligament in periapical inflammatory disease?

<p>Widening of the PDL space (B)</p> Signup and view all the answers

In acute apical periodontitis, what can the infection lead to if left untreated?

<p>Periapical cysts (C), Periapical granuloma (D)</p> Signup and view all the answers

What does the term 'rarefying osteitis' refer to in the context of periapical inflammatory lesions?

<p>Loss of bone mineralization (B)</p> Signup and view all the answers

What occurs when caries reach the pulp of a tooth?

<p>Endodontic treatment is required (C)</p> Signup and view all the answers

Which type of lesion is characterized by a well-defined periphery?

<p>Periapical granuloma (A)</p> Signup and view all the answers

What is a common consequence of necrotic pulp that progresses to acute periapical inflammation?

<p>Granuloma formation (C)</p> Signup and view all the answers

What is the primary distinction between sclerosing osteitis and rarefying osteitis?

<p>Bone deposition vs. bone loss (A)</p> Signup and view all the answers

Which radiographic feature is often associated with chronic apical periodontitis?

<p>Loss of trabecular bone (C)</p> Signup and view all the answers

Which of the following is a clinical sign of medication related osteonecrosis of the jaw?

<p>Swelling at the site of extraction (C)</p> Signup and view all the answers

What type of radiographic feature is associated with medication related osteonecrosis?

<p>Thickening of the lamina dura (C)</p> Signup and view all the answers

Which condition is characterized by inflammation of the tissues surrounding a partially erupted tooth?

<p>Pericoronitis (D)</p> Signup and view all the answers

What is the primary cause of caries formation?

<p>Bacterial fermentation of carbohydrates (B)</p> Signup and view all the answers

Which type of radiograph is best suited for finding interproximal caries?

<p>Bitewing radiographs (D)</p> Signup and view all the answers

What significant characteristic of radiolucent zones indicates the presence of caries?

<p>Lower absorption of x-ray photons (B)</p> Signup and view all the answers

What condition is more commonly associated with mandibular third molars?

<p>Pericoronitis (C)</p> Signup and view all the answers

Which technique is used in bitewing radiographs to improve image quality?

<p>Paralleling technique (B)</p> Signup and view all the answers

Which statement accurately differentiates medication related osteonecrosis from osteomyelitis?

<p>Medication related osteonecrosis rarely occurs in non-cancer patients. (D)</p> Signup and view all the answers

What is a common radiographic feature seen in dental caries?

<p>Darker radiolucent area at the site of demineralization (D)</p> Signup and view all the answers

Which condition involves a single tooth bud dividing to create two teeth?

<p>Gemination (D)</p> Signup and view all the answers

What is the characteristic feature of taurodontism?

<p>Large 'trunk'-like pulp extension (B)</p> Signup and view all the answers

What is the most common type of impacted teeth?

<p>Canines and molars (B)</p> Signup and view all the answers

Which developmental anomaly is caused by trauma to an erupting tooth, resulting in severe curvature?

<p>Dilaceration (B)</p> Signup and view all the answers

What is the cause of fusion in dental anomalies?

<p>Two tooth buds merging (B)</p> Signup and view all the answers

What identifies Hutchinson's teeth as a specific dental anomaly?

<p>Widened neck and constricted incisal portion (D)</p> Signup and view all the answers

Which anomaly is characterized by teeth fused at their roots by cementum?

<p>Concrescence (C)</p> Signup and view all the answers

In which condition is the enamel incorrectly formed or hypoplastic, often leading to a translucent appearance?

<p>Amelogenesis imperfecta (B)</p> Signup and view all the answers

Which type of dentin dysplasia is identified by short, conical roots?

<p>Type I (radicular) (D)</p> Signup and view all the answers

What is a common feature in regional odontodysplasia?

<p>Large pulp chambers and thin enamel (A)</p> Signup and view all the answers

Which condition can result in a tooth appearing submerged clinically due to a fusion with the bone?

<p>Ankylosis (C)</p> Signup and view all the answers

What describes the appearance of a tooth with dilaceration on a radiograph?

<p>Extreme curvature of the root (A)</p> Signup and view all the answers

What type of teeth does den evaginatus most commonly affect?

<p>Lateral incisors and premolars (A)</p> Signup and view all the answers

Which type of amelogenesis imperfecta is characterized by thin enamel that allows dentin to be visible?

<p>Hypoplastic (A)</p> Signup and view all the answers

What is the primary distinction between hyperdontia and hypodontia?

<p>Hyperdontia refers to the presence of too many teeth, whereas hypodontia refers to the absence of one or a few teeth. (C)</p> Signup and view all the answers

Which condition is most commonly associated with mesiodens?

<p>Supernumerary teeth (C)</p> Signup and view all the answers

What does the term 'oligodontia' specifically refer to?

<p>Missing multiple teeth, typically more than six (A)</p> Signup and view all the answers

What condition refers to the abnormal position of a tooth, where it erupts in an unexpected location?

<p>Ectopia (A)</p> Signup and view all the answers

Which syndrome is associated with a high risk of developing malignant tumors along with supernumerary teeth?

<p>Gardner’s syndrome (D)</p> Signup and view all the answers

What initiates the body's reaction to certain instruments during the treatment of osteomyelitis?

<p>The presence of infection (C)</p> Signup and view all the answers

Which part of the periosteum contains pluripotent mesenchymal stem cells?

<p>Inner osteogenic layer (C)</p> Signup and view all the answers

What is formed under the right conditions by the stem cells in the periosteum's osteogenic layer?

<p>Osteoblasts (D)</p> Signup and view all the answers

What symptom is associated with the infection of the periosteum spreading to the gingiva?

<p>Parulis (B)</p> Signup and view all the answers

In the context of periostitis, what happens as the infection progresses?

<p>The gap between layers fills with more bone (B)</p> Signup and view all the answers

What visual appearance is characterized by the layers of new bone in periostitis?

<p>Onion ring-like formation (C)</p> Signup and view all the answers

What complication may arise from an infection draining into the maxillary sinus?

<p>Odontogenic sinusitis (A)</p> Signup and view all the answers

Which of the following statements correctly describes Sharpey's fibers?

<p>Anchor the periosteum to the bone (B)</p> Signup and view all the answers

What is the primary type of tissue that the periosteum consists of?

<p>Connective (C)</p> Signup and view all the answers

What is a potential consequence of an acute infection in the maxillary sinus?

<p>Cold-like symptoms (A)</p> Signup and view all the answers

What is the term used for caries that has extended into the dentin-enamel junction (DEJ)?

<p>Advanced caries (B)</p> Signup and view all the answers

What is a common characteristic of occlusal caries?

<p>Demineralization originates in enamel pits and fissures. (B)</p> Signup and view all the answers

Which type of caries is known for its aggressive and rapidly progressing nature?

<p>Rampant caries (C)</p> Signup and view all the answers

What distinguishes root caries from cervical burnout?

<p>Root caries typically requires clinical detection. (B)</p> Signup and view all the answers

Which of the following can lead to misdiagnosis of proximal caries?

<p>Cervical burnout phenomena (C)</p> Signup and view all the answers

In which condition do lesions evolve from round to elliptical or semilunar shapes?

<p>Caries of buccal and lingual surfaces (D)</p> Signup and view all the answers

What is indicative of the mach band effect in dental radiography?

<p>It exaggerates the contrast in shades of gray. (B)</p> Signup and view all the answers

Where do proximal caries typically begin to form?

<p>Below the contact point (B)</p> Signup and view all the answers

Which of the following conditions is associated with the loss of salivary gland function leading to carious lesions?

<p>Radiation-induced caries (C)</p> Signup and view all the answers

What are early lesions of proximal caries primarily composed of?

<p>Demineralized enamel (D)</p> Signup and view all the answers

What is the primary characteristic of a radicular cyst?

<p>Presence of a well-defined cortical border (C)</p> Signup and view all the answers

Which of the following conditions is characterized by resorption of the surface of the tooth?

<p>External root resorption (C)</p> Signup and view all the answers

What type of feature is often seen in chronic osteomyelitis?

<p>Bone sclerotic formation (A)</p> Signup and view all the answers

What initiates the formation of osteoradionecrosis?

<p>Therapeutic radiation doses greater than 50 Gy (D)</p> Signup and view all the answers

Which pathology is characterized by the presence of a necrotic bone fragment surrounded by viable bone?

<p>Sequestrum (B)</p> Signup and view all the answers

Which of the following is NOT associated with osteomyelitis?

<p>Increased PDL space (D)</p> Signup and view all the answers

What is a significant radiographic feature of chronic osteomyelitis?

<p>Diffuse sclerotic changes (A)</p> Signup and view all the answers

Which condition involves a cystic degeneration due to inflammatory products from a non-vital tooth?

<p>Radicular cyst (B)</p> Signup and view all the answers

In which situation would the pulp chamber appear slightly widened on a radiograph?

<p>Internal resorption (C)</p> Signup and view all the answers

What distinguishes osteoradionecrosis from normal bone tissue?

<p>Hypovascularity (D)</p> Signup and view all the answers

What is often a significant outcome of healing in chronic osteomyelitis?

<p>Sequestrum formation (B)</p> Signup and view all the answers

Which condition is characterized by a well-defined radiolucent region at the apex of a non-vital tooth?

<p>Radicular cyst (D)</p> Signup and view all the answers

Which treatment method may lead to internal root resorption?

<p>Pulpotomy (B)</p> Signup and view all the answers

What is a defining feature of gingivitis compared to periodontitis?

<p>Gingival inflammation without destruction of host tissues (A)</p> Signup and view all the answers

Which type of radiographic view is best suited for assessing the extent of bone loss in periodontal disease?

<p>CBCT scan (C)</p> Signup and view all the answers

What is a significant limitation of intraoral images in periodontal assessment?

<p>They fail to show pocket depths accurately. (C)</p> Signup and view all the answers

Which imaging feature indicates early changes in bone related to periodontal disease?

<p>Localized erosion of the interproximal alveolar bone crest (D)</p> Signup and view all the answers

What does a reduced radiopacity indicate in the context of periodontal disease?

<p>Loss of interproximal bone (B)</p> Signup and view all the answers

What aspect of periodontal disease can be best evaluated using vertical bitewing images?

<p>Bone level assessment (A)</p> Signup and view all the answers

Which feature distinguishes periodontitis from gingivitis in terms of clinical diagnosis?

<p>Interproximal bone loss (A)</p> Signup and view all the answers

What is the role of diagnostic imaging in periodontal treatment planning?

<p>It is essential for evaluating local contributing factors. (A)</p> Signup and view all the answers

Which change in the morphology of bone is a hallmark of advanced periodontal disease?

<p>Loss of interproximal crestal bone (B)</p> Signup and view all the answers

What does widening of the periodontal ligament space suggest in periodontal disease assessments?

<p>Loss of attachment and possible bone loss (A)</p> Signup and view all the answers

What is a significant clinical characteristic of ankylosis in teeth?

<p>Loss of periodontal ligament space (A)</p> Signup and view all the answers

Which condition is characterized by a tooth that did not erupt due to soft or hard tissue obstruction?

<p>Impaction (C)</p> Signup and view all the answers

What is the typical radiographic feature of gemination?

<p>Two separate crowns with one pulp chamber (A)</p> Signup and view all the answers

Which anomaly is caused by local trauma or infection and results in teeth fused by cementum?

<p>Concrescence (D)</p> Signup and view all the answers

What condition is associated with an abnormally shaped tooth termed 'bull' due to a large pulp chamber?

<p>Taurodontism (D)</p> Signup and view all the answers

Which type of hypoplasia results in a local defect affecting only one or a few teeth?

<p>Turner’s hypoplasia (A)</p> Signup and view all the answers

What best describes the prevalence of dentinogenesis imperfecta?

<p>More prevalent than amelogenesis imperfecta (A)</p> Signup and view all the answers

Which condition is associated with the presence of 'ghost teeth'?

<p>Regional odontodysplasia (B)</p> Signup and view all the answers

Which dental anomaly involves the creation of a tooth within a tooth due to invagination?

<p>Dens in dente (D)</p> Signup and view all the answers

Hypocalcification can lead to which of the following issues?

<p>Brittle enamel prone to fractures (A)</p> Signup and view all the answers

Which type of dentin dysplasia is characterized by conical shaped roots?

<p>Type I radicular (C)</p> Signup and view all the answers

Which dental condition is associated with developmental anomalies and extra cusps often seen in cleft palate syndrome?

<p>Talon cusp (B)</p> Signup and view all the answers

Den evaginatus can cause complications due to which specific issue?

<p>Excessive occlusal forces leading to fractures (B)</p> Signup and view all the answers

How does the size of the field of view (FOV) in imaging affect radiation dose to the patient?

<p>A larger FOV contributes to increased scatter radiation, leading to a higher patient dose. (B)</p> Signup and view all the answers

What distinguishes voxel shape in CBCT compared to CT imaging?

<p>CBCT has isotropic voxel dimensions while CT has non-isotropic dimensions. (D)</p> Signup and view all the answers

Which statement about bit depth in imaging is correct?

<p>An 8-bit depth is commonly used and can affect image quality in similar ways as 2D imaging. (D)</p> Signup and view all the answers

What is a notable consequence of using a larger detector in imaging?

<p>It generates more scatter radiation, leading to decreased image quality. (B)</p> Signup and view all the answers

Why is a fan-shaped beam used in CT imaging more advantageous than a cone-shaped beam in CBCT?

<p>The fan-shaped beam allows for more precise imaging with less scatter. (B)</p> Signup and view all the answers

What is the primary role of a radiofrequency coil in MRI technology?

<p>To emit radiofrequency waves that energize protons (B)</p> Signup and view all the answers

Which T1 and T2 distinction correctly describes their imaging highlights?

<p>T1 highlights fats, while T2 highlights fluid (C)</p> Signup and view all the answers

Which of the following conditions is classified as an absolute contraindication for MRI?

<p>Cerebral aneurysm clips (A)</p> Signup and view all the answers

What type of MRI application is particularly beneficial for evaluating neoplasms in the oral cavity?

<p>Determining soft tissue extent and lymph node involvement (B)</p> Signup and view all the answers

Which type of implant material is considered relatively safe for MRI procedures?

<p>Titanium (B)</p> Signup and view all the answers

What is a potential risk when using MRI for patients with cardiac pacemakers?

<p>Magnetic disturbance of heart rhythm (C)</p> Signup and view all the answers

Which of the following MRI contraindications is classified as relative rather than absolute?

<p>Claustrophobic or uncooperative patients (B)</p> Signup and view all the answers

What type of lesions can MRI help evaluate in the orofacial region?

<p>Vascular lesions (A)</p> Signup and view all the answers

What is the primary benefit of a higher bit depth in imaging?

<p>Increased shades of gray (C)</p> Signup and view all the answers

What is the main consequence of increasing the mAs in imaging?

<p>Improved signal-to-noise ratio (D)</p> Signup and view all the answers

Which detector type is associated with newer 3D imaging technologies?

<p>Flat panel detectors (C)</p> Signup and view all the answers

Which imaging method is preferred for evaluating true lesion extensions in pathology?

<p>CBCT (C)</p> Signup and view all the answers

What is a significant drawback of using CBCT for caries detection?

<p>Image noise and metal artifacts (A)</p> Signup and view all the answers

What type of imaging uses radiofrequency waves rather than X-rays?

<p>MRI (A)</p> Signup and view all the answers

Which of the following conditions can result from using a higher KVP in imaging?

<p>Higher quality images (A)</p> Signup and view all the answers

What type of artifacts might be observed due to large metallic restorations in imaging?

<p>Cupping artifacts (D)</p> Signup and view all the answers

MRI typically provides excellent contrast resolution for which type of tissue?

<p>Soft tissue (D)</p> Signup and view all the answers

Which imaging modality is known for having long scan times of up to 40 minutes?

<p>MRI (A)</p> Signup and view all the answers

What does ionizing radiation primarily cause in biological tissues?

<p>Free radical formation (A)</p> Signup and view all the answers

What is a primary disadvantage of using a higher bit depth in imaging?

<p>Larger file sizes (D)</p> Signup and view all the answers

Which type of imaging is least effective at visualizing TMJ discs?

<p>CBCT (A)</p> Signup and view all the answers

What does the term 'ALARA' refer to in radiology?

<p>Minimizing radiation exposure (C)</p> Signup and view all the answers

What is one of the primary reasons for using 3D imaging in dentistry?

<p>To see the extent of etiology that may not be visible in 2D (C)</p> Signup and view all the answers

Which imaging modality was the first to be invented for cross-sectional images?

<p>Computed tomography (CT) (C)</p> Signup and view all the answers

What does CBCT specifically exclude when diagnosing pathologies?

<p>Diagnosis of soft tissue pathology (C)</p> Signup and view all the answers

What happens to the radiation dose when using CT in comparison to CBCT?

<p>CT has a higher radiation dose due to longer exposure (B)</p> Signup and view all the answers

In terms of imaging, which of the following accurately describes a 'soft tissue window' in CT?

<p>It is used to visualize soft tissues more effectively (C)</p> Signup and view all the answers

What is a primary application of CBCT in orthodontics?

<p>To create 3D models for impacted teeth assessment (D)</p> Signup and view all the answers

Which feature distinguishes CBCT from traditional CT imaging?

<p>CBCT provides isotropic voxel dimensions (A)</p> Signup and view all the answers

When would a clinician likely opt for 3D imaging over traditional 2D imaging?

<p>To identify the buccal-lingual dimension more accurately (A)</p> Signup and view all the answers

What is a limitation of CBCT compared to standard CT imaging?

<p>CBCT does not include soft tissue visualization (A)</p> Signup and view all the answers

Which of the following conditions is a common indication for the use of CT imaging?

<p>Developmental anomalies in craniofacial skeleton (C)</p> Signup and view all the answers

What does a helical CT machine allow during scanning?

<p>Quicker image acquisition through consistent rotation (A)</p> Signup and view all the answers

Which aspect of CBCT contributes to its effectiveness in dental implant planning?

<p>Isotropic voxel shape enabling precise measurements (C)</p> Signup and view all the answers

Regarding reconstructive imaging, what happens to the image quality in a bone window versus a soft tissue window in CT?

<p>Bone window enhances bony structure clarity but can wash out details (B)</p> Signup and view all the answers

What is the principal design of a cone beam in CBCT imaging?

<p>To deliver focused imaging of a specific area (A)</p> Signup and view all the answers

Flashcards

Hyperdontia

Having more teeth than normal.

Supernumerary teeth

Extra teeth.

Mesiodens

An extra tooth between the central incisors.

Hypodontia

Having fewer teeth than normal.

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Congenital anomaly

Present at birth, possibly inherited or due to environmental factors.

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Acquired anomaly

Develops after birth, often environmental cause.

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Anodontia

Complete absence of teeth.

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Oligodontia

Missing multiple teeth.

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Ectodermal Dysplasia

Autosomal dominant disorder affecting multiple ectodermal structures, including teeth.

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Microdontia

Teeth smaller than normal, often localized.

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Missing Teeth (common)

Lateral incisors, third molars, 2nd premolars, and maxillary lateral are commonly missing teeth.

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Size of teeth

Rule out positioning errors, supernumerary teeth, or radiation effects on tooth development when evaluating tooth size.

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Commonly Missing Teeth

Lateral incisors, third molars, and second premolars in the mandible and maxillary are frequent missing teeth.

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Radiolucent

Describes an area on a radiograph that appears dark, indicating soft tissue or a lack of density.

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Radiopaque

Describes an area on a radiograph that appears white, indicating dense structures like bone or enamel.

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Periapical Cemento-Osseous Dysplasia

A benign, non-cancerous condition that affects the bone around the tooth roots. It usually involves a gradual replacement of bone by fibrous tissue.

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Mature Cemento-Osseous Dysplasia

The final stage of this condition where the affected area appears completely white on the radiograph, often with a thin dark rim.

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Early Cemento-Osseous Dysplasia

The initial stage where the affected bone appears dark on the radiograph indicating a replacement with fibrous tissue.

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Peg Lateral

A lateral incisor that is abnormally small and peg-shaped. This is a common example of microdontia.

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Impaction

A tooth that fails to erupt through the gums and remains embedded in bone or soft tissue. It is most common in canines and molars, and can be identified radiographically.

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Transposition

A condition where two adjacent teeth switch places in the mouth. This is common in permanent canines and first premolars.

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Ankylosis

A condition where a tooth fuses to the surrounding bone due to trauma, infection, or lack of a permanent tooth. This results in loss of periodontal ligament space and often causes the tooth to appear submerged. It is common in primary teeth and can be diagnosed clinically.

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Ectopia

An abnormal position of a tooth or its follicle during development. It is common in permanent incisors and canines.

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Gemination

A condition where a single tooth bud splits, resulting in a single tooth with a double crown. This is common in primary teeth but can also occur in permanent teeth, most often in incisors and canines. The pulp chamber may be enlarged or partially divided.

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Fusion

A condition where two separate tooth buds fuse together during development, resulting in a single tooth with a single pulp chamber. This is common in maxillary molars, and the roots of the fused teeth are connected by dentin.

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Concrescence

A condition where teeth are fused together by cementum. This can be a developmental condition or acquired due to trauma, occlusal force, or infection.

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Taurodontism

A condition where molars have an enlarged pulp chamber that extends towards the root apices, resembling the shape of a bull's head. It is often seen with Down Syndrome or amelogenesis imperfecta.

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Dilaceration

An abrupt change in the direction of a tooth or root, usually caused by trauma during development. It is most common in maxillary premolars and incisors.

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Dens in dente

A condition where a tooth develops a tooth-like structure within its crown or root, often in maxillary first premolars and second molars. This is caused by an invagination (folding inward) or evagination (folding outward) of the enamel organ.

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Enamel Pearl

A small, pearl-shaped deposit of enamel on the root surface of molars, usually not clinically detectable. It is located apical to the cementoenamel junction, often near the furcation.

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Talon Cusp

An extra cusp on the lingual surface of an incisor, often associated with cleft palate syndrome.

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Turner's Hypoplasia

A localized hypoplastic defect in the crown of a permanent tooth caused by infectious or mechanical trauma to a primary tooth. It alters the normal contours of the affected tooth.

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Hutchinson's Teeth

A characteristic dental anomaly associated with congenital syphilis. Central incisors are wider at the neck and constricted at the incisal edge, while posterior teeth may have extra cusps (mulberry molar).

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Medication-Related Osteonecrosis of the Jaw

Bone death in the jaw caused by certain medications, especially bisphosphonates, used for bone health issues.

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Bisphosphonates

A class of drugs commonly used to treat osteoporosis and certain cancers, which can cause osteonecrosis of the jaw as a side effect.

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Clinical Signs of Osteonecrosis

Visible exposed bone, pain, and swelling in the jaw, especially after a tooth extraction, in patients taking bisphosphonates.

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Radiographic Features of Osteonecrosis

Similar to osteomyelitis and osteoradionecrosis. Thickened lamina dura (the bone lining of the tooth socket) is a key feature.

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Pericoronitis

Inflammation of tissues around a partially erupted tooth, often caused by trapped food and bacteria.

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Common Location for Pericoronitis

Mandibular third molars (wisdom teeth) are most commonly affected due to their delayed eruption and difficult access for cleaning.

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Radiographic Features of Pericoronitis

Ill-defined sclerotic bone formation (thickened, dense bone) and enlargement of the follicular space (where the tooth develops) around the impacted tooth.

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Caries

Tooth decay caused by the breakdown of enamel and dentin due to bacteria and acid production.

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Bitewing Radiographs

Specialized dental x-rays that focus on the interproximal surfaces (spaces between teeth) to detect hidden caries.

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Importance of Paralleling Technique

Using proper x-ray technique to minimize distortion and overlap between teeth, improving the accuracy of caries detection.

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What causes pulp necrosis?

Pulp necrosis, the death of the pulp tissue, can be caused by two main factors: caries (tooth decay) that reaches the pulp, and trauma to the tooth.

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What is the radiographic finding for pulp necrosis?

When the pulp dies, infection can spread to the surrounding area around the tooth root, resulting in a periapical radiolucency on radiographs.

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What are the stages of periapical infection?

The infection can progress through stages: acute (short-term) with periapical abscess, granuloma, or cysts, and chronic (long-term) with periapical granuloma, abscess, and ultimately a cyst.

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What is osteomyelitis?

Osteomyelitis is an inflammation of the bone, affecting both the outer cortical bone and the inner marrow bone.

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What are some early radiographic signs of periapical inflammation?

Early signs include widening of the periodontal ligament space, pushing up of the tooth due to inflammatory fluid, loss of the lamina dura and trabecular bone.

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What is the preferred term for periapical radiolucency?

Instead of 'periapical radiolucency', the preferred term is 'apical periodontitis', which describes the inflammatory condition.

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What is rareifying osteitis?

Rarefying osteitis is a specific type of bone inflammation with bone destruction, appearing as increased radiolucency.

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What is sclerosing osteitis?

Sclerosing osteitis is another type of bone inflammation where bone deposition occurs, appearing as increased radiopacity.

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What information does the periphery of a periapical lesion provide?

The periphery, or outline, of a periapical lesion can be 'ill-defined' (unclear margins) indicating significant infection, or 'well-defined' (clear margins) suggesting less severe inflammation.

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What are some internal structures of periapical lesions?

Internal structures can show either loss of bone density (radiolucency) indicating destruction, or sclerotic bone formation (radiopacity) indicating bone deposition.

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Gardner's Syndrome

A serious condition involving multiple osteomas, intestinal polyps, and frequent supernumerary teeth.

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Cleidocranial Dysplasia

A less serious condition affecting the skull, clavicle, and often resulting in supernumerary teeth.

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What is periosteum?

A thick layer of connective tissue covering the surface of jaw bones. It helps attach muscles and provides a source for new bone growth.

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What are Sharpey's Fibers?

Collagen fibers that extend from the periosteum, anchoring it securely to the bone.

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What is inflammatory periosteal bone reaction?

The body's response to infection near the bone, causing new bone formation and thickening of the periosteum.

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Periostitis

Inflammation of the periosteum, characterized by layered bone formation.

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What happens to the maxillary sinus during periostitis?

Infection can spread into the maxillary sinus, causing inflammation and displacement or perforation of its floor.

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What is parulis?

An infection of the periosteum that spreads to the gingiva, causing a localized abscess.

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What are the radiographic features of periostitis?

Onion-ring like bone formations, thickening of the periosteum, and displacement of the maxillary sinus floor.

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What are the radiographic features of osteomyelitis?

Radiolucent areas (indicating bone destruction) and sclerotic areas (indicating bone formation) within the bone.

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How does the body react to infection near the bone?

By forming sclerotic bone (thickened bone) to stop the infection from spreading.

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Proximal Caries

Tooth decay that occurs between two adjacent teeth, starting as a small triangular demineralization in the enamel and progressing towards the pulp chamber.

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Occlusal Caries

Tooth decay that starts in the grooves and pits on the chewing surface of a tooth, often appearing as a bowl-shaped radiolucent zone.

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Rampant Caries

Rapid, widespread tooth decay that progresses quickly, often seen in children with poor oral hygiene or adults with dry mouth.

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Caries of Buccal and Lingual Surfaces

Tooth decay on the outer (buccal) or inner (lingual) surfaces of teeth, starting as small round lesions and becoming elongated as they grow.

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Caries Associated with Restorations

Tooth decay that occurs around existing fillings or restorations, often appearing as a radiolucent area near the restoration margin.

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Root Caries

Tooth decay affecting the root surface, often associated with gum recession, and difficult to differentiate from cervical burnout.

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Radiation Induced Caries

Tooth decay that occurs after exposure to radiation, resulting in dry mouth and changes in oral bacteria.

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Periodontal Disease

Inflammation and destruction of the gums and supporting bone around teeth, which can lead to tooth loss.

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Cervical Burnout

A radiolucent area near the neck of the tooth, often mistaken for decay, but caused by a thinner enamel layer.

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Mach Band Effect

An optical illusion on radiographs that exaggerates contrast in shades of gray, making it difficult to distinguish between normal tooth structure and decay.

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Gingivitis

Inflammation of the gums without bone loss. It can be caused by plaque buildup and may progress to periodontitis.

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What are the radiographic limitations of intraoral images?

Intraoral images provide a 2D view of a 3D structure, making it hard to assess the full extent of bone loss and tooth-to-bone relationships. They also fail to show soft tissue-to-hard tissue relationship.

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What is the crucial role of diagnostic imaging in periodontal disease?

Radiographs are essential for diagnosing periodontal disease, planning treatment, and assessing the extent of bone loss and local factors impacting the prognosis.

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What are bitewing radiographs used for in periodontal disease?

Bitewings are used to assess the degree of bone loss and gingival recession, especially in the interproximal areas.

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What is the distinction between horizontal and vertical bitewings?

Horizontal bitewings show an equal portion of maxillary and mandibular teeth, while vertical bitewings provide a better view of bone level.

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How does normal bone appear on a radiograph?

Normal bone appears dense and radiopaque, with the cortical bone covering the alveolar crest located 0.5 to 2 mm below the CEJ and parallel to a line connecting adjacent CEJs.

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What are the major imaging features of periodontal disease?

Periodontal disease shows changes in bone morphology (loss of interproximal crestal bone) and changes in bone density (increased radiolucency due to bone loss).

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What does 'Shades of Grey' refer to in periodontal disease?

Shades of gray refer to the different shades of gray seen on a radiograph, which can indicate different levels of bone density and changes in bone structure associated with periodontal disease.

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Early Bone Changes in Periodontal Disease

Early bone changes in periodontal disease typically involve localized erosion of the interproximal alveolar bone crest.

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Cause root resorption

Factors that initiate the breakdown of tooth root structure.

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Don't cause root resorption

Factors that are not directly linked to the breakdown of tooth root structure.

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What is a radicular cyst?

A sac-like structure formed by leftover epithelial cells in the periodontal ligament, usually near the root of a non-vital tooth.

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What causes a radicular cyst?

Inflammation from a dead tooth stimulates the leftover epithelial cells (from the periodontal ligament) to grow and form a cyst.

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Radiographic features of a radicular cyst

A well-defined, round, radiolucent area with a corticated border, usually located at the root apex of a non-vital tooth.

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What is external root resorption?

Breakdown of the outermost layer of the tooth root.

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What is internal root resorption?

Breakdown of the dentin inside the tooth, towards the pulp chamber.

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SLOB technique: How does the image move for internal resorption?

The image of the resorbed area will remain in the same position on a second radiograph taken from a different angle.

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SLOB technique: How does the image move for external resorption?

The image of the resorbed area will move to the opposite side on a second radiograph taken from a different angle.

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How does osteomyelitis develop?

It can develop from abscessed teeth, post-surgical infection, or bacteria traveling through the bloodstream.

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What is a sequestrum?

Dead bone that has lost its blood supply and is separated from the rest of the bone.

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Radiographic features of osteomyelitis

Ill-defined borders, both radiolucent (dark) and radiopaque (white) areas, often located in the posterior mandible.

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What is osteoradionecrosis?

Bone death caused by excessive exposure to radiation therapy.

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What are the 3 H's of osteoradionecrosis?

Hypovascularity (lack of blood flow), hypoxia (lack of oxygen), and hypocellularity (loss of bone cells).

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3D Imaging: Why?

Provides a complete view of anatomical structures, including the extent of lesions, for accurate implant placement and treatment planning. 2D imaging can't always distinguish between structures.

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Sagittal View

A vertical slice of the body, dividing it into left and right halves.

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Coronal View

A horizontal slice of the body, dividing it into front and back sections.

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Axial View

A horizontal slice of the body, dividing it into upper and lower sections.

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CT vs. CBCT: Bone vs. Soft Tissue

CT can visualize both bone and soft tissue using different windows. CBCT only shows bone details.

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CT: Soft Tissue Window

Visualizes soft tissues in detail, making it useful for diagnosing infections or evaluating tissue changes.

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CT: Bone Window

Displays bone structures clearly, but may show soft tissues as less distinct.

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CT: Acquisition Time

Longer acquisition time because the X-ray tube and detector rotate multiple times around the patient.

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CBCT: Isotropic Resolution

All dimensions (X, Y, Z) have equal resolution, providing accurate measurements and visualization of 3D structures.

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CBCT: Applications

Used for implant planning, evaluating lesion extent, and detecting periodontal defects. Helpful for complex surgical procedures and orthodontics.

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CBCT: Radiation Dose

Lower radiation dose compared to CT, making it safer for patients.

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CT: Non-Isotropic Resolution

Unequal resolution in different dimensions, potentially affecting accuracy of 3D measurements.

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CT: Implications

Used to diagnose infections, trauma, developmental anomalies, and assess both bone and soft tissue conditions.

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CBCT: Cone Shaped Beam

Uses a cone shaped X-ray beam to capture a wider field of view and generate 3D data.

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CT: Fan Shaped Beam

Uses a fan shaped X-ray beam, generating a more detailed 3D reconstruction but with less coverage than the cone beam.

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Cone beam shaped

A type of x-ray beam used in CBCT imaging. It creates a wider beam that rotates around the patient's head once to capture images.

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Field of view (FOV)

The area of tissue that is captured in an image. A smaller FOV results in less scatter, higher image quality, and lower radiation dose.

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Voxel size & shape

3D imaging utilizes voxels instead of pixels. CBCT uses isotropic voxels (equal dimensions) while CT uses non-isotropic (unequal dimensions).

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What is scatter radiation?

X-rays that change direction after passing through the body. It reduces image quality and increases patient dose.

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Higher signal-to-noise ratio (SNR)

A measure of image quality where a high SNR indicates a stronger signal and less noise (scatter). This results in sharper and clearer images.

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MRI Signal Generation

Protons in a magnetic field align. Radiofrequency waves excite them to higher energy states. When they return to low energy, they release signals that are detected by the MRI machine.

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MRI Safety: Metal

MRI machines use strong magnets. Metallic objects can be attracted to the magnet, posing a serious risk of injury or death.

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T1 vs. T2

T1 weighted images highlight fatty tissues, while T2 weighted images highlight fluid. They are different ways of visualizing tissues depending on how they respond to magnetic fields.

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MRI in Oral Diagnosis

MRI is valuable for evaluating soft tissues in the maxillofacial region, including tumors, lymph nodes, salivary gland conditions, and vascular lesions.

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Absolute MRI Contraindications

Conditions that absolutely prevent a patient from undergoing MRI, such as cerebral aneurysm clips and cardiac pacemakers, due to the potential for harm from the strong magnetic field.

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Relative MRI Contraindications

Situations that increase risk during an MRI, requiring careful consideration, like claustrophobia, pregnancy, and metallic heart valves. They may not be a complete no, but need special attention.

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Dental Metal & MRI

Metal used in dental restorations, implants, and orthodontic hardware is generally safe during MRI, but can interfere with image clarity, creating artifacts.

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Understanding MRI Artifacts

Artifacts are distortions in MRI images caused by the presence of metals or other factors. They can obscure details and make accurate interpretation challenging.

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Bit Depth and Image Quality

The bit depth of an image determines the number of shades of gray it can display. A higher bit depth allows for more shades of gray, resulting in a higher-quality image.

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Contrast Resolution in CBCT

High contrast resolution is crucial in CBCT to distinguish between different tissues and structures, particularly important for differentiating between bone and soft tissue.

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Window in 3D Imaging

The 'window' in 3D imaging refers to the ability to adjust the shades of gray displayed, allowing the user to focus on specific structures or contrast levels.

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Flat Panel Detectors

Flat panel detectors are a newer technology used in 3D imaging, offering improved image quality and a cylindrical shape for capturing data.

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Exposure Time and SNR

Exposure time affects the signal-to-noise ratio (SNR). A longer exposure time with higher mA results in more photons, reducing noise and improving image quality.

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KVP and Image Quality

Higher KVP increases image quality, but also increases radiation dose to the patient. Finding a balance between image quality and radiation dose is crucial.

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CBCT Application: Implants

CBCT plays a crucial role in implant planning, creating surgical guides, and assessing bone density before implant placement.

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CBCT Application: Orthodontics

CBCT provides valuable information for orthodontists in 3D cephalometry, analyzing impacted teeth, root morphology, virtual occlusion, and TMJ evaluation.

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CBCT Application: Periodontics

CBCT enables periodontists to assess periodontal defects like bone loss, plan grafting procedures like sinus lifts, and evaluate the maxillary sinus.

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CBCT Limitations: Caries Detection

CBCT is not ideal for detecting caries due to image noise and metal artifacts. Periapical radiographs are preferred for caries detection.

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CBCT Limitations: Soft Tissue Lesions

CBCT has limited soft tissue contrast, making it difficult to visualize and diagnose soft tissue lesions.

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CBCT Limitations: TMJ Disc

CBCT has limited soft tissue contrast and resolution, making it difficult to visualize the TMJ disc.

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CBCT Limitations: Artifacts

CBCT can produce artifacts like cupping (distortion of metallic structures) and scatter and beam hardening (streaks and dark bands).

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MRI: Magnetic Resonance Imaging

MRI uses magnetic fields and radio waves to create detailed images of soft tissues, revealing structures and pathologies not visible with x-rays.

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MRI Advantages

MRI offers advantages over x-rays, as it doesn't use ionizing radiation, provides excellent soft tissue contrast, and allows for intravenous contrast enhancement.

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How MRI Works: Hydrogen Protons

MRI utilizes the magnetic properties of hydrogen protons in the body. These protons align with the strong magnetic field of the scanner and generate a signal that forms the image.

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Study Notes

Dental and Developmental Anomalies

  • Anomaly: Deviation or inconsistency from the normal.
  • Number of Teeth:
    • Hyperdontia/Supernumerary Teeth: Excessive teeth.
    • Mesiodens: Extra tooth commonly found between central incisors.
    • Hypodontia: Missing teeth.
    • Oligodontia: Missing multiple teeth.
    • Anodontia: Absence of teeth.
  • Size of Teeth:
    • Macrodontia: Teeth larger than normal.
    • Microdontia: Teeth smaller than normal.
  • Eruption or Position of Teeth:
    • Impaction: Tooth unable to erupt.
    • Transposition: Teeth switch positions.
    • Ankylosis: Tooth fused to the bone.
    • Ectopia: Tooth in abnormal position.
  • Morphology of Teeth:
    • Gemination: One tooth divides into two.
    • Twinning: Two teeth fuse together.
    • Fusion: Two teeth fuse together.
    • Concrescence: Roots of two teeth fuse together.
    • Taurodontism: Elongated pulp chamber in molars.
    • Dens Invaginatus: Invagination of the crown.
    • Dens Evaginatus: Outward folding of enamel organ.
    • Dilaceration: Irregular curvature of tooth.

Congenital and Acquired Conditions

  • Congenital: Conditions present at birth. May be hereditary or environmentally influenced.
  • Acquired: Conditions developing after birth. Often environmental in nature.

Number of Teeth (Anomaly Detail)

  • Hyperdontia/Supernumerary Teeth:

    • Premolars: Most common site in the mandible.
    • Generalized: Extra teeth in multiple areas.
  • Mesiodens:

    • Commonly in the space between central incisors.
  • Diseases Associated with Supernumerary Teeth:

    • Cleidocranial Dysplasia: Least severe condition; involves skull, clavicle, and supernumerary teeth.
    • Gardner's Syndrome: Individuals may have polyps in large intestines (100% chance of turning malignant), along with multiple osteomas and supernumerary teeth.
    • Hypodontia: Missing one or a few teeth. Most common missing:
      • Maxillary lateral incisors (most common)
      • Third molars
      • Second premolars in mandible
      • Maxillary lateral incisors
      • Mandible central incisors
  • Oligodontia: Missing more than six teeth.

  • Anodontia: Missing all teeth.

Size of Teeth

  • Rule Outs: Positioning errors in panoramic x-rays; supernumerary teeth; irradiation to jaws causing dwarfing of teeth
  • Macrodontia: Teeth larger than normal (usually impacts only one tooth). May occur with rare conditions.
  • Microdontia: Teeth smaller than normal (mostly affects only one tooth). May occur with rarer conditions.

Eruption or Position of Teeth

  • Tooth that fails to erupt:
    • Commonly identified in Canines and molars.
    • It can be due to bone or soft tissue impaction.

Morphology of teeth

  • Gemmination: Clefting or invagination of the crown. A single pulp may be enlarged or partially divided
  • Fusion: Two teeth fused together. If there is no PDL space between the two teeth it could indicate fusion.
  • Concrescence: The roots of two teeth fused together by cementum

Taurodontism

  • Molar shaped like a bull.
  • Large "trunk"- extension of the pulp
  • Short roots
  • Wide Pulp chambers

Dilaceration

  • Sudden change in direction of tooth.
  • Extreme root or tooth curvature.

Other anomalies

  • Ankylosis: Tooth fused to the bone.
  • Ectopia: Abnormal position of tooth.

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Description

Test your knowledge on periapical cemento-osseous dysplasia and various dental anomalies. This quiz covers key characteristics, differentiation methods, and maturation changes of dental conditions. Ideal for dental students and professionals interested in oral pathologies.

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