39 Questions
What is the primary limitation of cone beam CT in evaluating per-implantitis?
Metal artifact
What is the most suitable radiographic tool for assessing periodontal bone loss?
Bitewing radiograph
Which of the following radiographic techniques is most prone to foreshortening?
Bitewing radiograph
What is the primary advantage of using a bitewing radiograph for diagnosing caries?
High resolution and parallel technique
What is the Kari's susceptible zone for interproximal caries?
From the point where the two teeth almost touch to the level of the gum line
What is a major limitation of cone beam CT in assessing periodontal bone loss?
Inaccuracy due to beam hardening artifact
Why may a patient's head position affect the accuracy of a cone beam CT image?
It can cause the hyoid bone to appear distorted
What is a limitation of using cone beam CT in implant imaging?
Limitations due to beam hardening artifact
What is an advantage of using PA over cone beam CT in dental imaging?
Reduced beam hardening artifact
What can be a consequence of having a restoration in the area of interest during a cone beam CT scan?
Increased beam hardening artifact
What is a major limitation of intraoral imaging?
It projects a 3D image onto a 2D image, losing the third dimension
What can be hidden in intraoral imaging due to overlapping of bony walls?
Bone defects
What is a limitation of radiographs in assessing bone destruction?
It underestimates the lesions
Why is it difficult to assess periodontal bone loss using intraoral imaging?
Because of the overlapping of bony walls
What is not visible on radiographs?
Soft tissue
What is the advantage of adjusting the contrast and brightness of a radiograph image?
To visualize the gum line for carries diagnosis
What is a limitation of measuring the depth of periodontal pockets?
The CEJ is not a reliable reference point
What is the purpose of using the parallel technique in radiography?
To reduce distortion and minimize metal artifacts
What can happen when removing a radiograph sensor from the patient's mouth?
The glue is removed with the sensor
Why is it challenging to use the parallel technique in certain cases?
It is hard to minimize distortion in posterior teeth
What is the primary challenge in subtractive radiography?
Stabilizing the process to make it repeatable
What is the limitation of panoramic radiography in dental imaging?
It is a very sensitive technique that requires expertise
Why is it difficult to use subtractive radiography in dental imaging?
Because the process is not repeatable
What is the advantage of using a sensor or PSP in dental radiography?
It allows for the stabilization of the process
What is the primary difference between a dental CT and a PA in dental imaging?
One depicts the whole mouth in a single image
What is the reason the patient's medical history was not considered during the FMS examination?
The healthcare provider didn't ask about it.
What was the mistake made by the student during the clinical examination?
The student didn't clinically examine the patient before taking radiographs.
Why did the instructor question the need for a retake of the radiograph?
The radiograph wasn't necessary based on the clinical examination.
What was the problem with the tooth that the student had missed?
It had a large caries lesion.
What is the benefit of taking a thorough medical history during an FMS examination?
It helps identify potential medical contraindications.
What is the importance of considering a patient's dental history during an FMS examination?
It helps identify potential dental problems.
What is the benefit of performing a clinical examination before taking radiographs?
It helps reduce the number of radiographs needed.
What is the consequence of not considering a patient's medical history during an FMS examination?
It may lead to all of the above.
What can be a consequence of not performing a clinical examination before taking radiographs?
It may lead to all of the above.
What is the importance of considering a patient's dental history during an FMS examination?
It helps identify potential dental problems.
What can create a dark line that hinders diagnosis in a tooth near the cortical border of the mandible?
A defect or lesion
What can cause a bright area and increased contrast in a dental CT image?
Air and dense tissue adjacent to each other
What is a crucial factor in diagnosing carries in teeth like seven and ten?
Knowledge of dental anatomy
Why is a review of anatomy and basic interpretation essential for new rotations?
To provide a solid foundation for diagnostic skills
Study Notes
Limitations of Intraoral Imaging
- Intraoral imaging has limitations, including the loss of the third dimension when projecting a 3D image onto a 2D surface, resulting in artifacts like cervical burnout.
- Bony defects can be hidden by overlapping higher bony walls.
- Teeth overlapping or in close proximity can make it difficult to distinguish between caries and proximal bone levels.
Artifacts and Errors
- Cervical burnout is an artifact that occurs when there is air beside a dense structure, amplifying the contrast.
- Metal artifacts, especially with implants, can hinder diagnosis.
- Patient positioning and technique errors can cause distorted images, making it essential to check the patient clinically before taking radiographs.
Radiographic Examination
- Bite-wing radiographs are the best tool for diagnosing caries, as they provide the best technique-wise results due to parallel positioning.
- Panoramic radiographs are a crude tool for evaluating the entire mouth, but they can be affected by metal artifacts and are limited by resolution.
- Cone beam CT is limited by metal artifacts, especially with implants, and lacks the same resolution as other tools.
Anatomical Considerations
- The maxillary sinus position compared to periodontal bone loss, missing teeth, supernumerary teeth, and impacted teeth can be challenging to diagnose.
- Pediatric lesions and root resorption need to be considered in anatomical evaluations.
Bone Loss and Destruction
- Radiographs can underestimate the severity of bone destruction, and clinicians should be aware of this limitation.
- Bone loss can be difficult to diagnose, especially on the buckle or lingual side of the tooth.
- Decrease in root density can indicate bone loss.
Caries Diagnosis
- Caries can occur on various surfaces, including proximal, occlusal, buccal, and lingual surfaces, as well as in the interproximal area.
- The Kari's susceptible zone is the area from where the teeth almost touch to the gum line.
- Rampant caries can affect multiple teeth and surfaces.
Cone Beam CT Limitations
- Cone beam CT is limited by metal artifact, especially with implants, making it difficult to diagnose conditions like peri-implantitis.
- It lacks the same spatial resolution as other tools, making it challenging to diagnose certain conditions.
Technique Sensitivity
- Panoramic radiographs are highly technique-sensitive, and patient positioning can lead to distorted images.
- Failure to place the tongue in the palate or rotating the head can result in incorrect images.
Important Reminders
- Clinicians should be aware of dental anomalies, such as hyperplastic pits, and know how to differentiate them from incipient caries.
- It is essential to know normal anatomy to diagnose conditions accurately.
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