Radiographic Aids in Periodontal Disease Diagnosis PDF

5-Additional Radiographic Criteria 1  Additional Radiographic Criteria The following diagnostic criteria can be used as further aids in the radiographic identification of periodontal disease: 1. Radiopaque horizontal line across the roots. This lin...

5-Additional Radiographic Criteria 1  Additional Radiographic Criteria The following diagnostic criteria can be used as further aids in the radiographic identification of periodontal disease: 1. Radiopaque horizontal line across the roots. This line demarcates the portion of the root where the labial or lingual bony plate has been partially or completely destroyed from the remaining bone- supported portion. 2 3 2. Vessel canals in the alveolar bone.  linear and circular radiolucent areas produced by interdental canals and their foramina, respectively.  These canals indicate the course of the vascular supply of the bone and are normal radiographic findings. 4  The radiographic image of the canals is often so prominent, particularly in the anterior region of the mandible, that they might be confused with radiolucency resulting from periodontal disease. 5 3. Differentiation between treated and untreated periodontal disease.  It is sometimes necessary to determine whether the reduced bone level is the result of periodontal disease that is no longer destructive (usually after treatment and proper maintenance) or whether destructive periodontal disease is present. 6  Clinical examination is the basic determinant.  Radiographically detectable changes in the normal cortical outline of the interdental bone are corroborating evidence of destructive periodontal disease. 7 6-Skeletal Disturbances Manifested in the Jaws 8  Skeletal Disturbances Manifested in the Jaws  Local or systemic diseases of the bones of the face can alter the cortical and trabecular architecture of the alveolar ridge and can mimic the radiographic appearance of periodontitis. 9  Langerhans cell histiocytosis the disease manifestations appear as single or multiple radiolucent areas. 10  Malignancy, both primary and metastatic, A uniform widening of the PDL can be an early sign of osteosarcoma. 11  Multiple myeloma can cause multiple well-defined radiolucencies of the jaws. 12 Metabolic diseases that affect calcium homeostasis, such as:  Vitamin D deficiency eg. Rickets, hyperparathyroidism, and osteoporosis, diminish trabecular and cortical density and can lead to loss of lamina dura. 13  In Paget's disease the normal trabecular pattern is replaced by a hazy, diffuse meshwork of closely knit, fine trabecular markings, with absent lamina dura, or scattered radiolucent areas may contain irregularly shaped radiopaque zones. 14  In scleroderma the periodontal ligament is uniformly widened 15 7-Digital Intraoral Radiography 16  Advantages of intraoral digital radiography include: 1. The speed of image capture and display 2. Low x-ray exposure. 3. Ability to manipulate the image. 4. improved patient education. 5. Ease of storage, transfer, and copying. 17  The proper use of digital intraoral radiographs requires: 1. Familiarity with the digital nature of the images 2. Understanding of the principles of image manipulation by computer software. 18 8-Advanced Imaging Modalities 19  In the last decade, Cone Beam Computed Tomography (CBCT) has revolutionized the field of oral and maxillofacial imaging. 20  CBCT offers many advantages over conventional radiography, including the accurate three dimensional imaging of teeth and supporting structures. 21 22 23  Not recommended for every dental patient.  CBCT avoids the problems of geometric superimposition and unpredictable magnification and can provide valuable diagnostic information in periodontal evaluation. ------------------------------------------------------------ 24 THANK YOU 25