Interpreting Radiographs on Clinic Y2 BDS 2023-2024 PDF

Interpreting radiographs on clinic Y2 BDS Dr Safiya Robinson 2023-2024 Learning Outcomes  Detail anatomical features on intra-oral radiographs and OPGs  Report logically common physiological and pathophysiological features on an intra-oral radiograph  Describe how to interpret intra-oral r...

Interpreting radiographs on clinic Y2 BDS Dr Safiya Robinson 2023-2024 Learning Outcomes  Detail anatomical features on intra-oral radiographs and OPGs  Report logically common physiological and pathophysiological features on an intra-oral radiograph  Describe how to interpret intra-oral radiographs (Bitewings and Periapicals) and OPGs Terminology Terms for describing radiographs Radioluce Radiopaq nt ue  Intraoral radiographs Periapical radiographs  What is a periapical radiograph? Periapical radiography describes intraoral techniques designed to show individual teeth and the tissues around the apices. Each film/image usually shows 2-4 teeth and provides detailed information about the teeth and the surrounding alveolar bone. ology and radiography for dental care professionals - Eric Whaites , and Nicholas Drage (2013) What do you see on healthy periapical radiographs?  Crowns and roots of teeth – enamel, dentine, pulp (also unerupted teeth)  PDL  Bone  Lamina dura What else can you see on healthy periapical radiographs? – location/situation dependent  Foramen  Sinus (floor of antrum)  Soft tissue shadows  Orientation dots (film)  Cervical translucency (burnout)  Restorations (fillings, crowns, implants, RCF)  Premolar and molar periapical Radiology and radiography for dental care professionals - Eric Whaites , and Nicholas Drage (2013)  Canine and premolar periapical Radiology and radiography for dental care professionals - Eric Whaites , and Nicholas Drage (2013)  Canine and premolar periapical Radiology and radiography for dental care professionals - Eric Whaites , and Nicholas Drage (2013) Mixed Dentition Pocket dentistry A systematic approach to radiographs Orientation – is it the right way up? Teeth – enamel – is it in tact? Uniform shape? Is there a reasonable contrast between the enamel and the dentine? (and if there isn’t why might that be the case?) Dentine – contrast to enamel, and to surrounding lamina dura and bone. Root – morphology? Any resorption taking place (baby teeth about to exfoliate) Pulp chamber – size, shape, contrast. Lamina dura – is it in tact? A systematic approach to radiographs Periodontal ligament space – is it present? Size? Bone – appearance? Height around the teeth Radiolucencies in areas that should be radiopaque and vice versa Other features that represent – calculus, existing restorations, unerupted teeth Radiographic findings: (on clinic notes) Teeth present: General anatomy: sinus, peripheral bone etc. Alveolar bone: Bone levels, abnormal anatomy, fractures etc. Roots: Endodontic tmt/posts, apical disease etc. Clinical crowns: caries, restorations etc. Other: including implants, plates etc. Radiograph image quality How to describe radiographs What you see on the radiograph is varying degrees of radiolucency and radiopacity So when describing radiographs, use terminology or radiolucency/radiopacity Radiopacity indicative of… Radiolucency indicative of… What do you think is indicated on these radiographs? Pathology on Periapical radiographs Uses of periapical radiographs include  Detection of apical infections/inflammation  Assessment of periodontal status  After trauma  Assessing the presence of unerupted teeth  Assessing root morphology before extractions. What does the pathology look like? Radiolucency can indicate: Decay Endodontic pathology Root fractures Bone loss More sinister lesions World journal of radiology Periodontal status and periapicals Radiography reports of periodontal disease Degree of bone loss: if the apex is visible then bone loss should be measured and reported as a percentage Pattern or type of bone loss: e.g. horizontal bone loss or angular (vertical) defects Presence of furcation defects Presence of subgingival calculus Other features: e.g. perio-endo lesions; widened periodontal ligament spaces; abnormal root length or root morphology; overhanging restorations. British Society of Periodontology  Bitewing radiographs More about Bitewings… These show crowns and part of tooth root, and bone around healthy teeth  These are used for detection of lesions/caries  Monitoring the progress of caries  Assessment of existing restorations  Assessment of periodontal status Artefacts, burnouts, errors and limitations  Dr G’s Oral radiology Apical pathology VS Mental foramen Hindawi Case reports in dentistry – Holliday, Beecroft (2012) Film errors Images from dentalcare.com  Film errors Images from dentalcare.com underexposed overexposed Backwards Double film exposure  Pocket dentistry Cone cut Position error RDH magazine Images from dentalcare.com  Dentalcompare.com International journal of current re search OPG Orthopanoramic tomography Extraoral radiography Further reading interpretation Interpretation of panoramic radiographs Perschbacher, Susanne. (2012). Interpretation of panoramic radiographs. Australian dental journal. Positional errors in OPG Dhillon M, Raju SM, Verma S, et al. Positioning errors and quality assessment in panoramic radiography. (see references) Common errors with OPG Chin too high Chin too low Poor tongue position References Radiology and radiography for dental care professionals - Eric Whaites , and Nicholas Drage (2013) https://www.dentalcare.com/en-us/ce-courses/ce559/technique-errors https://www.dentalcare.com/en-us/ce-courses/ce559/miscellaneous-errors http://www.journalcra.com/sites/default/files/issue-pdf/17415.pdf Dhillon M, Raju SM, Verma S, et al. Positioning errors and quality assessment in panoramic radiography. Imaging Sci Dent. 2012;42(4):207–212. doi:10.5624/isd.2012.42.4.207 Interpretation of panoramic radiographs Perschbacher , Susanne. (2012). Interpretation of panoramic radiographs. Australian dental jo urnal. 57 Suppl 1. 40-5. 10.1111/j.1834-7819.2011.01655.x