Radiographical Intepretation

Question 1

Radiography? Definition?

Answer 1

Techniques involved in producing various types of radiographic image

Question 2

Radiology? Defintion?

Answer 2

Interpretation of the radiographic image

Question 3

The radiographic image? Dimensions?

Answer 3

A 2D picture of a 3D object

Question 4

Attenuation of the x ray determines the apperance?

Order

Answer 4

Mental restorations, enamel, dentine, cementum/bone, soft tissues, fluid and air

Question 5

Radio-opaque? defintion?

Answer 5

Absorb x rays

Question 6

Radiolucent? Defintion?

Answer 6

X rays pass through the object

Question 7

Basic radiology objectives? What we want to achieve?

Answer 7

• identify presence or absence of disease
• form a differential diagnosis
• provide some info on the nature and extend of disease

Question 8

Radiographs - Essentials for accurate interpretation? Factors affecting judgement?

Answer 8

• try to avoid on the spot diagnosis or tunnel vision
• create a quiet and good viewing facility
• use a logical and systematic approach to reporting (verbally and in notes)
• report on everything visible in the radiograph
• presence of dental history, but don’t be afraid 6o question your provisional diagnosis

Question 9

Bitewing radiograph? Aims of x ray?

Answer 9

• detection of caries
• monitoring the progress of caries
• assess restorations
• assess periodontal status

Question 10

Radiograph? What to include in notes?

Answer 10

• date
• grade of image (how good it is)
• what the image is showing (anatomically)
• teeth present
• bone level
• scan each tooth systematically to identify any irregularities and restorations

Question 11

Radiographs - Classification of caries? Anatomical sites? Severity? Activity?

Answer 11

Anatomical sites:
- pit/fissures
- smooth surfaces
- enamel 
- root
Severity:
- primary (previsouly unrestored)
- secondary/recurrent (adj to or under restorations)
- residual (demineralised tissue left behind before filling the tooth)
Activity:
- active (rampant)
- arrested (inactive lesions are remineralised)
- brown sport or white spot lesion

Question 12

Radiographic disadvantages? Highest susceptible zone? Factire affecting caries apperance?

Answer 12

• proximally between teeth (buccolingually masks the carious lesion)
• approx 40-50% demineralisation required for radiographic detection of a lesion
  Factors:
• buccolingual thickness of tooth (thicker and more difficult to see)
• 2D film (not see the buccolingial direction

Question 13

Radiographs - Occlusal caries? Characterisitcs?

Answer 13

Characteristics:

• penetrated into dentine
• thin radiolucent line or cup shaped zone underlying the occlusal ebamel

Question 14

Radiograph - Root caries? Characterisitics?

Answer 14

• saucer like cratering on root
• involving cementum
• common with recession periodontal disease and xerostomia

Question 15

How to describe a specific lesion? Radiographically?

Answer 15

• Site
• Size
• Shape
• Outline
• Relatice radiodensity and internal structures
• effect on adjacent surrounding structures
• time present

Question 16

Radiographs - Levels of disease? WHO classification (D1-4)

Answer 16

D1 - clinically decthavle enamel lesion with intact surfaces (prevention)
D2 - clinically detectable cavities limited to enamel (prevention)
D3 - clinically detectable lesions in dentine (restorations)
D4 - lesions in the pulp (restorations)