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SECOND EDITION
ii
SECOND EDITION
Lisa J. Koenig, BChD, DDS, MS

Associate Dean for Academic Affairs
Professor, Oral Medicine and Oral Radiology
Marquette University School of Dentistry
Milwaukee, Wisconsin
Dania Tamimi, C. Grace Petrikowski, Susanne E. Perschbacher,

BDS, DMSc DDS, MSc, FRCD(C) DDS, MSc, FRCD(C)
Oral and Maxillofacial Radiology Consultant Oral and Maxillofacial Radiologist Assistant Professor
Private Practice Huronia Maxillofacial Radiology Oral & Maxillofacial Radiology
Orlando, Florida Toronto, Ontario, Canada University of Toronto, Faculty of Dentistry
Adjunct Assistant Professor Toronto, Ontario, Canada
Department of Comprehensive Dentistry
University of Texas Health Science Center
San Antonio, Texas
Axel Ruprecht, DDS, MScD, David Hatcher, DDS, MSc Brad J. Potter, DDS, MS
FRCD(C) Clinical Professor, Orofacial Sciences Professor and Director of Oral
Professor Emeritus of Oral School of Dentistry and Maxillofacial Radiology
and Maxillofacial Radiology University of California, San Francisco Department of Diagnostic
Professor Emeritus of Radiology San Francisco, California and Biological Sciences
Professor Emeritus of Anatomy Clinical Professor, School of Dentistry University of Colorado
and Cell Biology University of California, Los Angeles School of Dental Medicine
The University of Iowa Los Angeles, California Aurora, Colorado
Adjunct Clinical Professor of Oral Adjunct Professor, School of Dentistry
and Maxillofacial Radiology Department of Orthodontics H. Ric Harnsberger, MD
University of Florida University of the Pacific R.C. Willey Chair in Neuroradiology
Gainesville, Florida San Francisco, California Professor of Radiology and Otolaryngology
Clinical Professor Volunteer, Department of University of Utah School of Medicine
Byron W. Benson, DDS, MS Surgical & Radiological Sciences Salt Lake City, Utah
School of Veterinary Medicine
Regents Professor and Vice Chair
University of California, Davis
Department of Diagnostic Sciences
Davis, California
Texas A&M University
Clinical Professor, School of Dentistry
College of Dentistry
Roseman University of Health Sciences
Dallas, Texas
Henderson, Nevada
Private Practice, Diagnostic Digital Imaging
Sacramento, California
iii
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
DIAGNOSTIC IMAGING: ORAL AND MAXILLOFACIAL, SECOND EDITION ISBN: 978-0-323-47782-6
Copyright © 2017 by Elsevier. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on
how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as
the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be
noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices,
or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described
herein. In using such information or methods they should be mindful of their own safety
and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the
method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each individual patient, and to
take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a matter
of products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.
Publisher Cataloging-in-Publication Data
Names: Koenig, Lisa J. | Tamimi, Dania Faisal | Petrikowski, C. Grace | Perschbacher, Susanne E.
Title: Diagnostic imaging. Oral and maxillofacial / [edited by] Lisa J. Koenig, Dania Tamimi,
C. Grace Petrikowski, and Susanne E. Perschbacher.
Other titles: Oral and maxillofacial.
Description: Second edition. | Salt Lake City, UT : Elsevier, Inc., [2017] | Includes
bibliographical references and index.
Identifiers: ISBN 978-0-323-47782-6
Subjects: LCSH: Mouth--Surgery--Handbooks, manuals, etc. | Maxilla--Surgery--Handbooks, manuals, etc. |
Face--Surgery--Handbooks, manuals, etc. | MESH: Radiograophy--Atlases. | Stomatognathic
Diseases--diagnostic images--Atlases. | Imaging, Three-Dimensional--Atlases. | Radiography,
Panoramic--Atlases.
Classification: LCC RK529.D52 2017 | NLM WU 140 | DDC 617.5’22059--dc23
International Standard Book Number: 978-0-323-47782-6

Cover Designer: Tom M. Olson, BA
Cover Art: Richard Coombs, MS
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
iv
Dedications
To my children, Sophie, Ben, Alex, Jack, and especially Natalie and baby Raphi, who have
kept me grounded; my friend Esme, who made me food; and my students and patients who
inspire me.
LJK
Dedicated to all the incredible teachers I’ve had in my life, most notably my parents and
children. Time management and compassion are the most precious of skills.
DT
Thank you to my parents for encouraging me to pursue a career in dentistry during a

time when women comprised only a small minority in dental school classes. Thanks also
to my teachers and mentors during my oral radiology training, as well as my coauthors,
colleagues, and editors, who so generously shared their knowledge and experience as
this book was being written. My biggest thanks go to my husband and best friend, Eggert
Boehlau, who has so generously supported me, both in my work as a radiologist, which
puts food on the table, and my passion as a musician, which feeds the soul.
CGP
To my teachers: For showing me the path.

To my students: For keeping me on it.
To Mom, Dad, and Kristina: For your enthusiasm.
To Anya and Daphne: For always sleeping while I wrote.
To Mark: For always staying up…I love you.
SEP
v
vi
Additional Contributors
Barton F. Branstetter, IV, MD, FACR
Rebecca S. Cornelius, MD, FACR
Julia Crim, MD
H. Christian Davidson, MD
Joanne Ethier, DMD, MBA, MS
Bronwyn E. Hamilton, MD
Patricia A. Hudgins, MD, FACR
Richard W. Katzberg, MD
Bernadette L. Koch, MD
Nicholas A. Koontz, MD
Luke N. Ledbetter, MD
Daniel E. Meltzer, MD
Michelle A. Michel, MD
Kevin R. Moore, MD
Kristine M. Mosier, DMD, PhD
Cheryl A. Petersilge, MD, MBA
Caroline D. Robson, MBChB
Jeffrey S. Ross, MD
Lubdha M. Shah, MD
Deborah R. Shatzkes, MD
Hilda E. Stambuk, MD
Margot L. Van Dis, DDS, MS
Richard H. Wiggins, III, MD, CIIP, FSIIM
vii
viii
Preface
We are very proud to present the second edition of our Diagnostic Imaging text dedicated
to oral and maxillofacial radiology. As in the first edition, the book is divided into three
parts: Anatomy, Diagnoses, and Differential Diagnoses. The Anatomy part has seen the
addition of a chapter on the posterior skull base that reflects the increasing need for oral
and maxillofacial radiologists to interpret larger fields of view. In this regard, the Diagnoses
part includes 18 new chapters dedicated to the more common findings in the cervical
spine. There are also extended chapters on TMJ and airway evaluation. The Diagnoses part
now contains over 200 chapters.
You will also find in this second edition new graphics from our expert illustrators,
exquisitely detailing the Anatomy and Diagnoses parts and serving to enhance the learning
experience. Each chapter has been meticulously updated with the addition of new
references and images wherever possible.
Purchase of the book comes with an electronic version, Expert Consult, that allows for easy
navigation between chapters and access to many more images, as well as text that was
excluded from the print version due to page constraints.
We trust that this second edition, like the first, will appeal to both the beginning and the
experienced radiologist, as well as the increasing number of general dental practitioners
and specialists who are using CBCT technology in their offices. For medical radiologists,
the book will also serve as a valuable companion text to Diagnostic Imaging: Head and Neck,
third edition.

Associate Dean for Academic Affairs
Professor, Oral Medicine and Oral Radiology
Marquette University School of Dentistry
Milwaukee, Wisconsin
ix
http://ebooksdental.net/oral-maxillofacial-surgery
x
Acknowledgments
Text Editors
Arthur G. Gelsinger, MA
Nina I. Bennett, BA
Terry W. Ferrell, MS
Karen E. Concannon, MA, PhD
Matt W. Hoecherl, BS
Megg Morin, BA
Image Editors
Jeffrey J. Marmorstone, BS
Lisa A. M. Steadman, BS
Illustrations
Lane R. Bennion, MS
Richard Coombs, MS
Laura C. Wissler, MA
Art Direction and Design

Tom M. Olson, BA
Laura C. Wissler, MA
Lead Editor
Lisa A. Gervais, BS
Production Coordinators
Rebecca L. Bluth, BA
Angela M. G. Terry, BA
Emily C. Fassett, BA
xi
xii
Sections
Part I: Anatomy
SECTION 1: Oral Cavity
SECTION 2: Nose and Sinuses
SECTION 3: Temporal Bone
SECTION 4: Base of Skull
SECTION 5: Cranial Nerves
SECTION 6: Cervical Spine
SECTION 7: Suprahyoid Neck
Part II: Diagnoses

SECTION 1: Teeth
SECTION 3: Mandible and Maxilla
SECTION 4: Temporomandibular Joint
SECTION 5: Maxillary Sinus and Nasal Cavity
SECTION 6: Masticator Space
SECTION 7: Parotid Space
SECTION 8: Cervical Spine
Part III: Differential Diagnoses

SECTION 1: Teeth
SECTION 2: Mandible and Maxilla
SECTION 4: Temporomandibular Joint
SECTION 5: Maxillary Sinus and Nasal Cavity
xiii
TABLE OF CONTENTS
Part I: Anatomy SECTION 5: CRANIAL NERVES

124 Cranial Nerve V
SECTION 1: ORAL CAVITY H. Ric Harnsberger, MD and Susanne E. Perschbacher,
4 Teeth DDS, MSc, FRCD(C)
Dania Tamimi, BDS, DMSc 138 Cranial Nerve VII
14 Dental Restorations H. Ric Harnsberger, MD and Susanne E. Perschbacher,
Dania Tamimi, BDS, DMSc DDS, MSc, FRCD(C)
22 Maxilla
Dania Tamimi, BDS, DMSc SECTION 6: CERVICAL SPINE
30 Mandible 150 Craniocervical Junction
Dania Tamimi, BDS, DMSc H. Ric Harnsberger, MD
36 Tongue
H. Ric Harnsberger, MD SECTION 7: SUPRAHYOID NECK
40 Retromolar Trigone 162 Suprahyoid Neck Overview
H. Ric Harnsberger, MD H. Ric Harnsberger, MD
44 Sublingual Space 168 Parapharyngeal Space
H. Ric Harnsberger, MD H. Ric Harnsberger, MD
48 Submandibular Space 172 Nasopharynx and Oropharynx
H. Ric Harnsberger, MD H. Ric Harnsberger, MD and Susanne E. Perschbacher,
52 Oral Mucosal Space/Surface DDS, MSc, FRCD(C)
H. Ric Harnsberger, MD 180 Masticator Space
H. Ric Harnsberger, MD
SECTION 2: NOSE AND SINUSES 184 Parotid Space
56 Sinonasal Overview H. Ric Harnsberger, MD
Susanne E. Perschbacher, DDS, MSc, FRCD(C) 188 Carotid Space
72 Ostiomeatal Complex H. Ric Harnsberger, MD
H. Ric Harnsberger, MD 192 Retropharyngeal Space
76 Pterygopalatine Fossa H. Ric Harnsberger, MD
H. Ric Harnsberger, MD 196 Perivertebral Space
SECTION 3: TEMPORAL BONE 200 Lymph Nodes
82 Temporomandibular Joint H. Ric Harnsberger, MD
Susanne E. Perschbacher, DDS, MSc, FRCD(C) 204 External and Internal Carotid Arteries
90 External, Middle, and Inner Ear Lisa J. Koenig, BChD, DDS, MS
SECTION 4: BASE OF SKULL

Part II: Diagnoses
98 Anterior Skull Base SECTION 1: TEETH
104 Central Skull Base DEVELOPMENTAL ALTERATIONS IN SIZE
H. Ric Harnsberger, MD AND SHAPE OF TEETH
110 Posterior Skull Base
212 Hypodontia
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS
118 Styloid Process and Stylohyoid Ligament
214 Hyperdontia
Susanne E. Perschbacher, DDS, MSc, FRCD(C)
216 Macrodontia, Gemination, and Fusion
xiv http://ebooksdental.net/oral-maxillofacial-surgery
TABLE OF CONTENTS
218 Microdontia 264 Periapical Rarefying Osteitis
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS Dania Tamimi, BDS, DMSc
219 Concrescence 268 Periapical Sclerosing Osteitis
220 Talon Cusp 270 Periodontal Disease
221 Dens Invaginatus
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS MISCELLANEOUS
222 Enamel Pearls 276 Gubernaculum Dentis
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS Lisa J. Koenig, BChD, DDS, MS
223 Taurodontism
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS SECTION 2: ORAL CAVITY
224 Dilaceration
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS CONGENITAL/GENETIC
225 Supernumerary Roots 280 Submandibular Space Accessory Salivary Tissue
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS Daniel E. Meltzer, MD
282 Lingual Thyroid
DEVELOPMENTAL ALTERATIONS IN Deborah R. Shatzkes, MD
STRUCTURE OF TEETH 284 Dermoid and Epidermoid
226 Amelogenesis Imperfecta Bernadette L. Koch, MD
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS 288 Submandibular Gland Aplasia-Hypoplasia
230 Dentinogenesis Imperfecta Byron W. Benson, DDS, MS
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS 290 Foregut Duplication Cyst in Tongue
232 Dentin Dysplasia Byron W. Benson, DDS, MS
233 Regional Odontodysplasia INFECTION
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS 292 Oral Cavity Soft Tissue Infections
234 Segmental Odontomaxillary Dysplasia Byron W. Benson, DDS, MS and Richard H. Wiggins, III, MD,
Lisa J. Koenig, BChD, DDS, MS CIIP, FSIIM
ACQUIRED ALTERATIONS OF TEETH AND INFLAMMATION
SUPPORTING STRUCTURES
296 Ranula
236 Attrition Richard H. Wiggins, III, MD, CIIP, FSIIM
Dania Tamimi, BDS, DMSc 300 Submandibular Gland Sialadenitis
238 Abrasion Richard H. Wiggins, III, MD, CIIP, FSIIM
Dania Tamimi, BDS, DMSc 302 Oral Cavity Sialocele
239 Erosion Richard H. Wiggins, III, MD, CIIP, FSIIM
Dania Tamimi, BDS, DMSc 304 Submandibular Gland Mucocele
240 Abfraction Byron W. Benson, DDS, MS
Dania Tamimi, BDS, DMSc
241 Turner Dysplasia NEOPLASM, BENIGN
Dania Tamimi, BDS, DMSc 306 Sublingual Gland Benign Mixed Tumor
242 Internal and External Resorption Byron W. Benson, DDS, MS
Dania Tamimi, BDS, DMSc 308 Submandibular Gland Benign Mixed Tumor
248 Hypercementosis Richard H. Wiggins, III, MD, CIIP, FSIIM
Dania Tamimi, BDS, DMSc 310 Palate Benign Mixed Tumor
Byron W. Benson, DDS, MS and Richard H. Wiggins, III, MD,
TRAUMA
CIIP, FSIIM
249 Concussion
Dania Tamimi, BDS, DMSc NEOPLASM, MALIGNANT
250 Luxation 312 Oral Cavity Minor Salivary Gland Malignancy
Dania Tamimi, BDS, DMSc Bronwyn E. Hamilton, MD
254 Dentoalveolar Fractures 314 Sublingual Gland Carcinoma
Dania Tamimi, BDS, DMSc Hilda E. Stambuk, MD
INFECTION/INFLAMMATION 316 Submandibular Gland Carcinoma
Hilda E. Stambuk, MD
260 Dental Caries
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TABLE OF CONTENTS
318 Submandibular Space Nodal Non-Hodgkin
Lymphoma
TRAUMA
Bronwyn E. Hamilton, MD 370 Mandible Fracture
320 Oral Tongue Squamous Cell Carcinoma Byron W. Benson, DDS, MS and Michelle A. Michel, MD
Nicholas A. Koontz, MD 374 Nasoethmoid Complex Fracture
324 Floor of Mouth Squamous Cell Carcinoma Byron W. Benson, DDS, MS and Michelle A. Michel, MD
Nicholas A. Koontz, MD 376 Complex Midfacial Fracture
326 Gingival Squamous Cell Carcinoma Byron W. Benson, DDS, MS and Michelle A. Michel, MD
C. Grace Petrikowski, DDS, MSc, FRCD(C) 378 Zygomaticomaxillary Complex Fracture
328 Retromolar Trigone Squamous Cell Carcinoma Byron W. Benson, DDS, MS and Michelle A. Michel, MD
Nicholas A. Koontz, MD 380 Transfacial Fracture (Le Fort)
330 Submandibular Space Nodal Squamous Cell Byron W. Benson, DDS, MS and Kristine M. Mosier, DMD,
Carcinoma PhD
Bronwyn E. Hamilton, MD
332 Buccal Mucosa Squamous Cell Carcinoma INFECTION/INFLAMMATION
Nicholas A. Koontz, MD 384 Mandible-Maxilla Osteomyelitis
334 Hard Palate Squamous Cell Carcinoma Susanne E. Perschbacher, DDS, MSc, FRCD(C)
Nicholas A. Koontz, MD 388 Mandible-Maxilla Osteoradionecrosis
MISCELLANEOUS/IDIOPATHIC 392 Mandible-Maxilla Osteonecrosis
336 Motor Denervation CNXII Susanne E. Perschbacher, DDS, MSc, FRCD(C)
Richard H. Wiggins, III, MD, CIIP, FSIIM
338 Submandibular Sialoliths CYSTS, ODONTOGENIC
Byron W. Benson, DDS, MS 396 Dentigerous Cyst
SECTION 3: MANDIBLE AND MAXILLA 400 Odontogenic Keratocyst
NORMAL VARIANTS
404 Lateral Periodontal Cyst
342 Buccal and Palatal Exostoses Lisa J. Koenig, BChD, DDS, MS
Lisa J. Koenig, BChD, DDS, MS 406 Residual Cyst
344 Mandibular Torus Lisa J. Koenig, BChD, DDS, MS
Lisa J. Koenig, BChD, DDS, MS 408 Buccal Bifurcation Cyst
346 Palatal Torus Lisa J. Koenig, BChD, DDS, MS
Lisa J. Koenig, BChD, DDS, MS 412 Calcifying Odontogenic Cyst
348 Accessory Mandibular Canal Lisa J. Koenig, BChD, DDS, MS
350 Mandibular Salivary Gland Defect (Stafne) CYSTS, NONODONTOGENIC
Lisa J. Koenig, BChD, DDS, MS 414 Mandible-Maxilla Aneurysmal Bone Cyst
354 Mandible-Maxilla Idiopathic Osteosclerosis Lisa J. Koenig, BChD, DDS, MS
Lisa J. Koenig, BChD, DDS, MS 418 Nasopalatine Duct Cyst
CONGENITAL/GENETIC
422 Nasolabial Cyst
356 Clefts Lisa J. Koenig, BChD, DDS, MS and Kristine M. Mosier,
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS DMD, PhD
358 Cherubism 424 Mandible-Maxilla Simple (Traumatic) Bone Cyst
C. Grace Petrikowski, DDS, MSc, FRCD(C) Lisa J. Koenig, BChD, DDS, MS
362 Basal Cell Nevus Syndrome
Susanne E. Perschbacher, DDS, MSc, FRCD(C) FIBROOSSEOUS LESIONS
364 Cleidocranial Dysplasia 428 Periapical Osseous Dysplasia
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS C. Grace Petrikowski, DDS, MSc, FRCD(C)
366 Pierre Robin Sequence 432 Florid Osseous Dysplasia
Caroline D. Robson, MBChB and Dania Tamimi, BDS, C. Grace Petrikowski, DDS, MSc, FRCD(C)
DMSc 436 Ossifying Fibroma
368 Treacher Collins Syndrome C. Grace Petrikowski, DDS, MSc, FRCD(C)
Brad J. Potter, DDS, MS, Margot L. Van Dis, DDS, MS, and 440 Mandible-Maxilla Fibrous Dysplasia
Caroline D. Robson, MBChB C. Grace Petrikowski, DDS, MSc, FRCD(C) and Dania
Tamimi, BDS, DMSc
xvi http://ebooksdental.net/oral-maxillofacial-surgery
TABLE OF CONTENTS
512 Burkitt Lymphoma
METABOLIC/SYSTEMIC C. Grace Petrikowski, DDS, MSc, FRCD(C)
446 Paget Disease 516 Non-Hodgkin Lymphoma of Pharyngeal Mucosal
C. Grace Petrikowski, DDS, MSc, FRCD(C) Space
Patricia A. Hudgins, MD, FACR
NEOPLASM, BENIGN, ODONTOGENIC 520 Multiple Myeloma
450 Odontoma Lisa J. Koenig, BChD, DDS, MS
Dania Tamimi, BDS, DMSc 524 Ewing Sarcoma
454 Adenomatoid Odontogenic Tumor Axel Ruprecht, DDS, MScD, FRCD(C)
Dania Tamimi, BDS, DMSc 528 Leukemia
456 Ameloblastoma Byron W. Benson, DDS, MS
460 Ameloblastic Fibroma TUMOR-LIKE LESIONS
Lisa J. Koenig, BChD, DDS, MS 530 Mandible-Maxilla Central Giant Cell Granuloma
464 Ameloblastic Fibroodontoma Susanne E. Perschbacher, DDS, MSc, FRCD(C)
Dania Tamimi, BDS, DMSc 534 Langerhans Histiocytosis
466 Calcifying Epithelial Odontogenic Tumor Lisa J. Koenig, BChD, DDS, MS
468 Cementoblastoma SECTION 4: TEMPOROMANDIBULAR
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS JOINT
470 Odontogenic Myxoma
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS CONGENITAL DISORDERS
472 Central Odontogenic Fibroma 540 Condylar Aplasia
Dania Tamimi, BDS, DMSc David Hatcher, DDS, MSc
542 Hemifacial Microsomia
NEOPLASM, BENIGN, NONODONTOGENIC David Hatcher, DDS, MSc
474 Central Hemangioma
Byron W. Benson, DDS, MS DEVELOPMENTAL ACQUIRED DISORDERS
476 Osteoid Osteoma 546 Condylar Hyperplasia
Lisa J. Koenig, BChD, DDS, MS David Hatcher, DDS, MSc and Lisa J. Koenig, BChD, DDS,
478 Osteoblastoma MS
Lisa J. Koenig, BChD, DDS, MS 552 Coronoid Hyperplasia
480 Mandible-Maxilla Osteoma Lisa J. Koenig, BChD, DDS, MS, David Hatcher, DDS, MSc,
Lisa J. Koenig, BChD, DDS, MS and Dania Tamimi, BDS, DMSc
482 Nerve Sheath Tumor 556 Condylar Hypoplasia
Lisa J. Koenig, BChD, DDS, MS David Hatcher, DDS, MSc, Lisa J. Koenig, BChD, DDS, MS,
486 Neurofibromatosis Type 1 and C. Grace Petrikowski, DDS, MSc, FRCD(C)
Lisa J. Koenig, BChD, DDS, MS 560 Fibrous Ankylosis
490 Desmoplastic Fibroma David Hatcher, DDS, MSc and Lisa J. Koenig, BChD, DDS,
Lisa J. Koenig, BChD, DDS, MS MS
562 Bony Ankylosis
NEOPLASM, MALIGNANT, ODONTOGENIC C. Grace Petrikowski, DDS, MSc, FRCD(C)
492 Malignant Ameloblastoma and Ameloblastic
Carcinoma TRAUMA
Byron W. Benson, DDS, MS 564 TMJ Fractures
David Hatcher, DDS, MSc and C. Grace Petrikowski, DDS,
NEOPLASM, MALIGNANT, MSc, FRCD(C)
NONODONTOGENIC 570 TMJ Dislocation
494 Mandible-Maxilla Metastasis C. Grace Petrikowski, DDS, MSc, FRCD(C)
C. Grace Petrikowski, DDS, MSc, FRCD(C) 572 Bifid Condyle
500 Mandible-Maxilla Osteosarcoma C. Grace Petrikowski, DDS, MSc, FRCD(C)
C. Grace Petrikowski, DDS, MSc, FRCD(C) 576 TMJ Osteochondritis Dissecans
504 Mandible-Maxilla Chondrosarcoma David Hatcher, DDS, MSc
C. Grace Petrikowski, DDS, MSc, FRCD(C)
508 Primary Intraosseous Squamous Cell Carcinoma INFLAMMATION
C. Grace Petrikowski, DDS, MSc, FRCD(C) 578 TMJ Rheumatoid Arthritis
510 Central Mucoepidermoid Carcinoma David Hatcher, DDS, MSc
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TABLE OF CONTENTS
584 TMJ Juvenile Idiopathic Arthritis
Lubdha M. Shah, MD and David Hatcher, DDS, MSc
SECTION 5: MAXILLARY SINUS AND
590 TMJ Pigmented Villonodular Synovitis
NASAL CAVITY
David Hatcher, DDS, MSc and Kristine M. Mosier, DMD, NORMAL VARIANTS
PhD
650 Deviated Nasal Septum
DEGENERATIVE DISORDERS Axel Ruprecht, DDS, MScD, FRCD(C)
652 Concha Bullosa
592 Degenerative Joint Disease
Axel Ruprecht, DDS, MScD, FRCD(C)
David Hatcher, DDS, MSc
656 Accessory Ostia
596 TMJ Synovial Cyst
598 Progressive Condylar Resorption DEVELOPMENTAL
658 Hypoplasia/Aplasia
DISC DERANGEMENT DISORDERS Axel Ruprecht, DDS, MScD, FRCD(C)
604 Disc Displacement With Reduction INFLAMMATION
Richard W. Katzberg, MD, David Hatcher, DDS, MSc, and
Joanne Ethier, DMD, MBA, MS 662 Mucus Retention Pseudocyst
610 Disc Displacement Without Reduction Axel Ruprecht, DDS, MScD, FRCD(C)
Richard W. Katzberg, MD, David Hatcher, DDS, MSc, and 664 Sinonasal Mucocele
Joanne Ethier, DMD, MBA, MS Axel Ruprecht, DDS, MScD, FRCD(C) and Michelle A.
616 Adhesions Michel, MD
David Hatcher, DDS, MSc 668 Sinonasal Granulomatosis With Polyangiitis
(Wegener Granulomatosis)
NEOPLASM, BENIGN Axel Ruprecht, DDS, MScD, FRCD(C) and Michelle A.
Michel, MD
618 TMJ Osteoma
672 Sinonasal Polyposis
Lisa J. Koenig, BChD, DDS, MS and H. Ric Harnsberger, MD
620 TMJ Osteochondroma
676 Acute Rhinosinusitis
David Hatcher, DDS, MSc and C. Grace Petrikowski, DDS,
Axel Ruprecht, DDS, MScD, FRCD(C) and Michelle A.
MSc, FRCD(C)
Michel, MD
TUMOR-LIKE LESIONS 680 Chronic Rhinosinusitis
626 TMJ Calcium Pyrophosphate Dihydrate Deposition Michel, MD
Disease 684 Odontogenic Sinusitis
C. Grace Petrikowski, DDS, MSc, FRCD(C) Axel Ruprecht, DDS, MScD, FRCD(C)
630 TMJ Primary Synovial Chondromatosis 686 Allergic Fungal Sinusitis
C. Grace Petrikowski, DDS, MSc, FRCD(C) and David H. Christian Davidson, MD
Hatcher, DDS, MSc 688 Invasive Fungal Sinusitis
NEOPLASM, MALIGNANT 692 Mycetoma
634 TMJ Osteosarcoma Michelle A. Michel, MD
C. Grace Petrikowski, DDS, MSc, FRCD(C) 694 Invasive Pseudotumor
636 TMJ Chondrosarcoma Axel Ruprecht, DDS, MScD, FRCD(C)
640 TMJ Metastasis NEOPLASM, BENIGN
C. Grace Petrikowski, DDS, MSc, FRCD(C) and Lisa J. 696 Sinonasal Inverted Papilloma
Koenig, BChD, DDS, MS Axel Ruprecht, DDS, MScD, FRCD(C) and Michelle A.
Michel, MD
MISCELLANEOUS 700 Sinonasal Osteoma
642 TMJ Simple (Traumatic) Bone Cyst Axel Ruprecht, DDS, MScD, FRCD(C)
C. Grace Petrikowski, DDS, MSc, FRCD(C) and Lisa J.
Koenig, BChD, DDS, MS NEOPLASM, MALIGNANT
644 Aneurysmal Bone Cyst 704 Sinonasal Squamous Cell Carcinoma
David Hatcher, DDS, MSc Axel Ruprecht, DDS, MScD, FRCD(C)
706 Sinonasal Adenoid Cystic Carcinoma
Michel, MD
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708 Nasopharyngeal Carcinoma 768 Parotid Mucoepidermoid Carcinoma
Luke N. Ledbetter, MD Barton F. Branstetter, IV, MD, FACR
712 Sinonasal Malignant Melanoma 772 Parotid Adenoid Cystic Carcinoma
Axel Ruprecht, DDS, MScD, FRCD(C) Barton F. Branstetter, IV, MD, FACR
774 Parotid Non-Hodgkin Lymphoma
FIBROOSSEOUS LESIONS Barton F. Branstetter, IV, MD, FACR
714 Sinonasal Fibrous Dysplasia 778 Metastatic Disease of Parotid Nodes
Axel Ruprecht, DDS, MScD, FRCD(C) Barton F. Branstetter, IV, MD, FACR
718 Sinonasal Ossifying Fibroma
Axel Ruprecht, DDS, MScD, FRCD(C) and Michelle A. AUTOIMMUNE
Michel, MD 782 Sjögren Syndrome
Byron W. Benson, DDS, MS
SECTION 6: MASTICATOR SPACE
MISCELLANEOUS/IDIOPATHIC
INFECTION
784 Parotid Sialoliths
724 Masticator Space Abscess Byron W. Benson, DDS, MS
SECTION 8: CERVICAL SPINE
DEGENERATIVE
728 Masticator Muscle Atrophy
DEVELOPMENTAL ALTERATIONS
Rebecca S. Cornelius, MD, FACR 788 C2-C3 Fusion
Kevin R. Moore, MD
NEOPLASM, BENIGN 790 C1 Assimilation
732 Masticator Space CNV3 Schwannoma Kevin R. Moore, MD
Rebecca S. Cornelius, MD, FACR 792 Ponticulus Posticus
Kevin R. Moore, MD
NEOPLASM, MALIGNANT 794 Ossiculum Terminale
Kevin R. Moore, MD
734 Masticator Space Chondrosarcoma
796 Split Atlas
Kevin R. Moore, MD
738 Masticator Space Sarcoma
798 Os Odontoideum
Kevin R. Moore, MD
742 Masticator Space CNV3 Perineural Tumor
802 Os Avis (Fused to Clivus)
Kevin R. Moore, MD
MISCELLANEOUS/IDIOPATHIC 804 Odontoid Hypoplasia/Aplasia
Kevin R. Moore, MD
746 Benign Masticator Muscle Hypertrophy 806 Failure of Formation
Rebecca S. Cornelius, MD, FACR Kevin R. Moore, MD
810 Failure of Segmentation
SECTION 7: PAROTID SPACE
Kevin R. Moore, MD
INFLAMMATION
DEGENERATIVE DISORDERS
750 Benign Lymphoepithelial Lesions: HIV
Barton F. Branstetter, IV, MD, FACR 814 Degenerative Joint Disorders of Craniovertebral
754 Parotid Sialadenitis Junction
Byron W. Benson, DDS, MS Cheryl A. Petersilge, MD, MBA
818 Ossification of Posterior Longitudinal Ligament
NEOPLASM, BENIGN Cheryl A. Petersilge, MD, MBA
822 Diffuse Idiopathic Skeletal Hyperostosis
756 Parotid Benign Mixed Tumor Cheryl A. Petersilge, MD, MBA
Barton F. Branstetter, IV, MD, FACR 826 Cervical Facet Arthropathy
760 Warthin Tumor Jeffrey S. Ross, MD
764 Parotid Schwannoma TUMOR AND TUMOR-LIKE LESIONS
830 Hemangioma, Cervical Spine
NEOPLASM, MALIGNANT Cheryl A. Petersilge, MD, MBA
834 Lytic and Blastic Metastases
766 Parotid Malignant Mixed Tumor Cheryl A. Petersilge, MD, MBA
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TABLE OF CONTENTS
896 Ground-Glass and Granular Radiopacities
FIBROOSSEOUS Dania Tamimi, BDS, DMSc
838 Fibrous Dysplasia, Cervical Spine 902 Generalized Radiopacities
Cheryl A. Petersilge, MD, MBA and Julia Crim, MD Dania Tamimi, BDS, DMSc
MISCELLANEOUS PERIOSTEAL REACTIONS

840 Tumoral Calcinosis 906 Periosteal Reactions
Jeffrey S. Ross, MD and Lubdha M. Shah, MD Dania Tamimi, BDS, DMSc
Part III: Differential Diagnoses SECTION 3: ORAL CAVITY

ANATOMICALLY BASED LESIONS
SECTION 1: TEETH 914 Submandibular Space Lesions
ALTERATIONS IN TOOTH NUMBER Byron W. Benson, DDS, MS
918 Parotid Space Lesions
844 Extra Teeth Byron W. Benson, DDS, MS
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS 922 Sublingual Space Lesions
846 Missing Teeth Byron W. Benson, DDS, MS
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS 926 Oral Mucosal Space/Surface Lesions
ALTERATIONS IN TOOTH 930 Root of Tongue Lesions
MORPHOLOGY/SHAPE Byron W. Benson, DDS, MS
848 Crown Changes
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS MISCELLANEOUS
850 Root Changes 934 Soft Tissue Calcifications
Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS Brad J. Potter, DDS, MS and Margot L. Van Dis, DDS, MS
SECTION 2: MANDIBLE AND MAXILLA SECTION 4: TEMPOROMANDIBULAR
JOINT
ALTERATIONS IN SUPPORTING STRUCTURES
OF TEETH CHANGES IN CONDYLAR SIZE AND
856 Periapical Radiolucencies FUNCTION
Dania Tamimi, BDS, DMSc 940 Small Condyle
860 Periapical Radiopacities and Mixed Lesions C. Grace Petrikowski, DDS, MSc, FRCD(C) and Dania
Dania Tamimi, BDS, DMSc Tamimi, BDS, DMSc
862 Floating Teeth 946 Large Condyle
Lisa J. Koenig, BChD, DDS, MS C. Grace Petrikowski, DDS, MSc, FRCD(C) and Dania
864 Widened Periodontal Ligament Space Tamimi, BDS, DMSc
Lisa J. Koenig, BChD, DDS, MS 950 Limited Condylar Translation
866 Lamina Dura Changes C. Grace Petrikowski, DDS, MSc, FRCD(C)
MASS LESIONS
RADIOLUCENCIES
954 TMJ Radiolucencies
870 Well-Defined Unilocular Radiolucencies C. Grace Petrikowski, DDS, MSc, FRCD(C)
Lisa J. Koenig, BChD, DDS, MS 956 TMJ Radiopacities
874 Pericoronal Radiolucencies Without Radiopacities C. Grace Petrikowski, DDS, MSc, FRCD(C) and Dania
Lisa J. Koenig, BChD, DDS, MS Tamimi, BDS, DMSc
876 Pericoronal Radiolucencies With Radiopacities
Lisa J. Koenig, BChD, DDS, MS MISCELLANEOUS
878 Multilocular Radiolucencies
960 TMJ Articular Loose Bodies
C. Grace Petrikowski, DDS, MSc, FRCD(C) and Dania
882 Ill-Defined Radiolucencies
Tamimi, BDS, DMSc
888 Generalized Rarefaction
RADIOPACITIES
892 Well-Defined Radiopacities
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SECTION 5: MAXILLARY SINUS AND
NASAL CAVITY
NASAL LESIONS
964 Perforated Nasal Septum
966 Nasal Lesion Without Bony Destruction
970 Nasal Lesion With Bony Destruction
974 Sinonasal Fibroosseous and Cartilaginous Lesions
SINUS LESIONS
976 Paranasal Sinus Lesions Without Bony Destruction
980 Paranasal Sinus Lesions With Bony Destruction
MISCELLANEOUS
984 Displaced Dental Structures Into Antrum
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SECOND EDITION
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PART I
SECTION 1
Oral Cavity
Teeth 4
Dental Restorations 14
Maxilla 22
Mandible 30
Tongue 36
Retromolar Trigone 40
Sublingual Space 44
Submandibular Space 48
Oral Mucosal Space/Surface 52
Teeth
Anatomy: Oral Cavity
• Position is described in relation to

TERMINOLOGY
○ Midline of arch (i.e., line between central Incs), not
Abbreviations anatomical midline
• Incisor (Inc), canine (C), premolar (PM), molar (M) – All surfaces of teeth that are in direction of midline
of arch are "mesial"
Synonyms – All surfaces of teeth away from midline of arch are
• Cuspid = canine "distal"
• Bicuspid = premolar ○ Inside or outside of arch
– Surfaces toward face are facial (can use buccal if
IMAGING ANATOMY posterior, labial if anterior)
Overview – Surfaces toward tongue are lingual (can use palatal if
maxillary)
• Humans have 2 dentitions: Primary and permanent
○ Anatomic tooth
• Teeth are divided into maxillary (upper) and mandibular
(lower) – If above crown of tooth, use "coronal to"
• Each jaw is divided into 2 quadrants: Right and left – If below apices of tooth, use "apical to"
separated by midline Eruption Patterns
• Each quadrant has 5 primary and 8 permanent teeth • 3 phases of eruption: Primary, mixed, and permanent
○ Primary: 2 Incs (central and lateral), 1 C, 2 Ms (1st and dentitions
2nd) • Primary dentition
○ Permanent: 2 Incs (central and lateral), 1 C, 2 PMs (1st ○ Starts to erupt between 6-12 months
and 2nd), 3 Ms (1st, 2nd, and 3rd) ○ 1st teeth are usually lower central Incs; last teeth are 2nd
• Teeth can be named or numbered Ms
• Naming teeth should follow this sequence: Dentition → jaw • Mixed dentition
→ side → tooth name ○ Combination of primary and permanent teeth have
○ Example: Primary maxillary right 1st M; permanent erupted
mandibular left C ○ 1st permanent teeth are permanent 1st Ms at 6 years
○ Exceptions are PMs and 3rd Ms: Only present in ○ Exfoliation of primary Incs followed by eruption of
permanent dentition, so no need to use "permanent" permanent Incs (6-9 years)
○ If only permanent teeth are present (all primary teeth ○ Exfoliation of primary mandibular Cs followed by
have been exfoliated), no need to use "permanent" eruption of permanent mandibular Cs (9-10 years)
• Numbering teeth depends on country ○ Exfoliation of primary Ms followed by eruption of PMs
○ Most countries use FDI (Federation Dentaire (10-12 years)
International) system for numbering ○ Exfoliation of primary maxillary Cs followed by eruption
– Quadrants are numbered of permanent Cs (11-12 years)
– Permanent: Upper right (UR) = 1, upper left (UL) = 2, – May get crowded out of arch, either impacted or
lower left (LL) = 3, lower right (LR) = 4 malerupted
– Primary: UR = 5, UL = 6, LL = 7, LR = 8 – High incidence of dentigerous cyst formation with
– Teeth are numbered impaction of these teeth
– Permanent: Central Inc = 1, lateral Inc = 2, C = 3, 1st • Permanent dentition
PM = 4, 2nd PM = 5, 1st M = 6, 2nd M = 7, 3rd M = 8 ○ No more primary teeth in jaws
– Primary: Central Inc = 1, lateral Inc = 2, C = 3, 1st M = 4, ○ Eruption of permanent 2nd Ms (11-13 years)
2nd M = 5 ○ Eruption of 3rd Ms (17-21 years)
– Example: Permanent mandibular right 1st M = tooth – Impactions are common; dentigerous cysts may
#46 (pronounced four six) occur around crown of impacted tooth
○ United States uses universal system
– Only teeth are numbered Tooth Anatomy
– Permanent teeth start with #1 (maxillary right 3rd M) • Teeth are made up of 4 basic anatomic structures: Enamel,
and go to #16 (maxillary left 3rd M) pronounced dentin, cementum, and pulp
sixteen ○ Enamel
– Mandibular left 3rd M is #17 (seventeen) and goes to – Hardest substance in body = most mineralized (95%
mandibular right 3rd M #32 (thirty two) calcified) = highest radiographic density
– Primary teeth are labeled with letters A → T starting – Covers crown of tooth; contacts dentin at
with last M on UR: UR → UL→ LL → LR dentinoenamel junction
○ Other tooth numbering systems exist; check with local – Contacts cementum at cementoenamel junction
dental organization (CEJ)
○ When in doubt, describe teeth by name – Develops from ameloblasts
Anatomy Relationships ○ Dentin
– Makes up majority of tooth; provides resiliency to hard
• When describing teeth or objects in relation to teeth, overlying enamel; 75% calcified
conventional anatomic positions (inferior, posterior,
medial, lateral, anterior, posterior) are not used
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Teeth

– Contains dentinoblastic processes: Tooth becomes Tooth Development and Tumorigenesis
sensitive when dentin is exposed • Potential sources for development of tumors
○ Cementum ○ Prefunctional dental lamina (odontogenic epithelium
– Thin layer of calcified material covering root of tooth with ability to produce tooth); more abundant distal to
and providing attachment for periodontal ligament lower 3rd Ms
(PDL) ○ Postfunctional dental lamina: Epithelial remnants, such
– Not visible radiographically unless hypercementosis as rests of Serres, in fibrous gingival tissue; epithelial cell
occurs rests of Malassez in PDL and reduced enamel organ
○ Pulp (a.k.a. "nerve") epithelium (covers enamel surface until tooth eruption)
– Vital portion of tooth (tooth "dies" when pulp dies) ○ Basal cell layer of gingival epithelium (source of dental
– Contains nerves and vessels that enter and emerge lamina)
through apical foramen of tooth ○ Dental papilla (origin of dental pulp); can be induced to
– Most radiolucent portion of tooth produce odontoblasts and synthesize dentin &/or
– Crown portion called pulp chamber with pointy pulp dentinoid material
horns; root portion called pulp canal ○ Dental follicle
• Teeth are made up of crown and root ○ PDL: Can induce production of fibrous and cemento-
○ Crown: Everything above CEJ osseous mineralized material
– Further subdivided into occlusal/incisal, middle, and
cervical 1/3rds ANATOMY IMAGING ISSUES
– Incs have incisal edges as functional component; all Imaging Recommendations
other teeth have cusps
○ Root: Everything below CEJ • For imaging of teeth for caries, periapical or periodontal
disease, intraoral radiography is recommended
– Further subdivided into cervical, middle, and apical
1/3rds ○ Horizontal bitewings for caries and early periodontal
disease detection
– Teeth can have single root or be multirooted; area
between roots of tooth is called furcation area ○ Vertical bitewings for moderate to severe periodontal
disease
– Roots are named according to location in alveolar
process: Buccal, lingual, mesial, distal, mesiobuccal, ○ Periapical radiographs if periapical pathology is
distobuccal suspected
○ Pros: High-resolution images showing fine changes in
Periodontium demineralization; low radiation dose, especially if F-
• Primary function is to support teeth; when teeth are lost, speed film or digital radiography is used
periodontal bone recedes ○ Cons: Limited to dimensions of intraoral film, cannot see
• Made up of periodontal bone, PDLs, and gingiva lesions or impacted teeth if they extend beyond
○ Periodontal bone • For general overview of teeth in jaws: Panoramic
– Portion of alveolar processes of maxilla and mandible radiography
that come in direct contact with teeth ○ Shows eruption pattern and impactions of teeth;
– Most cervical aspect called crest; corticated when presence of intraosseous pathology
healthy ○ Pros: Cost effective; lower radiation dose when
– If tooth is lost, most cervical aspect of bone is called compared to CBCT
residual ridge ○ Cons: Distortion, magnification, and blurring can impede
– Bone at apex of tooth called periapical bone evaluation
– Bone in furcation area called furcal bone • For relationship of impacted teeth with vital anatomic
– Thin radiopaque line seen radiographically lining tooth structures: CBCT
socket is called lamina dura ○ Can show inferior alveolar nerve canals in relation to 3rd
○ PDL Ms if extraction is planned
– Multidirectional fibers that attach tooth to socket; ○ Can show relationship of impacted Cs to anterior
offer resilience to tooth during function superior alveolar canal, nasopalatine canal, and floor of
– Radiographically seen as uniform radiolucent line on nasal cavity
inside of lamina dura ○ Pros: 3D representation of 3D structures; 3D
– If loses uniformity, suspect pathology reformations can be obtained to give exact visualization
of anatomy
– Houses epithelial rests of Malassez, which may
contribute to formation of cyst lining for odontogenic ○ Cons: Expensive imaging modality, generally not covered
cysts by insurance; higher radiation dose
– Position in relation to tooth can determine if lesion is ○ If unable to obtain CBCT or CT, use intraoral radiography
attached to tooth structure (inside PDL) or not and SLOB (same lingual, opposite buccal) rule and 2
(outside PDL) images at right angles to one another
○ Gingiva (a.k.a. gums)
– Soft tissue component covering periodontal bone
– Attaches to root to form small gingival sulcus with
crown; cannot be visualized radiographically
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Teeth
TOOTH DEVELOPMENT
Oral epithelium arising from

ectoderm
Ectomesenchyme
Dental sac
Dental lamina
Dental papilla
Developing bone
Erupting tooth
Permanent tooth bud

Ameloblasts secreting enamel
matrix
Enamel matrix
Enamel organ Dentin matrix
Odontoblasts secreting dentin
matrix
Developing bone
Dental papilla
Cervical loop
Enamel matrix
Hertwig root sheath

Ameloblasts
Stratum intermedium
Stellate reticulum Epithelial rests of Malassez
Outer enamel epithelium

Future cementoenamel
Dental papilla junction
Disintegration of Hertwig root
Odontoblasts sheath
Dentin matrix Forming periodontal ligaments
Developing bone
Cementum
Epithelial rests of Malassez
(Top) Graphic shows stages of tooth development: (A) Initiation: Ectoderm develops oral epithelium and dental lamina, (B) bud stage:
Dental lamina grows into bud penetrating the ectomesenchyme, (C) cap stage: Enamel organ forms cap surrounding dental papilla and
surrounded by dental sac, (D) bell stage: Differentiation of enamel organ and dental papilla into different cells types, (E) apposition
stage: Secretion of dental tissue matrix, and (F) maturation: Full mineralization of dental tissues. (Bottom) Graphic shows stages of root
development: (A) Apposition stage, (B) enamel deposition completion at the cervical loop and formation of Hertwig epithelial root
sheath from inner and outer enamel epithelium cells, (C) root sheath disintegration and fragmentation of some of its cells into
epithelial rests of Malassez, and (D) formation of cementum and periodontal ligaments with persistence of these epithelial remnants,
which may be the source of the epithelial component of some odontogenic cysts and tumors.
Teeth

TOOTH ERUPTION
Fusion of reduced enamel

Oral epithelium epithelium to oral epithelium
Connective tissue
Reduced enamel epithelium
Bone
Enamel
Dentin
Tissue disintegration Erupting tooth cusp
Initial junctional epithelium
Developing maxillary canine

with incomplete root
formation
Ankylosed tooth
Developing mandibular canine

with incomplete root
formation
(Top) Graphic shows process of tooth eruption: (A) Enamel organ reduces to thin layers covering enamel and secretes enzymes, (B)
fusion of the reduced enamel epithelium with the oral epithelium, (C) disintegration of the central fused tissues, leaving a canal for
tooth movement, and (D) peripheral-fused tissues peel back from the crown as the tooth erupts and form initial junctional epithelium
that migrate cervically to cementoenamel junction. (Bottom) The age of the patient can be determined by examining the eruption of
the teeth. This CBCT 3D reformation shows that the permanent incisors and 1st molars have erupted, but the premolars have not. This
puts the patient's age at between 8-10 years. 3D reformations can be helpful in evaluation of erupting teeth if malocclusion and
malalignment are present. Note that the maxillary right central incisor has not fully erupted, although the apical foramen is almost
closed. This may be due to ankylosis (loss of periodontal ligament) of the tooth. (Courtesy 3D Diagnostix, Inc.)
Teeth
TEETH NOMENCLATURE AND ERUPTION AGES
Maxillary central incisor (7-8

years)
Maxillary lateral incisor (8-9 Maxillary 1st premolar (10-12
years) years)
Maxillary canine (11-12 years)
Maxillary 2nd premolar (10-12
years)
Maxillary 1st molar (6 years)
Maxillary 2nd molar (12 years)
Maxillary 3rd molar (17-21

years)
Mandibular 3rd molar (17-21

years)
Mandibular 2nd molar (12

years)
Mandibular 1st molar (6 years)
Mandibular canine (9-10 years)
Mandibular lateral incisor (7-8 Mandibular 2nd premolar (10-

years) 12 years)
Mandibular 1st premolar (10-
Mandibular central incisor (6-7 12 years)
years)
(Top) The maxilla has 16 permanent teeth arranged in 2 quadrants: The upper right quadrant, also known as quadrant 1, and the upper
left quadrant, also known as quadrant 2. Eruption ages are in parenthesis. The functional cusps on the maxillary posterior teeth are
lingual (palatal) cusps. (Bottom) The mandible has 16 permanent teeth arranged in 2 quadrants: The lower left quadrant, also known as
quadrant 3, and the lower right quadrant, also known as quadrant 4. Eruption ages are noted in parenthesis. The functional cusps on
the mandibular posterior teeth are the buccal (facial) cusps. The permanent maxillary and mandibular incisors and canines have
similarly named deciduous predecessors. The predecessors of the 1st and 2nd premolar teeth are the 1st and 2nd deciduous molars,
respectively. The deciduous incisors and canines have a single root, the mandibular deciduous molars have 2 roots, and the maxillary
deciduous molars have 3 roots.
Teeth

HUMAN DENTITIONS
Permanent 1st molar

Primary central incisor
Permanent central incisor
Primary 1st molar
Permanent incisors
Premolars
Permanent 1st molars Permanent 1st molars
Premolars
Permanent incisors
3rd molar follicles 3rd molar follicles
(Top) Panoramic reformat of CBCT data shows a patient at the primary dentition stage. All 20 primary teeth have erupted into the oral
cavity and are in occlusion, but all permanent teeth are still unerupted. Examination of the follicles of the permanent teeth for any
displacement or expansion is recommended when evaluating images for the primary dentition phase. It is also important to note any
missing permanent teeth to aid in future orthodontic treatment planning. (Middle) Panoramic radiograph shows a patient at the mixed
dentition stage. The upper and lower permanent 1st molars have erupted as well as the upper and lower incisors. As the premolars have
not erupted yet, it means the patient's age is between 8-10 years. (Bottom) CBCT panoramic reformat shows a patient in the
permanent dentition/late adolescence stage. All erupted teeth are permanent. The developing 3rd molars are present but unerupted.
The stage of 3rd molar development indicates that the patient's age is between 17-20 years.
Teeth
DENTAL ANATOMY
Enamel
Dentin Dentinoenamel junction
Pulp horn
Cementoenamel junction Pulp chamber
Periodontal ligament space
Buccal plate Lingual plate
Pulp canal Alveolar bone adjacent to

periodontal ligament space,
appears as thin radiopaque
line (lamina dura)
Nutrient canal radiographically
Inferior alveolar canal

containing inferior alveolar
neurovascular bundle
Crown
Crest of alveolar bone (crestal

lamina dura)
Tooth furcation
Cementum
Root
Periodontal ligament space
Lateral canal
Nutrient canal Apical foramen
(Top) Graphic representation shows a mandibular 1st molar in coronal cross section through the mesial root. Identification of the
location of pathology in relation to the DEJ and CEJ helps in classifying caries and periodontal disease. Cross sections of the teeth are
the most common reformation for dental applications, such as implant and impaction analysis, as they allow for evaluation of alveolar
bone width and height and accurate localization of the inferior alveolar nerve canal. (Bottom) Graphic representation shows sagittal
cross section of a mandibular 1st molar. The tooth is attached to the socket through the periodontal ligaments. The crest of the healthy
alveolar bone is located about 1-2 mm apical to the CEJ of a tooth. Innervation and vasculature exit through the apical foramen, but on
occasion, lateral canals may exit through the lateral aspects of the root. If pulpal death occurs, bacteria can seep through the lateral
canals, causing lateral radicular abscesses and cysts, and through the apical foramina, causing periapical inflammation.
Teeth

DENTAL RADIOGRAPHIC ANATOMY
Enamel Dentinoenamel junction
Dentin
Cementoenamel junction
Pulp horn
Pulp chamber
Crest of alveolar bone (crestal
lamina dura)
Tooth furcation Alveolar interdental bone
Pulp (root) canal

Furcal bone
Lamina dura
Periapical periodontal Periodontal ligament space

ligament space
Nutrient canal
Mental foramen
Anterior nasal spine
Shadow of nose
Pulp canal
Intermaxillary suture
Gingival embrasure
Pulp chamber
Interproximal contact
Incisal embrasure Incisal edge
(Top) Periapical radiograph shows normal dental and periodontal anatomy. The periodontal ligament space is a thin radiolucent line
that surrounds the root of the tooth. The lamina dura is a thin radiopaque line that surrounds the tooth socket radiographically.
Healthy alveolar bone crests (crestal laminae dura) are corticated. Nutrient canals may appear as small corticated canals within the
bone connected to the apical foramen. (Courtesy M. Kroona, DXT.) (Bottom) Periapical radiograph of the central incisors shows the
normal anatomic landmarks in this area. It is important to realize that soft and hard tissue superimpositions may occur when imaging
teeth, and their recognition is necessary to determine normal from abnormal. Evaluation of the interproximal contact point and crown
contours is important as caries tends to occur cervical to the contact point, and incomplete contact or improper crown contour may
lead to plaque accumulation and resulting caries and periodontal disease. (Courtesy M. Kroona, DXT.)
Teeth
TOOTH IMPACTIONS
Inferior alveolar nerve seen in 3D

reformation running between roots of
Cross sections showing inferior alveolar distoangularly impacted mandibular left
nerve canals highlighted 3rd molar
Panoramic reformat with inferior

alveolar nerve canals highlighted
Horizontally impacted 3rd molar
Supernumerary impacted tooth

Horizontally impacted 3rd molar
Panoramic reformat with inferior

alveolar nerve canals highlighted
Mesioangularly impacted 3rd molar
Inferior alveolar nerve running through

mesial root
(Top) Cross sections, panoramic, 3D reformations using Simplant software show the inferior alveolar nerve canal traveling between the
roots of the distoangularly impacted mandibular left 3rd molar. (Courtesy 3D Diagnostix, Inc.) (Middle) Panoramic and 3D reformations
show a horizontally impacted left 3rd molar with its crown oriented distally and an impacted supernumerary tooth (4th molar) with its
crown oriented mesially, both lying on top of the left inferior alveolar nerve canal. The right 3rd molar is horizontally impacted with its
crown oriented mesially. CBCT imaging can aid in predicting and preventing nerve damage when removing 3rd molars surgically.
(Courtesy 3D Diagnostix, Inc.) (Bottom) 3D reformation shows the left inferior alveolar nerve going through the mesial root of the
mesioangularly impacted mandibular left 3rd molar. This occurs during tooth development due to proximity of the tooth follicle to the
inferior alveolar nerve, which is engulfed by the root as it develops and calcifies. (Courtesy 3D Diagnostix, Inc.)
Teeth

TOOTH IMPACTIONS
Root apex in nasal cavity

Impacted canine with crown located Impacted canine with crown located
lingual to primary maxillary lateral incisor lingual to permanent maxillary left
and permanent maxillary central incisor lateral incisor
Primary lateral incisor crown Primary canine crown
Horizontally oriented permanent canines

Developing root of 2nd molar
2nd premolar
1st premolar
Impacted canine
Inferior alveolar nerve
(Top) CBCT 3D reformation with transparent bone shows the vertical impaction of the permanent canines with lingual placement of the
crowns and slight facial tipping of the roots. Knowledge of this orientation aids the surgeon in deciding on the entry point for either
extraction or exposure of the crowns for placement of an orthodontic bracket. (Courtesy 3D Diagnostix, Inc.) (Middle) The bone can also
be made transparent on CBCT 3D reformations and segmentations to further visualize the relationship of the teeth with one another.
This image shows unerupted maxillary canines with the crowns oriented facially. The roots are not completely formed. (Courtesy 3D
Diagnostix, Inc.) (Bottom) CBCT 3D reformation and segmentation using Simplant software shows an impacted mandibular canine. The
position of the impacted tooth in relation to the erupted dentition can easily be determined with 3D reformation. Virtual extractions
(digital removal of teeth) can also be performed. (Courtesy 3D Diagnostix, Inc.)
Dental Restorations
• Sealer cement
TERMINOLOGY
○ Viscous radiopaque material that seals gaps between
Definitions gutta percha cones
• Materials used to restore form and function of teeth or to ○ May extend beyond apex of tooth and cause rarefaction
enhance dental aesthetics of bone; most are biocompatible
Orthodontics
IMAGING ANATOMY
• Brackets
Restorative Materials ○ Traditionally fixed to facial aspect of teeth with resin;
• Amalgam lingual brackets available
○ Traditional silver filling material; metallic in density • Bands
○ Combination of silver, mercury, tin, and copper and ○ Placed on posterior teeth as anchors for appliance
sometimes zinc, indium, and palladium • Archwire
• Composite ○ Stainless steel wires that follow outline of arch fixed to
○ Tooth-colored restoration that binds to enamel through brackets and bands with elastic &/or ligature wire
acid-etching bonding • Other fixed appliances
○ Historically radiolucent, now mixed with radiopaque ○ Anchored to posterior teeth through bands
fillers ○ May have several metallic spring and loop components
○ More radiodense than enamel, but less than metal as well as acrylic components
• Glass ionomer
Pediatrics
○ Tooth-colored restoration that binds to dentin
chemically • Stainless steel crown
○ Used on root lesions where there is no enamel present ○ Prefabricated crown
for acid etching ○ Used when tooth structure cannot be restored by
○ Also used as base under other large restorations amalgam alone or when tooth is root canal-treated
(pulpotomy or pulpectomy)
Prosthetic • Space maintainer
• Crowns ○ Teeth will drift mesially when adjacent mesial tooth is
○ Full or partial tooth coverage extracted
○ Full cast metal, full porcelain, or porcelain fused to ○ To ensure enough space for permanent successor tooth,
metal space maintainer is placed on tooth adjacent to
○ Tooth must be prepped: Ground down to specific edentulous space
dimensions to create space for crown material ○ Many different types: Fixed and removable; unilateral
• Bridges and bilateral
○ Replace missing teeth by crowning at least 2 adjacent ○ Band and loop space maintainer: Made of band soldered
teeth (abutments) to thick wire formed to abut with tooth mesial to
○ Portion that replaces missing tooth called pontic edentulous space, thus preventing drift
○ Bridge can be supported by implants
• Post and core ANATOMY IMAGING ISSUES
○ Post: Metal rod affixed to, or cast with, core to anchor it Imaging Recommendations
to root canal • MR for orthodontic patients
○ Core: Cast metal replacement of tooth structure to ○ If MR of head and neck
mimic crown prep; crown placed on top of it
– Temporary removal of orthodontic appliances to
• Implants prevent signal void artifact
○ Osseointegrated root form replacement of teeth ○ If MR of other body structures
restored with crown
– Stainless steel archwire is magnetic and should be
• Complete and partial dentures removed
○ Removable dentures used when several or all teeth are – All orthodontic brackets and bands should be
missing secured
○ Should be removed from mouth prior to imaging to
prevent metal artifact unless scan with denture is Imaging Pitfalls
requested • Dental restorations can cause metal streaking and beam-
Endodontics hardening artifact on CT and signal voids on MR, thus
marring evaluation of adjacent bone and soft tissue
• Gutta percha ○ 2D imaging radiographic and clinical examination is
○ Cone-shaped flexible radiopaque material that can be recommended for evaluation of bone and dental lesions
condensed to fill tapering prepared root canal if artifact is excessive on CBCT or CT
○ Should be ≤ 1 mm from apex within root ○ To reduce artifact when examining oral cavity soft
– 0.5 mm is ideal tissues on CT and MR, obtain scans without teeth crowns
○ If it extends beyond apex, called overfill in field of view (modified axial)
– If it is 1 mm from apex (within root canal), called
underfilled or short
Dental Restorations

PERIAPICALS AND AXIAL CBCT
Mesio-occluso-distal Amalgam build-up

Amalgam (class I)
Posterior composite restoration

(radiolucent) Posterior composite restoration
(radiopaque)
Amalgam restoration (class I) Posterior composite restoration
Amalgam restoration (class II) Temporary filling
Cotton roll
Root canal filling (gutta percha)
Anterior composite restorations
(Top) Bitewing radiograph shows several posterior restorations. Amalgam is metallic and, therefore, appears completely radiopaque
(image void). Posterior composite restorations can be used for more aesthetic results if clinically indicated and appear radiolucent (if of
1st-generation composites), posing a diagnostic challenge if evaluating for recurrent caries. Composites with radiopaque fillers appear
moderately radiopaque. (Courtesy B. Friedland, BDS.) (Middle) Bitewing radiograph shows 2 types of amalgam restorations that are
named according to surfaces replaced [occlusal (class I), mesio- or disto-occlusal (class II), amalgam build-up, etc.]. If treatment of a
tooth has not been completed or if a period of pulpal healing is required after deep caries excavation, a temporary (interim) filling may
be placed. If a root canal-treated tooth is awaiting a crown, a cotton ball is placed to separate the gutta percha from the sticky
temporary filling. (Courtesy B. Friedland, BDS.) (Bottom) Axial CBCT shows several anterior composite restorations.
Dental Restorations
AXIAL CBCT AND PERIAPICALS
Anterior composite restorations

(radiolucent)
Full metal crown
Gutta percha
Root canal filling short of apex
Abutment tooth
Pontic
Crown on abutment tooth
Ceramic on PFM bridge
Root canal filling
(Top) Axial CBCT shows multiple rounded well-defined radiolucencies on the proximal surfaces of the teeth, representing radiolucent
old-generation composite restorations. (Middle) A periapical radiograph shows a full metal coverage crown on the mandibular left 1st
molar. The contours of the crown should follow the original contours of the tooth with no overhangs or open margins. This tooth is root
canal treated, and the filling material in the mesial root is short, which may mean that a portion of the root canal was not instrumented
to remove debris, presenting a risk for periapical rarefying osteitis. (Courtesy B. Friedland, BDS.) (Bottom) A periapical radiograph
shows a porcelain fused to metal (PFM) bridge. The teeth onto which the bridge is fixed are called abutments and are covered with
crowns. The portion that replaces the missing tooth is called a pontic. According to the number of teeth involved and replaced, the
bridge is called a 3-unit, 4-unit, 5-unit, etc. bridge. (Courtesy B. Friedland, BDS.)
Dental Restorations

CBCT REFORMATS
Mucus retention pseudocyst
Periapical rarefying osteitis
Posts
Post and core

Porcelain fused to metal crown
Root canal overfill

Root apex
Post angled lingual to pulp canal
Porcelain crown
Cement
(Top) CBCT cropped panoramic reformat shows multiple root canal-treated teeth that have been restored with post and core
restorations followed by crowns. A core recreates proper crown preparation outline when tooth structure is inadequate to support
seating of the crown restoration. A post anchors the core to the root and should not extend more than 2/3 of the root length. Note
large mucus retention pseudocyst in left maxillary sinus. (Middle) CBCT sagittal section shows root canal overfill of the central incisor
with post and core not in line with the pulp canal. Perforation of the tooth structure with the post can occur during preparation of the
tooth. Root canal filling in the periapical tissues may be attached to the apex or may be dissociated from it. This foreign body may illicit
an inflammatory reaction with symptoms of pain, or it may be asymptomatic. (Bottom) CBCT panoramic reformat shows full porcelain
coverage crowns in the maxillary and mandibular 1st molars. These are cemented to the tooth with radiopaque cement.
Dental Restorations
CBCT REFORMATS
Glass ionomer cement

Cementoenamel junction
Split palatal suture
Rapid palatal expander
Orthodontic spacers
Orthodontic spacers
(Top) CBCT sagittal reformat shows a restoration of glass ionomer cement (GIC) in the buccal cervical region of this anterior tooth. GICs
are used to restore carious or tooth wear lesions that occur on the root surface of the tooth, or partially in enamel and partially in
dentin. (Middle) Coronal CBCT shows a rapid palatal expander, which is a type of fixed appliance that is used to quickly increase the
width of the maxillary arch by splitting the intermaxillary suture before puberty. It is cemented onto the posterior teeth of the patient.
(Bottom) Axial CBCT shows orthodontic separators (spacers) that are placed between the molars before fixed appliances, such as a
palatal expander or orthodontic bands, are applied. Spacers are circular rubber bands about a centimeter in diameter placed between
adjacent molars. There may be 1-12 spacers applied. The spacers stay between the teeth for 1-2 weeks and move the teeth apart slowly
until they are far apart enough so that the dentist can fit an orthodontic band in between them.
Dental Restorations

CBCT REFORMATS
Orthodontic brackets
Orthodontic archwire
Orthodontic band
Caries
Orthodontic band
Widening of lingual periodontal ligament

space
Orthodontic bracket
(Top) Axial CBCT shows a traditional fixed orthodontic appliance, which consists of brackets fixed to the facial surfaces of teeth, bands
that are cemented to 1 posterior tooth bilaterally, and archwire that is fixed to the brackets with elastic bands. Stainless steel archwire
is ferromagnetic, and metal hardware may cause degradation of image quality on MR. (Middle) Axial CBCT shows caries in a tooth with
an orthodontic band and bracket. Meticulous oral hygiene should be maintained for the duration of the orthodontic treatment to
prevent plaque accumulation and the development of caries. (Bottom) Orthodontic brackets are placed on the crown of the tooth, and
force is applied through the tightening of the orthodontic wire attached to them. With the movement of the teeth, widening of the
periodontal ligament (PDL) space along the surface of the tooth away from the direction of the movement of the root is commonly
seen. In this cross-sectional CBCT, the widening is noted on the lingual surface of the root due to the facial torquing of the root.
Dental Restorations
CBCT REFORMATS
Simulated implant
2 mm of facial alveolar bone thickness
1 mm of lingual alveolar bone thickness

Simulated crown
Facial aspect of implant not covered with

bone
Crown in contact with opposing crown
Implant centered in alveolar process
Crown on tilted abutment
(Top) CBCT 3D surface rendering shows implant planning for an edentulous maxillary anterior alveolar process. The simulated implant
is positioned in the alveolar process following several rules: The crown restoration should function against the opposing dentition, there
should be at least 2 mm of facial alveolar bone and 1 mm of lingual alveolar bone, and there should be 1.5- to 2.0-mm between the
implant and the adjacent teeth. The anatomy should be evaluated to prevent violation of vital anatomical structures. (Courtesy D.
Chenin, DDS.) (Middle) CBCT cross section of a central incisor implant that was positioned to bring the crown into contact with the
opposing teeth, but no ridge augmentation, was performed, resulting in no bone coverage on the facial aspect of the implant. (Bottom)
Sagittal CBCT shows an implant that was centered in the alveolar process but without considering the position of the final restoration.
A tilted abutment was used to bring the crown into occlusion (in this case, not biomechanically ideal for load distribution).
Dental Restorations

PERIAPICAL RADIOGRAPH AND CBCT REFORMATS
Bone level
Shadow of nose
Image of threads shows no blurring or

superimposition
Implant apex
Inferior alveolar canal
Implant apices in nasal cavity
(Top) Periapical radiograph of an implant replacing the left lateral incisor shows severe peri-implant bone loss, extending to the apical
portion of the implant. Vertical bitewings or periapical radiographs in which the central x-ray beams pass through the threads (resulting
in a crisp image of the threads) are ideal for evaluation of peri-implant bone loss, as metal artifact does not obscure evaluation on these
intraoral 2D imaging. (Middle) CBCT panoramic reformat shows the apex of an implant passing through the right inferior alveolar
canal. Cross-sectional reformations of the alveolar process are the gold standard during implant treatment planning to avoid violating
important anatomy. (Bottom) CBCT panoramic reformation shows maxillary anterior implants placed in the right and left nasal cavities.
Evaluation of the amount of bone present and its angulation in relation to the opposing dentition is necessary prior to placement of
implants to determine the need for alveolar process augmentation. (Courtesy T. Sawisch, DDS.)
Maxilla
– Alveolar bone is resorbed when tooth is lost

TERMINOLOGY
– Bone overlying tooth roots forms wave-like
Abbreviations eminences
• Maxilla (Mx) – Bulky part surrounding facial aspect of canine called
canine eminence
IMAGING ANATOMY – Concavity noted on facial surface mesial to canine
called incisive fossa (a.k.a. lateral fossa)
Overview
– Concavity noted on facial surface distal to canine
• Forms majority of midface skeleton and upper jaw called canine fossa
• Contains maxillary sinuses – Most posterior aspect called maxillary tuberosity
• There are 2 maxillae that fuse in midline (intermaxillary – Site of extracted tooth called tooth or extraction
suture) socket
• Presence of "premaxilla" in humans widely contested – Early tooth extractions may cause localized
○ Exists in early embryonic human development developmental hypoplasia
○ Disappears early by fusing to anterior aspect of maxillary • Innervation
bones ○ Infraorbital nerve
○ Has implications for cleft palate development – Continuation of V2
Anatomy Relationships – Passes anteriorly through infraorbital groove and
infraorbital canal and exits onto face via infraorbital
• Articulates with
foramen
○ Opposite Mx
– Gives rise to 2 alveolar branches: Middle superior and
○ Frontal, sphenoid, nasal, vomer, and ethmoid bones
anterior superior
○ Inferior nasal concha
○ Middle superior alveolar nerve
○ Palatine, lacrimal, and zygomatic bones
– May or may not be present
○ Septal and nasal cartilages
– As it descends to form superior dental plexus,
Internal Contents innervates part of maxillary sinus, premolars, and
• Maxillary bone mesiobuccal root of 1st molar, and gingiva and
mucosa of same teeth
○ Body
– Not usually visualized radiographically
– Major part of bone
○ Anterior superior alveolar nerve
– Pyramid-like shape
– As it descends to form superior dental plexus,
– Gives borders to 4 different regions: Orbit, nasal
innervates part of maxillary sinus, maxillary anterior
cavity, infratemporal fossa, middle 1/3 of face
teeth, and gingiva and mucosa of these teeth
– Infraorbital canal and foramen pass from orbit region
– Vertical component may be seen on coronals and
to face region
cross sections lateral to lateral wall of nasal cavity in
– Anterior nasal spine: Pointed prominence in midline
canine/premolar region
– Nasal notch: Concave rims lateral to anterior nasal
– Horizontal component may be seen on axials
spine that form floor of piriform aperture
extending from inferior aspect of vertical component
○ Frontal process
to midline
– Articulates superiorly with nasal, frontal, ethmoid, and
○ Posterior superior alveolar nerve
lacrimal bones
– Branch of V2
– Forms posterior boundary of lacrimal fossa and
– In infratemporal fossa: Passes on posterior surface of
houses lacrimal canal
Mx along region of maxillary tuberosity
○ Zygomatic process
– Gives rise to gingival branch that innervates buccal
– Articulates laterally with maxillary process of
gingiva alongside maxillary molars
zygomatic bone
– Enters posterior surface of Mx and supplies maxillary
○ Palatine process
sinus and maxillary molars, except mesiobuccal root of
– Extends medially to form majority of hard palate 1st molar
– Articulates with palatine process of opposite Mx in ○ Nasopalatine nerve (V2 sensory branch) travels from
midline superior portion of nasal cavity to nasal septum, then
– Articulates with horizontal plate of palatine bone travels anteroinferiorly to go through incisive
posteriorly (nasopalatine) canal and exit through incisive foramen
– Incisive foramen located anteriorly and may be in (foramen of Stenson)
midline or slightly shifted – Supplies sensory fibers to gingiva and mucosa of
– In axial plane, palate may be U shaped or V shaped anterior hard palate from central incisor to canine
(high palatal vault) – May be single, fused, paired, or have multiple canals ±
○ Alveolar process single large incisive canal
– Supports maxillary teeth – Canals located lateral to incisive foramen are called
– Extends inferiorly from Mx foramina of Scarpa
– Each maxillary bone normally contains 5 primary and ○ Greater palatine nerve descends palatine canal in
8 permanent teeth palatine bone
Another random document with
no related content on Scribd:
+ − Booklist 16:345 Jl ’20
“The novel as a whole is excessively chaotic and immature, an

obvious attempt at a youthful smartness which seems incapable of
artistic restraint. Mr Agate has been a wide reader, but he shows at
the present moment little power of assimilation.” E. F. E.
− + Boston Transcript p7 My 8 ’20 900w
“A first and promising novel.”
+ − Dial 69:102 Jl ’20 90w
“Undoubtedly Mr Agate has both talent and promise. Today he is

not an ageless portent but a beginner with very much to learn.”
− + Nation 110:772 Je 5 ’20 850w

New Repub 23:235 Jl 21 ’20 550w
“It is a sober-minded book, this novel of Mr Agate’s. But it is also a

very rich book, rich in character, in thought, in understanding, in
comment upon life and art, original in style and treatment. We are
much mistaken if Mr James E. Agate has not definitely ‘arrived.’”
+ N Y Times 25:252 My 16 ’20 600w
“The book is a hodge-podge.” H. W. Boynton
− Review 2:573 My 29 ’20 370w

“The genius of the book might as well be a grown man’s as a boy’s
—it is ageless as genius always is. But the faults—and they are grave
—are a young man’s or at any rate a young writer’s, faults. We should
plump for Mr Agate being, say, in the early thirties. We profoundly
hope that we are right, because we want many more books from him.
We do not ask for them to confirm our judgment, but because
English literature is starvingly in need of a new and still young first-
rate performer.”
+ − Sat R 128:535 D 6 ’19 1700w
“A novel which bears clear traces of models so diverse as Wells and

James and, perhaps, even the author of ‘Tristram Shandy.’ But such
strength as the novel possesses lies in what is simple and
straightforward. There are good glimpses of character.”
+ − Springf’d Republican p9a Jl 4 ’20 300w
“The great quality of the book is a manly and vigorous brilliance,

which is enough to supply ten ordinary novels; the chief faults are a
rhetorical exuberance of style and an inability to see that the reader
wants time to appreciate the really good passages, such as the page
where Edward’s father sends him to school or the illegitimate son’s
explanation of what moved him to join the army.”
+ − The Times [London] Lit Sup p629 N 6

’19 750w
AIKEN, CONRAD POTTER. House of dust; a
symphony. *$2 Four seas co. 811
21–968
A series of poems defining the delicate shadings of sense
perceptions. They correspond to the so-called “tone poems” of music.
Among the titles given to individual pieces are: The fulfilled dream;
Interlude; Nightmare; Retrospect; The box with silver handles;
Haunted chambers; Porcelain; Clairvoyant. Parts of the book have
appeared in the North American Review, Others, Poetry, Youth,
Coterie and the Yale Review.
“Mr Aiken possesses many poetical merits. He has a flow of

language that is refreshing in this age of meagrely trickling springs.
He has vivid sensations and a felicitous ease in exactly expressing
them. But he has the defects of his qualities. His facility is his
undoing; for he is content to go on pouring out melodious language—
content to go on linking image to bright image almost indefinitely.
One begins to long for clarity and firmness, for a glimpse of
something definite outside this golden haze.” A. L. H.
+ − Ath p235 Ag 20 ’20 440w

Nation 112:86 Ja 19 ’21 100w
“He is not easy to understand, and some minds would doubt

whether a drift of phenomena so irrational as this, however delicately
and imaginatively it is described, can be worth describing, except
from the point of view of scientific interest. That Mr Aiken’s work is
both delicate and imaginative, there is no question.”
+ − The Times [London] Lit Sup p554 Ag

26 ’20 170w
AIKEN, CONRAD POTTER. Scepticisms; notes
on contemporary poetry. *$2 (3c) Knopf 809.1
19–17334
For descriptive note see Annual for 1919.
“Mr Aiken is not quite a good enough talker; his gossip is

entertaining, but he has not the knack of telling a story well, of
putting an idea into a forcible and convincing form. A certain
diffuseness—it is noticeable, but to a lesser degree, in his poetry—
takes the edge and point off what he says; a fact that is the more
regrettable, since we believe his psychological methods of criticism to
be fundamentally sound and fruitful.” A. L. H.
+ − Ath p10 Ja 2 ’20 500w
“At times rather technical for the lay reader but worth while for all
interested in contemporary poetry.”
+ − Booklist 16:160 F ’20
“It makes good sedative reading after you have got tired of
Mencken, Cabell, Powys and some few others of the real brains of
America—in the matter of the essay, I mean.” Mary Terrill
− Bookm 51:194 Ap ’20 600w
“The poets and the books that he makes an intellectual flourish of

judging in the re-printed reviews which make up this volume have,
for the most part, their fundamental purposes and qualities befogged
and perverted by such critical charlatanry, no matter how brilliant
the execution may be. Often Mr Aiken makes a most convincing case
for or against a poet, but the average reader will be inclined to
discount his own agreement because he cannot be sure of the critic’s
motives.” W. S. B.
− + Boston Transcript p6 F 11 ’20 1300w
“One’s quarrel with Mr Aiken will be with his limits, not with his
accomplishment within his limits. What in most instances he sets out
to do, namely, to particularize (he says illuminate) with a careful
casualness, he certainly does well. It is because he has done so much
carefully that dissatisfaction arises at the incomplete significance of
the whole work.” C: K. Trueblood
+ − Dial 68:491 Ap ’20 2250w
“In so far as Mr Aiken’s lucid and discriminating opinions may

offset the mawkish and meaningless eulogy of ‘poeteering’
journalists, we may be unqualifiedly grateful to him. He does,
however, invite disagreement with his critical principles by
announcing them with excessive candor.” G: F. Whicher
+ − Nation 111:509 N 3 ’20 800w
“Mr Aiken’s book shows a nicely adjusted intellect at work,

weighing and measuring contemporary achievements, with whatever
degree of bias human nature can never escape, as he admits himself,
but with some degree of impartiality. He is chiefly interested in
aesthetic values. His style is adroit and sharp and restrained.”
Marguerite Wilkinson
+ − N Y Times 25:59 F 1 ’20 1050w
ALBERTSON, RALPH. Fighting without a war.

il *$1.50 (7c) Harcourt, Brace & Howe 947
20–4690
This “account of military intervention in north Russia” (Sub-title)

is given by a Y. M. C. A. secretary assigned to work with the army
landing at Murmansk, November 1918. He took part in every phase
of the campaign from the northernmost to the southernmost points
of the expedition and was the last American to leave. He is
scrupulously careful in handling army rumors and most of his matter
is based on his own personal observation and knowledge. On the
whole he considers intervention as a “bad job” on the part of the
governments who undertook it. “We organized civil war in Russia.
The Russians were not fighting the Bolsheviki—not our way. They
did not want to fight them—in our way. We made them. We
conscripted them to fight for their own freedom. It was difficult, but
we had our army there and the army made the peasant patriotic—our
way.” Contents: The expedition; The Archangel government;
Management; The fall campaign; The winter campaign; Kitsa;
Fighting without a flag; “America dobra”; America exit; The new
British army; The new Russian army; Making Bolsheviki; The white
man’s burden; Atrocities; The mutinies; The debâcle; Military
intervention finance; Propaganda; Concerning military intervention;
Concerning Russian peasants.
“Settles any lingering doubt about military intervention in Russia.”
+ Booklist 16:272 My ’20

“So amazing is the story of British arrogance, tactlessness, and
brutality in northern Russia, revealed by Ralph Albertson that it
would be well nigh impossible to accept it, if the trustworthiness of
the writer was not in a striking manner vouched for by the two
citations which he gained from the British.”
+ Nation 110:659 My 15 ’20 650w
Reviewed by A. C. Freeman
N Y Call p11 Ap 18 ’20 550w

+ R of Rs 61:557 My ’20 120w
“This little book of 140 pages, read at a sitting, but unforgettable

for many a day, is full of valuable information, all the most vital of
which was from his own personal and careful observation.” W. H.
Crook
+ Socialist R 8:380 My ’20 650w
Reviewed by Reed Lewis
+ Survey 44:51 Ap 3 ’20 100w
“The reading of the book helps to an understanding not only of the

Russian problem but of what British imperialism—or American—
always means in countries where a foreign army is in control.”
+ World Tomorrow 3:157 My ’20 400w

ALDERSON, VICTOR CLIFTON. Oil shale
industry. il *$4 Stokes 622
20–14240
The book heralds the birth of a new industry: the extracting of oil
from oil shale, which, in the face of our growing demand for oil, the
diminishing supply of underground oil, and the almost inexhaustible
supply of raw material in the form of oil shale, promises to be one of
paramount importance. Contents: The dawn of a new industry;
Nature, origin, and distribution of oil shale; The history of oil shale;
Mining oil shale; Retorting and reduction; Experimental and
research work; Economic factors; Summary; Opinions; The future;
Bibliography, index and illustrations.
“Not a finished work as far as statistics are concerned, but a good

survey of a comparatively new industry.”
+ Booklist 17:143 Ja ’21
“For a scientific work it is too uncritical and in such remarks as

‘mountains of shale’ it is reminiscent of a promoter’s prospectus. In
fact, the whole book is written with too much apparent intention to
see all the favorable points and to disregard the at present
unfavorable ones.”
− N Y Evening Post p27 O 23 ’20 230w
ALDON, ADAIR. At the sign of the Two Heroes.

il *$1.75 (3½c) Century
20–16500
The scene of this story for boys is laid on South Hero island, one of
the two islands in Lake Champlain that are named for Ethan and Ira
Allen. The old Frenchman, Pierre Lebeau, suggests to the three boy
campers, Christopher, Andrew and Howard, that they spend a night
in the deserted old inn that commands a view of the bay and
surrounding islands. He is under the stress of emotion and obviously
has a purpose in making the suggestion. Their curiosity aroused, they
take his advice and what they see and hear convinces them that
smuggling on a large scale is going on. They also learn the cause of
old Pierre’s emotion, for his scapegrace grandson is one of the
smugglers. The story tells how the three boys, animated by the spirit
of Ethan Allen, put an end to the law breaking.
“Keeps the interest and is not too improbable.”
+ Booklist 17:120 D ’20
“The background is well laid in and the story is full of ‘thrills’

having some really dramatic situations. A good tale of its type.”
+ N Y Evening Post p10 S 25 ’20 50w
Reviewed by Hildegarde Hawthorne
+ N Y Times p9 D 12 ’20 70w

+ Springf’d Republican p9a D 5 ’20 70w
Wis Lib Bul 16:197 N ’20 70w
ALDRICH, LILIAN (WOODMAN) (MRS
THOMAS BAILEY ALDRICH). Crowding
memories. il *$5 Houghton
20–19664
These reminiscences of the wife of a poet center about her

celebrated husband but are rich in pictures of other great personages
that she has intimately known, notably Edwin Booth, William Dean
Howells, Samuel L. Clemens, Robert Browning, James McNeill
Whistler, Julia Ward Howe, Charles Dickens. The book is well
illustrated and has an index.
+ Booklist 17:111 D ’20
“Mrs Aldrich’s memories are of superlative interest because of

both their subject matter and the great intimacy of their manner.” E.
F. Edgett
+ Boston Transcript p4 O 9 ’20 1500w
“The author’s stilted phrasing, trite similes, and thinly veiled

snobbery offer a melancholy contrast to the easy-flowing naturalness
and genial democracy of her gifted husband. Nevertheless, ‘Crowding
memories’ is a valuable book because of the deep and abiding
interest of many of the figures who appear in it.” A. R. H.
+ − Freeman 2:454 Ja 19 ’21 290w

“She has not produced a quite independent volume, for she quotes
from Mr Greenslet’s book at considerable length and uses excerpts
from Aldrich’s semi-autobiographical writings to complete the
structure of her narrative. Nor has she the special gift of the great
memoir writer, that easy command of detail which gives its solid
reward in social documentations. But as a casual record of certain
trivialities ‘Crowding memories’ is something of a social document.”
C. M. Rourke
+ − New Repub 25:175 Ja 5 ’21 1300w
Reviewed by Brander Matthews
+ N Y Times p6 O 31 ’20 2300w
“Even in unskillful hands the result would have been useful, and
Mrs Aldrich has handled the rich material with good judgment and
much insight, making a total that is always interesting, and often
enlightening, entitling it to a definite place in our literary chronicles.”
+ Review 3:505 N 24 ’20 1000w

+ R of Rs 62:669 D ’20 120w
+ Springf’d Republican p10 O 13 ’20 940w
+ Wis Lib Bul 16:236 D ’20 80w
ALEICHEM, SHALOM. Jewish children;

authorized tr. from the Yiddish by Hannah Berman.
*$2 Knopf
20–26870
“Nineteen stories by one of the best known of contemporary

Hebrew novelists and journalists, the Russian Shalom Rabinowitz
(‘Shalom Aleichem’): picturing with a vividness and intimacy which
has gained him the name of ‘the Yiddish Dickens’ the life of Jewish
children in the villages and small towns of the Russian pale.”—The
Times [London] Lit Sup F 26 ’20
“They are written with a terse, beautiful simplicity. An especial

appeal for those who recognize the truth of the picture.”
+ Booklist 17:70 N ’20
“Undoubted power of camera-like observation, the God-given

genius for interpretation of the sorrows and sadness of life so surely
a heritage of Jew, Irish or Russian, help make this little volume a
delight.”
+ Bookm 52:174 O ’20 120w

+ Cleveland p108 D ’20 40w
“Studies at once tentative and precocious, executed with a rare

economy and a vivid understanding. Moods are evoked as if by the
striking of a chord; the effect is instantaneous and sharp, yet
softened with queer overtones of feeling.”
+ Dial 69:547 N ’20 50w

“‘Shalom Aleichem,’ speaking generally is a humorist, and often
broadly so. Instances could be cited in which a verbal audacity,
almost a horseplay in phrasing, stands out as his most striking
characteristic.” C. K. Scott
+ Freeman 2:45 S 22 ’20 500w
“Perhaps the best quality of these stories is their humor, and such
characters as Isshur the Beadle and Boaz the Teacher do, indeed,
allowing for less breadth and vigor, justify the comparison of
Rabinowitz with Dickens that has been made.”
+ Nation 111:353 S 25 ’20 180w

+ Spec 124:588 My 1 ’20 50w
The Times [London] Lit Sup p142 F 26
’20 50w
“It is difficult to determine whether without the species of prestige

conferred by unfamiliarity of subject and idiom, the spice of
strangeness imparted by the mere fact of translation, the book would
arouse much more than curiosity. It is a collection of incidents in the
lives of Russian Jewish children, told with perhaps too unrestrained
a fluency, as the matter is usually of the slightest, but with a
pervading kindness, an unshakable good humour, a pleasant if not
inspired drollery, that enlist one’s sympathy.”
+ − The Times [London] Lit Sup p264 Ap

29 ’20 290w
[2]
ALEXANDER, HARTLEY BURR. Latin
American [mythology]. (Mythology of all races) il *$7
Jones, Marshall 299
20–16109
“The present volume follows the general plan [of the series]. The
author has aimed at a descriptive treatment following regional
divisions, directed to essential conceptions rather than exhaustive
classification.” (Booklist) “The book includes the Antilles, Mexico,
Yucatan, Central America, the Andes (North and South), the tropical
forests, the Orinoco and Guiana, the Amazon and Brazil, and finally,
the pampas to the Land of fire. The notes and bibliography comprise
almost a fifth of the volume. More than forty illustrations add to the
interest of a text that really illustrates itself.” (Bookm)
Booklist 17:47 N ’20
“The book is more than a succinct history. It embodies the poetry

of ancient days and the cruelty and the splendor of ancient ways,
without abandoning the calm attitude that wards the scientist from
hasty or sentimental judgments.” I: Goldberg
+ Bookm 52:365 D ’20 560w

[2]
ALLEN, ARTHUR WATTS. Handbook of ore
dressing, equipment and practice. il *$3 McGraw
622.7
20–6647
“The book aims to supply a handy and practical vade mecum for
millmen and engineers, covering in condensed form the various
stages in the mechanical handling and preparation of ore for
metallurgical treatment. Good drawings and half-tone illustrations.
Bibliography of 86 references.”—N Y P L New Tech Bks
+ Booklist 17:96 D ’20

+ N Y P L New Tech Bks p62 Jl ’20 40w
ALLEN, FREDERICK JAMES. Advertising as a

vocation. *$2 Macmillan 659
19–17750
“This book by Mr Allen of the Bureau of vocational guidance of

Harvard university is intended to place the subject of advertising as a
vocation especially before that part of the public concerned with the
choosing of a vocation. It is an extensive exposition of the field of
advertising, the emoluments, the qualities needed for it as a vocation,
and a thorough investigation of the various fields. It considers
advertising as a business rather than as a profession, since in the
main it is connected with the trades, and it aims to show the future of
advertising as an important element in the choosing of a life work.”—
Boston Transcript
“Sets a high standard. Excellent bibliography.”
+ Booklist 16:191 Mr ’20

Boston Transcript p6 Ja 17 ’20 250w
Brooklyn 12:100 Mr ’20 30w
ALLEN, NELLIE BURNHAM. New Europe.

(Geographical and industrial studies) il $1 Ginn 914
20–4490
This volume is a revision of the book issued in 1913 with the title
“Europe.” It has been revised and partly rewritten to conform to
changes growing out of the war. New chapters have been added on:
Ireland and the linen industry; The brave little country of Belgium;
Finland and Lapland; The country of Poland, and The countries of
the Balkan peninsula.
Booklist 17:79 N ’20
ALLEN, STEPHEN HALEY. International

relations. *$5 Princeton univ. press 327
20–5637
“The reader will find here in outline the ancient and modern
conceptions of a nation, and especially a clear statement of what has
been done to regulate international intercourse by conventions,
efforts to prevent war by arbitration and mediation and to mitigate
the barbarities of war when it does come. Included in the volume are
the documents representing the important general conventions that
were in force at the outbreak of the great war, and in conclusion the
peace treaty itself and the constitution of the League of nations are
presented.”—R of Rs
Booklist 17:8 O ’20

+ R of Rs 61:669 Je ’20 120w
ALLISON, WILLIAM. My kingdom for a horse!

*$8 Dutton
“The recollections of one who has had so varied a career as Mr

William Allison cannot fail to be interesting. His pages cover a great
variety of ground, life in Yorkshire in the middle of the last century,
Rugby in the ‘sixties, Balliol in the ‘seventies, the bar, horse racing,
and the selling of blood stock, breeding of fox terriers, political and
society journalism, editorship, and special commissionership in the
Sportsman—a multitude of memories, in fine, with fluctuations of
fortune to give a savour to the whole.”—The Times [London] Lit Sup
“Well charged with readable gossip.”
+ Ath p962 S 26 ’19 50w

“The ordinary reader will wish that his own interest had been a
little more consulted by omitting many of these equine records. He
will wish, too, that Mr Allison had not been so generous in quoting
from his voluminous correspondence. Barring this overplus, we think
the author too modest in describing his memoirs as a ‘farrago of
insignificant events.’”
+ − Review 3:655 D 29 ’20 450w
“His book shows quite exceptional familiarity with the

thoroughbred, set forth in English free—though split infinitives are
to be counted against him—from the distressing phraseology
common to most men who write about racing.”
+ Sat R 128:365 O 18 ’19 900w
“His digressions are rather bewildering and his arguments not all
strictly convincing. When Mr Allison gives himself, as he rarely does,
the time to describe something with enthusiasm, William Hickey
himself could do no better.”
+ − The Times [London] Lit Sup p512 S 25

’19 1600w
ALLISON, WILLIAM. Secret of the sea. il *$1.75

(2c) Doubleday
20–6428
The story has evidently been suggested by Poe’s “The murders in
the rue Morgue.” An American millionaire’s pleasure yacht, touring
on the Mediterranean, encounters a derelict yacht, fitted up most
luxuriously with every evidence of recent occupancy but not a soul on
board. Here’s mystery, and Peter Knight, the millionaire’s secretary
and lover of his daughter, Betty, sets himself to unravel it. His rôle as
detective proves full of danger but brings to light much past history
and romance. An Italian duke of fabulous wealth is discovered to
have been the owner of the yacht, and Peter Knight’s father—and
thereby hangs a tale of dark plots and poison cups worthy of the
middle ages. The outcome of this tale would have been a different
one had not a baboon, one of the yacht’s inmates, taken a hand in it
to do some of the murdering on his own account. Peter himself
barely escapes with his own life, but in doing so is enabled to rescue
his beloved Betty who has in the meanwhile fallen into the clutches
of the same criminal family.
“A mystery yarn, fantastic and impossible, but quite readable.”
+ − Booklist 16:280 My ’20
“A well-conceived and engaging mystery tale.”
+ Springf’d Republican p11a Ag 1 ’20

280w
ALLISON, WILLIAM. Turnstile of night. il

*$1.90 (2c) Doubleday
This tale of mystery begins in India where three white men

combine in a successful attempt to gain possession of some priceless
diamonds worn as the “breastplate of the seven stars” by an idol in a
temple of Buddha. Then the scene shifts to England; two of the
treasure seekers are dead, by fair means or foul, and the third is
trying to keep for himself the whole treasure, part of which belongs
in reality to Honour Brooke, daughter of the one, and Ronald
Charteris, nephew of the other adventurer. Loris St Leger, the villain,
aided by his wicked old uncle, and using his beautiful cousin as his
tool, stops at nothing, and as Honour and Ronald are entirely
ignorant of his game or his reasons for playing it, he soon has them
completely in his power. But there are some influences at work that
he has no knowledge of, which are acting against him, and in the end
his evil purposes are defeated, after many harrowing experiences for
Honour and Ronald.
“Unfortunately the bright promise of the earlier chapters is not

fulfilled. There are thrills and mystery a-plenty, but the author takes
too long in expounding them and by the time they are cleared up
they have ceased to thrill.”
+ − N Y Evening Post p10 O 30 ’20 70w
“In spite of the story being such a jumble, the writing evidently is
that of a trained hand, for the sentences are neatly put together and
the author is not devoid of descriptive power. Readers who enjoy
hurrying along from one disconnected incident to another and who
like a long story will probably find this one to their taste.”
+ − N Y Times p24 D 26 ’20 500w

Springf’d Republican p9a O 31 ’20 120w

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Diagnostic Imaging : Oral And

Maxillofacial. 2nd Edition Lisa J. Koenig

Diagnostic Imaging: Obstetrics 4th Edition Paula J.

Advances in Oral and Maxillofacial Surgery 1st Edition

Diagnostic Imaging Oncology 2nd Edition Akram M.

Orthodontics for the Oral and Maxillofacial Surgery

Primer of diagnostic imaging Sixth Edition Chen - eBook

Diagnostic Imaging Genitourinary 4th Edition Ganeh

Diagnostic Imaging Gastrointestinal 4th Edition Atif

Diagnostic Imaging: Gynecology 3rd Edition Akram M.

Lisa J. Koenig, BChD, DDS, MS

Dania Tamimi, C. Grace Petrikowski, Susanne E. Perschbacher,

DIAGNOSTIC IMAGING: ORAL AND MAXILLOFACIAL, SECOND EDITION ISBN: 978-0-323-47782-6

Copyright © 2017 by Elsevier. All rights reserved.

Publisher Cataloging-in-Publication Data

International Standard Book Number: 978-0-323-47782-6

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Thank you to my parents for encouraging me to pursue a career in dentistry during a

To my teachers: For showing me the path.

Lisa J. Koenig, BChD, DDS, MS

Art Direction and Design

Part II: Diagnoses

Part III: Differential Diagnoses

Part I: Anatomy SECTION 5: CRANIAL NERVES

SECTION 4: BASE OF SKULL

MISCELLANEOUS PERIOSTEAL REACTIONS

Part III: Differential Diagnoses SECTION 3: ORAL CAVITY

• Position is described in relation to

Anatomy: Oral Cavity

Oral epithelium arising from

Permanent tooth bud

Hertwig root sheath

Outer enamel epithelium

Dentin matrix Forming periodontal ligaments

Epithelial rests of Malassez

Anatomy: Oral Cavity

Fusion of reduced enamel

Tissue disintegration Erupting tooth cusp

Initial junctional epithelium

Developing maxillary canine

Developing mandibular canine

TEETH NOMENCLATURE AND ERUPTION AGES

Maxillary central incisor (7-8

Maxillary 2nd molar (12 years)

Maxillary 3rd molar (17-21

Mandibular 3rd molar (17-21

Mandibular 2nd molar (12

Mandibular lateral incisor (7-8 Mandibular 2nd premolar (10-

Anatomy: Oral Cavity

Permanent 1st molar

Permanent central incisor

Primary 1st molar

Permanent 1st molars Permanent 1st molars

3rd molar follicles 3rd molar follicles

Dentin Dentinoenamel junction

Cementoenamel junction Pulp chamber

Periodontal ligament space

Buccal plate Lingual plate

Pulp canal Alveolar bone adjacent to

Inferior alveolar canal

Crest of alveolar bone (crestal

Nutrient canal Apical foramen

Anatomy: Oral Cavity